Barriers and facilitators to use of digital health tools by healthcare practitioners and their patients, before and during the COVID-19 pandemic: a multimethods study

Objectives To explore how healthcare practitioners (HCPs) made decisions about the implementation of digital health technologies (DHTs) in their clinical practice before and during the COVID-19 pandemic.Design A multimethods study, comprising semistructured interviews conducted prior to the COVID-19...

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Main Authors: Barbora Silarova, Charlotte Dack, Ben Ainsworth, Sabrina Grant, Gemma Lasseter, Sophie Louise Turnbull, Jiedi Lei, Irem Aksu
Format: Article
Language:English
Published: BMJ Publishing Group 2024-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/3/e080055.full
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author Barbora Silarova
Charlotte Dack
Ben Ainsworth
Sabrina Grant
Gemma Lasseter
Sophie Louise Turnbull
Jiedi Lei
Irem Aksu
author_facet Barbora Silarova
Charlotte Dack
Ben Ainsworth
Sabrina Grant
Gemma Lasseter
Sophie Louise Turnbull
Jiedi Lei
Irem Aksu
author_sort Barbora Silarova
collection DOAJ
description Objectives To explore how healthcare practitioners (HCPs) made decisions about the implementation of digital health technologies (DHTs) in their clinical practice before and during the COVID-19 pandemic.Design A multimethods study, comprising semistructured interviews conducted prior to the COVID-19 pandemic, supplemented with an online survey that was conducted during the pandemic with a different sample, to ensure the qualitative findings remained relevant within the rapidly changing healthcare context. Participants were recruited through HCP networks, snowballing and social media. Data were analysed thematically.Setting Phone interviews and online survey.Participants HCPs represented a range of professions from primary and secondary care across England, with varied socioeconomic deprivation.Results 24 HCPs were interviewed, and 16 HCPs responded to the survey. In the interviews, HCPs described three levels where decisions were made, which determined who would have access to what DHTs: health organisation, HCP and patient levels. These decisions resulted in the unequal implementation of DHTs across health services, created barriers for HCPs using DHTs in their practice and influenced HCPs’ decisions on which patients to supply DHTs with. In the survey, HCPs described being provided support to overcome some of the barriers at the organisation and HCP level during the pandemic. However, they cited similar concerns to pre-pandemic about barriers patients faced using DHTs (eg, digital literacy). In the absence of centralised guidance on how to manage these barriers, health services made their own decisions about how to adapt their services for those who struggled with DHTs.Conclusions Decision-making at the health organisation, HCP and patient levels influences inequalities in access to DHTs for HCPs and patients. The mobilisation of centralised information and resources during the pandemic can be viewed as good practice for reducing barriers to use of DHTs for HCPs. However, attention must also be paid to reducing barriers to accessing DHTs for patients.
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spelling doaj-art-75dd8e126d8a49ca90a955b6f9c271b42025-08-20T03:12:39ZengBMJ Publishing GroupBMJ Open2044-60552024-03-0114310.1136/bmjopen-2023-080055Barriers and facilitators to use of digital health tools by healthcare practitioners and their patients, before and during the COVID-19 pandemic: a multimethods studyBarbora Silarova0Charlotte Dack1Ben Ainsworth2Sabrina Grant3Gemma Lasseter4Sophie Louise Turnbull5Jiedi Lei6Irem Aksu7Personal Social Services Research Unit, University of Kent, Canterbury, UKDepartment of Psychology, University of Bath, Bath, UKUniversity of Southampton, Southampton, UK1 Respiratory, Calderdale Royal Hospital, Halifax, West Yorkshire, UKUniversity of Bristol, Bristol, UKUniversity of Bristol, Bristol, UKKing`s College London, London, UKDepartment of Psychology, City University of London, London, UKObjectives To explore how healthcare practitioners (HCPs) made decisions about the implementation of digital health technologies (DHTs) in their clinical practice before and during the COVID-19 pandemic.Design A multimethods study, comprising semistructured interviews conducted prior to the COVID-19 pandemic, supplemented with an online survey that was conducted during the pandemic with a different sample, to ensure the qualitative findings remained relevant within the rapidly changing healthcare context. Participants were recruited through HCP networks, snowballing and social media. Data were analysed thematically.Setting Phone interviews and online survey.Participants HCPs represented a range of professions from primary and secondary care across England, with varied socioeconomic deprivation.Results 24 HCPs were interviewed, and 16 HCPs responded to the survey. In the interviews, HCPs described three levels where decisions were made, which determined who would have access to what DHTs: health organisation, HCP and patient levels. These decisions resulted in the unequal implementation of DHTs across health services, created barriers for HCPs using DHTs in their practice and influenced HCPs’ decisions on which patients to supply DHTs with. In the survey, HCPs described being provided support to overcome some of the barriers at the organisation and HCP level during the pandemic. However, they cited similar concerns to pre-pandemic about barriers patients faced using DHTs (eg, digital literacy). In the absence of centralised guidance on how to manage these barriers, health services made their own decisions about how to adapt their services for those who struggled with DHTs.Conclusions Decision-making at the health organisation, HCP and patient levels influences inequalities in access to DHTs for HCPs and patients. The mobilisation of centralised information and resources during the pandemic can be viewed as good practice for reducing barriers to use of DHTs for HCPs. However, attention must also be paid to reducing barriers to accessing DHTs for patients.https://bmjopen.bmj.com/content/14/3/e080055.full
spellingShingle Barbora Silarova
Charlotte Dack
Ben Ainsworth
Sabrina Grant
Gemma Lasseter
Sophie Louise Turnbull
Jiedi Lei
Irem Aksu
Barriers and facilitators to use of digital health tools by healthcare practitioners and their patients, before and during the COVID-19 pandemic: a multimethods study
BMJ Open
title Barriers and facilitators to use of digital health tools by healthcare practitioners and their patients, before and during the COVID-19 pandemic: a multimethods study
title_full Barriers and facilitators to use of digital health tools by healthcare practitioners and their patients, before and during the COVID-19 pandemic: a multimethods study
title_fullStr Barriers and facilitators to use of digital health tools by healthcare practitioners and their patients, before and during the COVID-19 pandemic: a multimethods study
title_full_unstemmed Barriers and facilitators to use of digital health tools by healthcare practitioners and their patients, before and during the COVID-19 pandemic: a multimethods study
title_short Barriers and facilitators to use of digital health tools by healthcare practitioners and their patients, before and during the COVID-19 pandemic: a multimethods study
title_sort barriers and facilitators to use of digital health tools by healthcare practitioners and their patients before and during the covid 19 pandemic a multimethods study
url https://bmjopen.bmj.com/content/14/3/e080055.full
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