Exploring the factors that influence physician technostress from using mobile electronic medical records

Technostress in Nuclear Medicine: A Qualitative Study of Causes, Mitigators, and Resolution Levels

BACKGROUND

In contemporary healthcare, information and communication technology enables specialized treatment and efficient information sharing. However, it also causes stress and frustration, so-called technostress, among healthcare staff.

PURPOSE

To investigate the day-to-day occurrence of technostress, we ask the research question: What causes the stressful situations with technology, how are they mitigated, and to what extent are they resolved?

METHOD

We interviewed 15 healthcare providers in the department of nuclear medicine at a Danish hospital about their experiences with technology-induced stress in their daily work.

RESULTS

The interviewees described 185 stressful situations with technology, mostly technology indispensable to their work. The two most frequent causes of stressful situations are system performance (46%) and technology-related organizational procedures (18%). To mitigate the situations, the most frequent strategies are accommodating (51%), consulting others for help (18%), and repeating previous task steps (13%). The mitigation strategies indicate that the stressful situations involve adapting work practices to the technology to a much larger extent than succeeding in adapting the technology to the work. Regarding the level of resolution, as much as 66% of the stressful situations are merely solved for now, that is, the concrete situation is resolved but the underlying issue remains unsolved. The underlying issue is resolved in only 10% of the situations, thereby indicating that the vast majority of the stressful situations are likely to recur later.

CONCLUSION

The staff at the studied hospital department repeatedly experience stressful situations with the technology they rely on in their work. This technostress is an extra stressor on top of those induced by the staff's responsibility for providing quality patient treatment. At the individual level, technostress leads to frustration and possibly burnout; at the organizational level, it calls for preventive action.

Digital stressors and resources perceived by emergency physicians and associations to their digital stress perception, mental health, job satisfaction and work engagement

BACKGROUND

Digital technologies are increasingly being integrated into healthcare settings, including emergency departments, with the potential to improve efficiency and patient care. Although digitalisation promises many benefits, the use of digital technologies can also introduce new stressors and challenges among medical staff, which may result in the development of various negative work and health outcomes. Therefore, this study aims to identify existing digital stressors and resources among emergency physicians, examine associations with various work- and health-related parameters, and finally identify the potential need for preventive measures.

METHODS

In this quantitative cross-sectional study, an online questionnaire was used to examine the relationship between digital stressors (technostress creators), digital resources (technostress inhibitors), technostress perception as well as mental health, job satisfaction and work engagement among 204 physicians working in German emergency medicine departments. Data collection lasted from December 2022 to April 2023. Validated scales were used for the questionnaire (e.g. "Technostress"-scale and the Copenhagen Psychosocial Questionnaire (COPSOQ). Descriptive and multiple regression analyses were run to test explorative assumptions.

RESULTS

The study found medium levels of technostress perception among the participating emergency physicians as well as low levels of persisting technostress inhibitors. The queried physicians on average reported medium levels of exhaustion symptoms, high levels of work engagement and job satisfaction. Significant associations between digital stressors and work- as well as health-related outcomes were analyzed.

CONCLUSION

This study provides a preliminary assessment of the persistence of digital stressors, digital resources and technostress levels, and their potential impact on relevant health and work-related outcomes, among physicians working in German emergency departments. Understanding and mitigating these stressors is essential to promote the well-being of physicians and ensure optimal patient care. As digitisation processes will continue to increase, the need for preventive support measures in dealing with technology stressors is obvious and should be expanded accordingly in the clinics. By integrating such support into everyday hospital life, medical staff in emergency departments can better focus on patient care and mitigate potential stress factors associated with digital technologies.

Stressors, Resources, and Strain Associated with Digitization Processes of Medical Staff Working in Neurosurgical and Vascular Surgical Hospital Wards: A Multimethod Study

The digitization of German hospitals is proceeding continuously, leading to the implementation of new digital technologies, such as electronic health records (EHRs) or other technologies, used for the purpose of medical documentation tasks. Even though the replacement of paper documentation through digitized documentation in general promises to come along with plenty of benefits, the daily utilization of technologies might also lead to stresses and strains among the medical staff, eventually possibly leading to the development of different negative work and health-related outcomes. This study, therefore, aims at identifying persisting digitization-associated stressors and resources among medical hospital staff, examining their influences on different work and health-related outcomes, and finally, identifying potential needs for preventive measures. A quantitative study in the form of an online questionnaire survey was conducted among physicians working in the medical field of neuro- and vascular surgery in German hospitals. The study was carried out between June and October 2022 utilizing an online questionnaire based on several standardized scales, such as the technology acceptance model (TAM) and the technostress model, as well as on several scales from the Copenhagen Psychosocial Questionnaire (COPSOQ). The study found medium levels of technostress among the participating physicians (n = 114), as well as low to medium levels of persisting resources. The queried physicians, on average, reported low levels of burnout symptoms, generally described their health status as good, and were mostly satisfied with their job. Despite the prevalence of technostress and the low levels of resources among the surveyed physicians, there is little awareness of the problem of digital stress, and preventive measures have not been widely implemented yet in the clinics, indicating a needs gap and the necessity for the strategic and quality-guided implementation of measures to effectively prevent digital stress from developing.

Techno-distress and parental burnout: The impact of home facilitating conditions and the system quality

The incorporation of Information and Communications Technology (ICT) in educational environments has generated diverse effects. The literature has established that the use of ICT can generate techno-distress in both teachers and students. However, the techno-distress and burnout caused in parents who help their children to use technological platforms have not been analyzed in depth. To contribute to closing this theoretical gap, we conducted a study with 131 parents who helped their children to use technological platforms, considering two antecedents of techno-distress and its effect on parental burnout. Our results demonstrate that both the home facilitating conditions and the system quality influence parental techno-distress. Additionally, it was possible to demonstrate that techno-distress has a significant effect on parental burnout. The use of technology in educational environments is increasing at all educational levels. Therefore, the present study provides relevant information that schools can use to reduce the impact of the negative effects generated by technology.

Factors Influencing Teacher’s Technostress Experienced in Using Emerging Technology: A Qualitative Study

In this era of rapid technology growth, many countries have begun to adopt emerging technologies into their educational systems to improve learning outcomes. The aim of this study is to explore the factors influencing teachers’ experiences of technostress while using new technology in academic classrooms and how it might be mitigated. Prior research has not focused on how technostress develops among individuals over time or how it can be mitigated in an individual context; the intention of this study is to contribute to the technostress literature in these particular areas. To address the research gap, we conducted a qualitative study that collected data through the use of an open-ended question questionnaire. Seventy teachers of different backgrounds and locations responded to the survey. We used thematic analysis to analyze their responses and reveal how lack of school support and their professional identities influence their levels of technostress. Technology characteristics, including the complexity and the benefits of a given technology, and privacy concerns play a crucial role in teachers’ experiences of technostress. Moreover, we found that colleague support in using new technology and open educational resources each contributed to mitigating teachers’ technostress levels. Our study extends technostress research to examine a new learning environment and context. This focus allowed us to highlight the need to develop open educational resources and better social support structures for teachers and to rethink the professional identities of developing teachers to mitigate their levels of technostress. Suggestions for further research that resulted from this work include using a mixed methods research approach in future studies and including more teachers in future work to determine the relationships among the factors identified by this study.

Overcoming the "Dark Side" of Technology-A Scoping Review on Preventing and Coping with Work-Related Technostress

In the course of the digitalisation of work, the phenomenon of technostress is increasingly being examined. While there is a plethora of research on its causes and consequences, a growing body of research on mitigating work-related technostress is emerging. In order to identify opportunities to overcome this "dark side" of technology, this scoping review aims to provide a comprehensive overview of the current state of research on how to prevent and cope with work-related technostress. The databases PubMed, MEDLINE, PsycInfo, PSYNDEX, and Web of Science were searched in the time period between 2008 and 2021. The studies were screened independently by two authors and selected based on predefined inclusion and exclusion criteria. Sixty-two studies were included and their methodological quality was assessed using standardised checklists. Resources were identified at the technical, organisational, social and personal level, including, e.g., leadership, organisational and technical support as well as self-efficacy and IT mindfulness. Problem- and emotion-focused coping strategies were, e.g., seeking support or distancing from IT. None of the included studies investigated prevention measures, emphasising a dearth of research that needs to be addressed in the future. Nevertheless, the identified resources and coping strategies provide starting points to address adverse work- and health-related consequences and reduce work-related technostress.

A multigroup analysis of factors underlying teachers' technostress and their continuance intention toward online teaching

Online teaching has been implemented in response to the COVID-19 pandemic. Nonetheless, teaching online consumes considerable time and adds pressure to teachers' daily lives. Teachers have to not only acquire technical skills but also provide engaging instruction online. Meanwhile, privacy breaches occasionally occur in online teaching. The objective of the current study is to analyze the factors underlying the continuance intention toward online teaching beyond the COVID-19 pandemic. We use the person-environment fit theory to develop the survey for investigation. An open-ended question appended to the survey helps to gather teachers' further thoughts on sustainable online teaching. The structural equation modeling reveals that teachers' technostress is associated with their privacy concerns and self-efficacy in delivering effective instruction amid online teaching. The multigroup analysis further demonstrates that technostress, self-efficacy and school support are related to the continuance intention to teach online for teachers at distinct teaching levels to different extents. The responses to the open-ended question reveal that teachers' preference for online instruction lies in wealthy teaching resources and flexibility. Students' learning performance and the effectiveness of assessments constitute a concern in conducting online teaching. The implications for policymakers and teachers are remarked upon at the end of this paper.

Preparing Workplaces for Digital Transformation: An Integrative Review and Framework of Multi-Level Factors

The rapid advancement of new digital technologies, such as smart technology, artificial intelligence (AI) and automation, robotics, cloud computing, and the Internet of Things (IoT), is fundamentally changing the nature of work and increasing concerns about the future of jobs and organizations. To keep pace with rapid disruption, companies need to update and transform business models to remain competitive. Meanwhile, the growth of advanced technologies is changing the types of skills and competencies needed in the workplace and demanded a shift in mindset among individuals, teams and organizations. The recent COVID-19 pandemic has accelerated digitalization trends, while heightening the importance of employee resilience and well-being in adapting to widespread job and technological disruption. Although digital transformation is a new and urgent imperative, there is a long trajectory of rigorous research that can readily be applied to grasp these emerging trends. Recent studies and reviews of digital transformation have primarily focused on the business and strategic levels, with only modest integration of employee-related factors. Our review article seeks to fill these critical gaps by identifying and consolidating key factors important for an organization’s overarching digital transformation. We reviewed studies across multiple disciplines and integrated the findings into a multi-level framework. At the individual level, we propose five overarching factors related to effective digital transformation among employees: technology adoption; perceptions and attitudes toward technological change; skills and training; workplace resilience and adaptability, and work-related wellbeing. At the group-level, we identified three factors necessary for digital transformation: team communication and collaboration; workplace relationships and team identification, and team adaptability and resilience. Finally, at the organizational-level, we proposed three factors for digital transformation: leadership; human resources, and organizational culture/climate. Our review of the literature confirms that multi-level factors are important when planning for and embarking on digital transformation, thereby providing a framework for future research and practice.

Developing and Evaluating A One-Stop Patient-Centered Interprofessional Collaboration Platform in Taiwan

(1) Background: Effective healthcare collaboration not only improves the outcomes of patients, but also provides benefits to healthcare providers. A patient-centered communication platform, a so-called “one-stop platform”, is necessary to promote interprofessional collaboration (IPC) for optimal patient care. (2) Methods: Chi Mei Medical Center developed a patient-centered computerized platform to fulfill interprofessional collaboration needs. The platform features a spiral-shaped integrated care area and a communication area that allows the medical team to access patients’ information including the medical care they received within seven days, and veritably shows whether the team members have read communication messages. After pilot adoption, an online survey was conducted. (3) Results: A one-stop IPC platform was implemented and promoted for patient care. The online survey revealed that medical team members have high positive appraisal of the platform. It also pointed out that resistance to change among the medical team still has a significant impact on behavioral intention. (4) Conclusions: The interprofessional collaboration platform was recognized by the medical teams of Chi Mei Medical Center as an effective and convenient tool for assisting clinical decision making. However, actions to reduce user resistance to change and encourage collaboration among team members still need to be continued. Shared decision making within physicians and patients will be valuable to develop in the platform in the future.

A model to measure self-assessed proficiency in electronic medical records: Validation using maturity survey data from Canadian community-based physicians

OBJECTIVE

Adoption of electronic medical records (EMRs) does not necessarily translate to proficiency -referred to here as EMR maturity. To realize the full benefit of wide scale EMR adoption, the focus must shift from adoption to advancing mature use. This calls for validated assessment models so that researchers, health system planners and digital health developers can better understand what contributes to maturity among physicians. This research aims to validate a measurement model for self-assessed EMR maturity among community-based physicians.

METHODS

As part of an Ontario government-funded EMR adoption program, the EMR Maturity Model for community-based practices was adapted from a hospital-based EMR maturity model. A survey instrument was developed on the foundation of the new model and revised by experts and stakeholders. Content validity, face validity and user acceptance were established before survey administration. Internal consistency and construct validity of the model were tested after survey data were collected. Finally, physicians' comments collected via the survey were qualitatively analyzed to provide additional insights that can be applied to refinement of the model and survey.

RESULTS

As of August 1, 2019, 1588 physicians completed the survey. Ordinal alpha tests for reliability and content validity yielded an alpha value of 0.86 across all key measures specifically associated with maturity. Among most of these, there was a pattern of weak to moderate significant (p < .0001) positive Spearman inter-correlations. One factor was extracted for items measuring dimensions of maturity and all factor loadings of the key measures were greater than 0.40. The fit of the one-factor model was moderately adequate. This indicates the model is valid and reliable, with consistency across key measures for measuring one factor: maturity.

CONCLUSIONS

This is the first known validated model published in English that measures EMR maturity among community-based physicians. While the model is shown to be valid and reliable statistically and qualitative analysis supports this, there is room for improvement. Both the statistical analysis and portions of the qualitative analysis suggest areas of exploration to strengthen the model and survey. Future efforts will include refining the survey to improve user interface and accrue further data, as the sample to date is insufficient for generalizability.