This chapter will discuss about digital technology fields adoption and experiences among providers and individuals’ perspectives. Utilization technology and eHealth services have become more common in healthcare, and it has brought unity to the social and health care field.
Adoption of information and communication technology has been complicated in healthcare.
For healthcare organization, the adjustment can be described as an event that takes employees out of their “comfort zone” to an unknown area (Wiest, 2006) or an event where employees have to adapt and have no opportunity to contribute (Bruhn, 2004). Individual’s motivation, working conditions and management are the elements which will affect the type of service provided. Transition of digitalization in healthcare is complex and difficult process. In the beginning, there is little information on how it affects the daily life of an organization. Almost always, changes temporarily impair the performance (Kallankari, 2019).
ITC has known to bring well-known advantages, such as improve quality of care, increase effectivity and opportunities to educate healthcare professionals. (Rouleau et.al, 2015) In general, the use of eHealth services is depended on the attitudes and willingness among individuals. The evidence has showed diverse experiences from nurses and medical providers.
There is only limited research conducted of the professionals´ experiences of health technology.
This chapter will introduce the variety of experiences among healthcare professionals globally and in Finland.
2.4.1 PERCEPTIONS, ATTITUDES & CHARASTERISTICS
Adapting to the digital era is often the diligent part to the health care professionals. It requires a shift towards flexible and risk-taking mindset. Often the digitalization can bring out challenges and it can be experienced as threat. Most of Finnish health care professionals regards the digitalization of health services as a benefit. Attitudes towards using technology and remote services are mostly positive. However, the use of eHealth services depends on the overall attitudes and willingness. The attitudes are mostly based on individuals’ preferences. The
attitude of the individual is influenced by enthusiasm, interest and confidence towards own work. Sufficient technical skills require the ability to take risks and withstand uncertainty (Ministry of Finance, 2017, 16).
Most of the conducted researches focuses on the attitudes towards VC. Technology utilization and remote services are prevalent in social and health care field in Finland. They are integrated into the use of healthcare organizations and different work processes. Since technology services has been activated in Finnish healthcare, commitment and deployment process of all healthcare professionals has been important because new models are anchored in their daily work. The functionality of the ITC-systems is important for performance of healthcare professionals.
(Koivisto et.al, 2019) Overall impact of health technology has been positive.
Positive experiences have been reported in particular with regard to improving workflow.
Technology allows more efficient communication and improved availability of services.
(Koivisto et.al 2019) When health information is more accessible, the productivity at work increases. Health care professionals do not have to consume time on searching information from EHR, when they can achieve patient´s health status more quickly. Health care professionals are willing to use the eHealth services because they are aware of its utility, usability and cost-effectiveness. Medical providers found the use of ePrescribtion easy and useful for work and thought it will improve patient safety. Because of ePrescribition, number of medical errors has decreased (Kivekäs, 2019). According to reports, collaboration between nursing staff improved because of ICT. (Saurman et.al, 2011) Improvements in communication and improved access to services has accepted by the Finnish health care professionals. Medical providers overall experience was satisfied.
Telehealth has been introduced in mental health care, home care, remote monitoring and remote- consultation services. Benefit of utilization of video technology in consultation, treatment or monitoring has been shown to be as effective as face-to-face counselling. (Bucley
& Weisser, 2012) The benefits have considered to increase safety, assist of nursing care and improvement of quality of care. In rural areas in Australia, the health care professionals have experienced benefits by providing healthcare services remote. Telehealth offers opportunity for better health outcomes for people living in remote areas. (Bradford, 2015) Providing remote services, neither of participants needs to travel. It has been stated that introducing new technology solutions for telehealth, improves monitoring, access and efficiency of care.
Providing similar services such social and psychosocial support as face-to-face appointment is possible because of telehealth. Literature shows negative attitudes towards utilizing VC in mental health field. Most of the opinions were result that face-to-face contact was not a substitute for video contact. The views reported that relationship with patient was challenging to accomplish via VC. In health care, human interactions still play a major role and digitalization will not replace it. Patient examination, data collection and storage, data analysis and decision about treatment plan are the responsibility of health care professional. The health technology will only support these functions (Kauhanen et.al 2012).
Overall experiences of the health care professionals are positive. Cooperation between organizations are fluent. The report (2019) concluded that because of the health care technology services are available on a regional level, medications in other organizations are available, patient data is up-to-date and information systems try to help improve quality, continuity and support treatment recommendations (Vehko et. al 2019b). However, evidence shows that more effort must be focused on health care professionals’ attitudes, education and technical support.
2.4.2 BARRIERS, FACILITATORS & INFLUENCES
There are many different factors which influence eHealth and its professional healthcare users.
Globally, health care professionals’ experiences have been contradictory to eHealth services.
In 2009, health care professionals experienced and stated that the use of ITC was low. However, according to EU report (2019), countries with highest level of adoption were Denmark, Estonia, Finland, Spain, Sweden and United Kingdom. The way of transformation and the type of health system is associated with the overall eHealth adoption. Barriers became from the needs of strengthening the implementation and training. The indicators showed that more planning must be conducted by the policymakers in a government level (Flynn et.al 2009). Adoption has been relative slow compared to many other industries. However, nowadays the experiences towards eHealth have changed. Especially, the EU-survey showed that those countries had positive influence on digital transition. (EU report, 2019) Positive factors include EHR, VC, ePrescription and self-monitoring devices.
Organizations have been noticed to have a considerable influence towards the choices people make. Digital technology allows health care professionals improve efficiency and communicate more effectively. If the organization and management are motivated towards integrating
eHealth services, promotes it to positive implementation in the workplace. (Brwster et.al 2014) In addition, ITC bring autonomy for nurses in their role and support for co-workers and administration. (Rouleau et.al 2015) As stated in Philips Future Health Index 2019, health care professionals are in adoption mode and it’s the beginning to recognise benefits of digital health.
69% of the respondents agreed with improvements by digital technology, also their satisfaction had increased after they gradually became more comfortable with artificial intelligence-based technology (Future health index, 2019 Positive attitude has seen to promote adaption towards technology in all fields. Also, employees must be motivated to learn more and able to explore beyond their comfort. Adoption to technology can be challenging. Häyrinen states that professional’s knowledge, skills and competences are necessary for the development process (Häyrinen, 2019).
Understanding and committing new guidelines is not an easy task for health care professions.
Multilevel change will present number of challenges and barriers. Several barriers will surface and therefore managers play a big role. The most challenges have been noticed in implementation of the digital health services. It involves changes in different levels such as healthcare providers, organization and governmental. Implementation must be focused on case-by-case basis and needs of each participant. Every participant has active role of implementation.
(De Weger et. al. 2013) Literature shows the considerable barrier has been noticed in implementation the services to healthcare. Addressing new implementation strategies to health care is important. It enhances health care professionals values, needs and attitudes and alleviate the implementation process. (Parra-Calderón, 2017). The overall challenges of implementations were lack of resources, lack of organizational support and technical problems (Odeh, 2014).
Being aware of health care professionals’ attitudes can facilitate the implementation of new technology. (Montero-Marin et.al 2014).
The most challenges have been in implementation the digital services. Based on a survey, every health care professional has different technology skills. Health care professionals experience that technical support must active in all time (Cegarra-Navarro & Carrion, 2011). Need of an education increases when the starting point varies. Therefore, it is necessary to look at what kind of skills needs the staff have and how they can develop their skills and practices. Kujala points out that employees must give enough time to learn and adapt new things. (Kujala et. al, 2018). Based on a survey in Netherlands, the registered nurses were more willingness to use technology when it was supported by the colleagues. It increased their workflow, usability and
cost-effectiveness. The most surprising of the results were that older staff nurses used technology rather than young nurses. (Van HouweIngens et.al 2015) In North- Scotland, health care professionals believed utility and cost-effectiveness of technology but did not felt comfortable using new health technology such as VC. (Levy & Strachan, 2013) Increasing training increases has been seen a willingness to use technology. Positive experiences were recorded of the working equipment, collaboration of the technical service provider and user-friendliness (Brwster et.al 2014). Several articles emphasize technology to enhance health care professional’s confidence in care, responsibility and decision-making (Trondsen et.al 2014). In addition, support from management is important.
According to several reports, the reduction of the face-to-face encounters and technical problems of the use of technology are perceived as negative. Changes in the working profile through the use of technology and telehealth services are perceived as contradictory. (Koivisto et.al, 2019) Even though several articles have shown telemental health services effective, health care professionals’ attitudes and perspectives towards it are negative. Telemental health services has been introduced in several areas in health services, but more research must be conducted on its effectivity and experiences among patients. Other disadvantages have been stated in privacy and security, complexity of the communicated information and access and competences related issues (Ahmadinia & Eriksson-Backa).
Finnish health care professionals’ experiences are mostly positive but concerns towards technical problems are rising. Challenges has been issued from deficiencies and inconveniences in the technical equipment, connections, and applications that limit work. More closely, in developing countries establishing eHealth is difficult because lack of communication infrastructure (Iluyemi, 2009). Experiences have been tough, but from 2009 development has been significant. According to EU report (2016) states that by focusing on accessibility, usability, training and implementation will adopt health care workers to digital health care (EU report, 2016). Using satellite broadband technology is often only solution to provide accessible services. Fortunately, there is no need to concern about slow internet access in Finland. Based on eHealth report (2019), medical providers manifest about the requirement for supportive system and technical support. Technical problems such as downtime and slowness, multiple system logins, and simultaneous operation of many systems caused stress for healthcare professionals. (Vehko et.al 2018a) The report (2019) revealed that private sector´s medical
providers were more satisfied with their EHR concerning the technical reliability. (Kouri et.al 2019)
In the future, employees will be required to understand and see the potential of ITC in different situation. A shared vision of a desirable future will help motivate and coordinate measures that will bring about change. Different applications will be available to facilitate work, and also to help patients receive virtual treatment and guidance. Despite all the technological issues, the overall experiences have been mainly positive. If extensive trainings are offered, the participants have been even more satisfied (Adler et.al 2013). eHealth does not only influence health care professional but other people. All in all, benefits of eHealth will build better capacity, decrease professional isolation and alleviate communication. Globally range of health care professionals have experienced ITC feasible and acceptive. In a broader view, technology plays important role achieving and developing new approaches to medicine and care, and also more personalized care (Sebri & Savioni, 2019).