National Healthcare Group Polyclinics, Singapore, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
J Med Internet Res. 2024 Oct 15;26:e53705. doi: 10.2196/53705.
Digital health has become essential for effective clinical practice. However, the successful adoption of digital health is dependent on the strength of the patient-physician relationship. The patient-physician relationship shapes the quality of care and impacts health care outcomes, especially in primary care. However, the impact of the increasing use of digital health on the patient-physician relationship is uncertain.
This study aims to explore the types of digital health primary care physicians use and understand their impact on the patient-physician relationship from their perspective.
This exploratory qualitative descriptive study used individual in-depth interviews guided by a semistructured topic guide. We purposively sampled physicians from 6 general primary care clinics in Singapore and used thematic analysis to identify emergent themes.
We conducted 12 interviews. We found that primary care physicians in Singapore had minimal exposure to digital health beyond the scope of institutional implementation. The three key themes that emerged were as follows: (1) evolving roles of both physicians and patients; (2) impact on trust, knowledge acquisition, and longitudinal care; and (3) adoption and use factors of digital health impacting patient-physician relationships. The adoption and use factors comprised "social and personal," "technical and material," and "organization and policy" factors.
The study identified that, while primary care physicians held mostly positive views on adopting digital health in improving the patient-physician relationship, they were concerned that digital health might erode trust, hinder proper knowledge acquisition, and reduce humanistic interaction. These concerns called for a nuanced approach to ensure that digital health would not compromise the patient-physician relationship. This could be achieved by ensuring that physicians possess the necessary skills, knowledge, and positive attitude, while health care organizations would provide robust IT capabilities and support. We recommend that education be refined and government policies on digital health adoption and use be revised to align with the goal of strengthening the patient-physician relationship.
数字健康已成为有效临床实践的必要条件。然而，数字健康的成功采用取决于医患关系的强弱。医患关系塑造了医疗质量并影响了医疗保健结果，尤其是在初级保健中。然而，数字健康的使用日益增加对医患关系的影响尚不确定。
本研究旨在探讨初级保健医生使用的数字健康类型，并从他们的角度了解其对医患关系的影响。
这是一项采用半结构式主题指南指导的探索性定性描述研究。我们从新加坡 6 家普通初级保健诊所中有意选择医生进行个体深入访谈，并使用主题分析来确定出现的主题。
我们进行了 12 次访谈。我们发现，新加坡的初级保健医生对数字健康的接触仅限于机构实施范围。出现的三个关键主题如下：（1）医患双方角色的演变；（2）对信任、知识获取和纵向护理的影响；（3）影响医患关系的数字健康采用和使用因素。这些采用和使用因素包括“社会和个人”、“技术和物质”和“组织和政策”因素。
该研究表明，尽管初级保健医生在采用数字健康改善医患关系方面持有较为积极的观点，但他们担心数字健康可能会破坏信任、阻碍适当的知识获取，并减少人文互动。这些担忧需要采取细致的方法来确保数字健康不会损害医患关系。这可以通过确保医生具备必要的技能、知识和积极的态度来实现，同时医疗保健组织将提供强大的 IT 能力和支持。我们建议完善教育，并修订有关数字健康采用和使用的政府政策，以符合加强医患关系的目标。
