Abstract
BackgroundDespite a growing body of knowledge about eHealth innovations, there is still limited understanding of the implementation of such tools in everyday primary care.ObjectiveThe objective of our study was to describe health care staff’s experience with a digital communication system intended for patient-staff encounters via a digital route in primary care.MethodsIn this qualitative study we conducted 21 individual interviews with staff at 5 primary care centers in Sweden that had used a digital communication system for 6 months. The interviews were guided by narrative queries, transcribed verbatim, and subjected to content analysis.ResultsWhile the digital communication system was easy to grasp, it was nevertheless complex to use, affecting both staffing and routines for communicating with patients, and documenting contacts. Templates strengthened equivalent procedures for patients but dictated a certain level of health and digital literacy for accuracy. Although patients expected a chat to be synchronous, asynchronous communication was extended over time. The system for digital communication benefited assessments and enabled more efficient use of resources, such as staff. On the other hand, telephone contact was faster and better for certain purposes, especially when the patient’s voice itself provided data. However, many primary care patients, particularly younger ones, expected digital routes for contact. To match preferences for communicating to a place and time that suited patients was significant; staff were willing to accept some nuisance from a suboptimal service—at least for a while—if it procured patient satisfaction. A team effort, including engaged managers, scaffolded the implementation process, whereas being subjected to a trial without likely success erected barriers.ConclusionsA digital communication system introduced in regular primary care involved complexity beyond merely learning how to manage the tool. Rather, it affected routines and required that both the team and the context were addressed. Further knowledge is needed about what factors facilitate implementation, and how. This study suggested including ethical perspectives on eHealth tools, providing an important but novel aspect of implementation.
Highlights
BackgroundIn many countries, primary care providers struggle to meet the needs and demands of increasing numbers of patients seeking their services [1]
A digital communication system introduced in regular primary care involved complexity beyond merely learning how to manage the tool
We interviewed health care staff about halfway into the 1-year pilot period following a regional decision to test the digital communication system
Summary
Primary care providers struggle to meet the needs and demands of increasing numbers of patients seeking their services [1]. In this case, primary care implies the entry point or opening contact with health care, provided by outpatient services located within the community but organized by the regional or a private health care organization. The implementation process of eHealth innovations has attracted limited attention, despite its importance for progress [5]. Despite a growing body of knowledge about eHealth innovations, there is still limited understanding of the implementation of such tools in everyday primary care
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have