Wessex Academic Health Science Network, Southampton, UK.
R-Outcomes Ltd, Newbury, UK
BMJ Open Qual. 2022 Jun;11(2). doi: 10.1136/bmjoq-2022-001865.
Our aim was to understand how digital readiness within general practice varies between different technologies and to identify how demographic, workplace and external factors affect this. The technologies considered include electronic patient records, telehealth (text messaging and video consultations), patient online access, patient clinical apps and wearables, and social media.
A digital readiness survey tool was developed and used in one area of southern England during Spring 2020. Semistructured qualitative interviews were also carried out with some practice staff and digital technology company representatives.
GPs, nurses and non-clinical staff submitted 287 responses from 27 general practices (out of 33 invited).Staff digital readiness differs significantly between technologies. The mean perceived digital competency scores on 0-100 scale (high is good) were electronic patient records (75.7), telehealth (64.2), patient online access (65.8), patient clinical apps and wearables (50.8), and social media (51.2).Younger general practice staff, those in post for 5 or less years are more digitally competent and confident than older staff. This applies to both clinical and non-clinical staff. Older patient population, rurality and smaller practice size are associated with lower digital readiness. Readiness to use digital technology may have improved since the start of the COVID-19 pandemic but barriers remain in poor IT and mobile infrastructure, software usability and interoperability, and concerns about information governance.
Improving digital readiness in general practice is complex and multifactorial. Issues may be alleviated by using dedicated digital implementation teams and closer collaboration between stakeholders (GPs and their staff, patients, funders, technology companies and government).
我们的目的是了解一般实践中不同技术的数字准备情况,并确定人口统计学、工作场所和外部因素如何影响这一点。所考虑的技术包括电子患者记录、远程医疗(短信和视频咨询)、患者在线访问、患者临床应用程序和可穿戴设备以及社交媒体。
在 2020 年春季,我们在英格兰南部的一个地区开发并使用了数字准备情况调查工具。还对一些实践工作人员和数字技术公司代表进行了半结构化定性访谈。
从 33 家受邀的诊所中,有 27 家诊所的 287 名全科医生、护士和非临床人员提交了回复。员工的数字准备情况因技术而异。0-100 分制的感知数字能力得分平均值(高表示优秀)分别为电子患者记录(75.7)、远程医疗(64.2)、患者在线访问(65.8)、患者临床应用程序和可穿戴设备(50.8)以及社交媒体(51.2)。较年轻的全科医生和工作不满 5 年的人员比年长的人员更有数字能力和信心。这适用于临床和非临床人员。老年患者群体、农村地区和较小的实践规模与较低的数字准备情况相关。自 COVID-19 大流行开始以来,使用数字技术的准备情况可能有所改善,但仍然存在 IT 和移动基础设施较差、软件可用性和互操作性以及信息治理问题等障碍。
提高一般实践中的数字准备情况是复杂且多方面的。通过使用专门的数字实施团队以及利益相关者(全科医生及其工作人员、患者、资助者、技术公司和政府)之间更紧密的合作,可以缓解这些问题。