Health Services Research Unit, Singapore General Hospital, Singapore, Singapore.
Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.
JMIR Hum Factors. 2024 Aug 27;11:e51972. doi: 10.2196/51972.
Digital technologies have impacted health care delivery globally, and are increasingly being deployed in clinical practice. However, there is limited research on patients' expectations of doctors' clinical competencies when using digital health care technologies (DHTs) in medical care. Understanding these expectations can reveal competency gaps, enhance patient confidence, and contribute to digital innovation initiatives.
This study explores patients' perceptions of doctors' use of DHTs in clinical care. Using Singapore as a case study, it examines patients' expectations regarding doctors' communication, diagnosis, and treatment skills when using telemedicine, health apps, wearable devices, electronic health records, and artificial intelligence.
Findings were drawn from individual semistructured interviews with patients from outpatient clinics. Participants were recruited using purposive sampling. Data were analyzed qualitatively using thematic analysis.
Twenty-five participants from different backgrounds and with various chronic conditions participated in the study. They expected doctors to be adept in handling medical data from apps and wearable devices. For telemedicine, participants expected a level of assessment of their medical conditions akin to in-person consultations. In addition, they valued doctors recognizing when a physical examination was necessary. Interestingly, eye contact was appreciated but deemed nonessential by participants across all age bands when electronic health records were used, as they valued the doctor's efficiency more than eye contact. Nonetheless, participants emphasized the need for empathy throughout the clinical encounter regardless of DHT use. Furthermore, younger participants had a greater expectation for DHT use among doctors compared to older ones, who preferred DHTs as a complement rather than a replacement for clinical skills. The former expected doctors to be knowledgeable about the algorithms, principles, and purposes of DHTs such as artificial intelligence technologies to better assist them in diagnosis and treatment.
By identifying patients' expectations of doctors amid increasing health care digitalization, this study highlights that while basic clinical skills remain crucial in the digital age, the role of clinicians needs to evolve with the introduction of DHTs. It has also provided insights into how DHTs can be integrated effectively into clinical settings, aligning with patients' expectations and preferences. Overall, the findings offer a framework for high-income countries to harness DHTs in enhancing health care delivery in the digital era.
数字技术已在全球范围内对医疗服务产生影响，并越来越多地应用于临床实践。然而，关于患者在医疗中使用数字医疗保健技术（DHT）时对医生临床能力的期望，相关研究有限。了解这些期望可以揭示能力差距，增强患者信心，并为数字创新举措做出贡献。
本研究探讨了患者对医生在临床护理中使用 DHT 的看法。本研究以新加坡为例，考察了患者对医生在使用远程医疗、健康应用程序、可穿戴设备、电子健康记录和人工智能时的沟通、诊断和治疗技能的期望。
研究结果来自于对门诊患者的个别半结构化访谈。参与者是通过目的性抽样招募的。数据使用主题分析进行定性分析。
本研究共招募了来自不同背景和患有各种慢性疾病的 25 名参与者。他们期望医生能够熟练处理来自应用程序和可穿戴设备的医疗数据。对于远程医疗，参与者期望医生对他们的病情进行评估，其水平与面对面咨询相当。此外，他们希望医生在需要时进行体格检查。有趣的是，在使用电子健康记录时，参与者在各个年龄段都欣赏眼神交流，但认为其非必要，因为他们更看重医生的效率而非眼神交流。然而，无论是否使用 DHT，参与者都强调在整个临床过程中需要有同理心。此外，年轻参与者比年长参与者更期望医生使用 DHT，而年长参与者则更喜欢将 DHT 作为临床技能的补充，而非替代。前者期望医生了解人工智能等 DHT 的算法、原理和用途，以便更好地帮助他们进行诊断和治疗。
通过在医疗保健数字化日益普及的情况下确定患者对医生的期望，本研究强调，尽管基本临床技能在数字时代仍然至关重要，但随着 DHT 的引入，临床医生的角色需要发生演变。它还为如何在临床环境中有效整合 DHT 提供了思路，使它们与患者的期望和偏好保持一致。总体而言，研究结果为高收入国家在数字时代利用 DHT 提高医疗服务提供了框架。
