GPs' perspectives on eHealth use in the Czech Republic: a cross-sectional mixed-design survey study

Background

Digitalisation of health services is among the top priorities of the European Union (EU), yet take-up of eHealth tools is slower in some EU countries than others.

Aim

The aim of this study was to evaluate the use of information communication technology (ICT) and eHealth tools by Czech GPs, to elucidate their motivation and barriers to the adoption of eHealth technologies.

Design & setting

A cross-sectional, mixed-design survey study, administered online and conducted with GPs from seven randomly selected Czech regions. Of the invited 777 GPs, 196 participants responded (25% response rate) and 153 completed the survey.

Method

Quantitative (measured using, for example, the eHealth readiness scale) and qualitative (thematic analysis) methods were used.

Results

Hierarchical multilinear regression (controling for age, sex, and city size) showed that ICT usage in general practice was predicted by eHealth readiness. Among GPs with their own practice, age and practice size also predicted ICT use. Analysis of barriers specific to mobile health tools identified obstacles on the side of GPs (such as low perceived usefulness), patients (such as lack of interest), and contextual barriers (such as lack of time).

Conclusion

In addition to system-level change, educating Czech GPs about the benefits of eHealth tools for better patient–provider interaction and quality of care is necessary to facilitate eHealth adoption and usage in the Czech Republic.

Perceived impact of electronic medical records in physician office practices: a review of survey-based research

BACKGROUND

Physician office practices are increasingly adopting electronic medical records (EMRs). Therefore, the impact of such systems needs to be evaluated to ensure they are helping practices to realize expected benefits. In addition to experimental and observational studies examining objective impacts, the user's subjective view needs to be understood, since ultimate acceptance and use of the system depends on them. Surveys are commonly used to elicit these views.

OBJECTIVE

To determine which areas of EMR implementation in office practices have been addressed in survey-based research studies, to compare the perceived impacts between users and nonusers for the most-addressed areas, and to contribute to the knowledge regarding survey-based research for assessing the impact of health information systems (HIS).

METHODS

We searched databases and systematic review citations for papers published between 2000 and 2012 (May) that evaluated the perceived impact of using an EMR system in an office-based practice, were based on original data, had providers as the primary end user, and reported outcome measures related to the system's positive or negative impact. We identified all the reported metrics related to EMR use and mapped them to the Clinical Adoption Framework to analyze the gap. We then subjected the impact-specific areas with the most reported results to a meta-analysis, which examined overall positive and negative perceived impacts for users and nonusers.

RESULTS

We selected 19 papers for the review. We found that most impact-specific areas corresponded to the micro level of the framework and that appropriateness or effectiveness and efficiency were well addressed through surveys. However, other areas such as access, which includes patient and caregiver participation and their ability to access services, had very few metrics. We selected 7 impact-specific areas for meta-analysis: security and privacy; quality of patient care or clinical outcomes; patient-physician relationship and communication; communication with other providers; accessibility of records and information; business or practice efficiency; and costs or savings. All the results for accessibility of records and information and for communication with providers indicated a positive view. The area with the most mixed results was security and privacy.

CONCLUSIONS

Users sometimes were likelier than nonusers to have a positive view of the selected areas. However, when looking at the two groups separately, we often found more positive views for most of the examined areas regardless of use status. Despite limitations of a small number of papers and their heterogeneity, the results of this review are promising in terms of finding positive perceptions of EMR adoption for users and nonusers. In addition, we identified issues related to survey-based research for HIS evaluation, particularly regarding constructs for evaluation and quality of study design and reporting.