Finnish Institute for Health and Welfare, Helsinki, Finland.
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
J Med Internet Res. 2022 Aug 17;24(8):e38714. doi: 10.2196/38714.
In health care, the benefits of digitalization need to outweigh the risks, but there is limited knowledge about the factors affecting this balance in the work environment of physicians. To achieve the benefits of digitalization, a more comprehensive understanding of this complex phenomenon related to the digitalization of physicians' work is needed.
The aim of this study was to examine physicians' perceptions of the effects of health care digitalization on their work and to analyze how these perceptions are associated with multiple factors related to work and digital health usage.
A representative sample of 4630 (response rate 24.46%) Finnish physicians (2960/4617, 64.11% women) was used. Statements measuring the perceived effects of digitalization on work included the patients' active role, preventive work, interprofessional cooperation, decision support, access to patient information, and faster consultations. Network analysis of the perceived effects of digitalization and factors related to work and digital health usage was conducted using mixed graphical modeling. Adjusted and standardized regression coefficients are denoted by b. Centrality statistics were examined to evaluate the relative influence of each variable in terms of node strength.
Nearly half of physicians considered that digitalization has promoted an active role for patients in their own care (2104/4537, 46.37%) and easier access to patient information (1986/4551, 43.64%), but only 1 in 10 (445/4529, 9.82%) felt that the impact has been positive on consultation times with patients. Almost half of the respondents estimated that digitalization has neither increased nor decreased the possibilities for preventive work (2036/4506, 45.18%) and supportiveness of clinical decision support systems (1941/4458, 43.54%). When all variables were integrated into the network, the most influential variables were purpose of using health information systems, employment sector, and specialization status. However, the grade given to the electronic health record (EHR) system that was primarily used had the strongest direct links to faster consultations (b=0.32) and facilitated access to patient information (b=0.28). At least 6 months of use of the main EHR was associated with facilitated access to patient information (b=0.18).
The results highlight the complex interdependence of multiple factors associated with the perceived effects of digitalization on physicians' work. It seems that a high-quality EHR system is critical for promoting smooth clinical practice. In addition, work-related factors may influence other factors that affect digital health success. These factors should be considered when developing and implementing new digital health technologies or services for physicians' work. The adoption of digital health is not just a technological project but a project that changes existing work practices.
在医疗保健领域，数字化的好处必须超过风险，但对于医生工作环境中影响这种平衡的因素知之甚少。为了实现数字化的好处，需要更全面地了解与医生工作数字化相关的这种复杂现象。
本研究旨在调查医生对医疗数字化对其工作的影响的看法，并分析这些看法与工作和数字健康使用相关的多种因素之间的关联。
使用了具有代表性的 4630 名（回应率 24.46%）芬兰医生（2960/4617，64.11%为女性）的样本。衡量数字化对工作影响的指标包括患者的积极作用、预防工作、跨专业合作、决策支持、获取患者信息和更快的咨询。使用混合图形建模对数字化的感知效果以及与工作和数字健康使用相关的因素进行网络分析。调整和标准化回归系数表示为 b。中心性统计用于评估每个变量在节点强度方面的相对影响。
近一半的医生认为数字化促进了患者在自身护理中的积极作用（4537 人中的 2104 人，占 46.37%）和更容易获取患者信息（4551 人中的 1986 人，占 43.64%），但只有 1/10（4529 人中的 445 人，占 9.82%）的人认为数字化对与患者的咨询时间产生了积极影响。近一半的受访者估计，数字化既没有增加也没有减少预防工作（4506 人中的 2036 人，占 45.18%）和临床决策支持系统的支持性（4458 人中的 1941 人，占 43.54%）的可能性。当将所有变量整合到网络中时，最具影响力的变量是使用健康信息系统的目的、就业部门和专业状态。然而，主要使用的电子健康记录（EHR）系统的评级与更快的咨询（b=0.32）和更方便地获取患者信息（b=0.28）之间存在直接联系。至少使用主要 EHR 6 个月与更方便地获取患者信息有关（b=0.18）。
研究结果强调了与医生工作数字化的感知效果相关的多种因素的复杂相互依存关系。似乎高质量的 EHR 系统对于促进顺畅的临床实践至关重要。此外，工作相关因素可能会影响影响数字健康成功的其他因素。在为医生的工作开发和实施新的数字健康技术或服务时，应考虑这些因素。采用数字健康不仅仅是一个技术项目，而是一个改变现有工作实践的项目。
