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• Response to 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
  Madison Milne-Ives, Ananya Ananthakrishnan, Victoria Riccalton, Cen Cong and Edward Meinert
  Published on: 6 November 2024

• Published on: 6 November 2024

  Response to 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

  • Madison Milne-Ives, Research Associate Newcastle University
  • Other Contributors:
    • Ananya Ananthakrishnan, Research Assistant
    • Victoria Riccalton, PhD student
    • Cen Cong, Research Associate
    • Edward Meinert, Professor in Digital Health and Clinical Artificial Intelligence

  Dear Editor,

  We recently read “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,” which explores the critical question of how healthcare professionals adopt and use digital health technologies (DHTs).

  The authors’ examination of barriers to DHT access and use on organisational and individual levels was a particularly valuable finding for their future implementation. We found the observation that some healthcare professionals (HCPs) acted as gatekeepers for patients’ access to DHTs particularly compelling. This highlights the importance of addressing biases and assumptions about the type of patients who could use and benefit from DHTs, to avoid unintentionally increasing digital health inequity. While this was not the primary focus of the study, we believe it is an important finding that should be further explored to understand how HCPs made such judgments and how they compare with patients’ perceptions. Understanding the underlying factors shaping professionals’ assumptions may provide a deeper understanding of the barriers to using digital tools. Additionally, it would have been interesting to further investigate usage patterns within the participants' geographic regions. The characteristics of these regions (e.g. socioeconomic status, demographics, digital access levels) may be associated with different adoption rates of DHTs by profe...

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  Dear Editor,

  We recently read “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,” which explores the critical question of how healthcare professionals adopt and use digital health technologies (DHTs).

  The authors’ examination of barriers to DHT access and use on organisational and individual levels was a particularly valuable finding for their future implementation. We found the observation that some healthcare professionals (HCPs) acted as gatekeepers for patients’ access to DHTs particularly compelling. This highlights the importance of addressing biases and assumptions about the type of patients who could use and benefit from DHTs, to avoid unintentionally increasing digital health inequity. While this was not the primary focus of the study, we believe it is an important finding that should be further explored to understand how HCPs made such judgments and how they compare with patients’ perceptions. Understanding the underlying factors shaping professionals’ assumptions may provide a deeper understanding of the barriers to using digital tools. Additionally, it would have been interesting to further investigate usage patterns within the participants' geographic regions. The characteristics of these regions (e.g. socioeconomic status, demographics, digital access levels) may be associated with different adoption rates of DHTs by professionals. Exploring these regional differences could provide valuable socioeconomic context to inform future implementation strategies and more equitable access to DHTs.

  We believe the authors’ decision to conduct additional research to understand how barriers and facilitators may have shifted due to the COVID-19 pandemic strengthened the study. It also raised our curiosity about how these barriers and facilitators may have continued to change throughout the pandemic. Data collected from HCPs at the start of the pandemic (July-August 2020) might not provide the most up-to-date insight into the evolving role of these tools. The burden on healthcare services increased exponentially while DHTs and their implementation simultaneously improved in each subsequent lockdown [1,2]. Notably, while healthcare services had begun using digital tools before the pandemic, the change was generally slow. The pandemic accelerated this transformation in Scotland, where healthcare consultations rapidly shifted from face-to-face to videoconferencing, with video appointments increasing from 20,000 in mid-2020 to over 1 million in July 2021 [1]. Future research could build on this study to generate additional insights into how the pandemic has altered HCPs’ access to and use of DHTs now that the pandemic's peak has passed.

  Some research has suggested that, from a patient perspective, elevated public interest levels in digital health during the Covid-19 pandemic were not sustained [3]. Potential reasons for this include digital infrastructure and competency issues [3] and barriers to systems integration and trust [4]. This highlights the importance of understanding how barriers for HCPs to access and uptake of DHTs intersect with barriers experienced by patients. This study highlights HCPs’ perspectives of patients’ barriers; future research could generate additional insights by exploring barriers from patients’ perspectives and identifying areas of alignment and misalignment. This will be a necessary step in training HCPs in the use of DHTs with patients in a way that does not increase health inequity and digital exclusion.

  References

  1 Fang ML, Walker M, Wong KLY, et al. Future of digital health and community care: Exploring intended positive impacts and unintended negative consequences of COVID-19. Healthc Manage Forum. 2022;35:279–85. doi: 10.1177/08404704221107362
  2 Newman KL, Jeve Y, Majumder P. Experiences and emotional strain of NHS frontline workers during the peak of the COVID-19 pandemic. Int J Soc Psychiatry. 2022;68:783–90. doi: 10.1177/00207640211006153
  3 van Kessel R, Kyriopoulos I, Wong BLH, et al. The effect of the COVID-19 pandemic on digital health-seeking behavior: Big data interrupted time-series analysis of Google Trends. J Med Internet Res. 2023;25:e42401. doi: 10.2196/42401
  4 Peek N, Sujan M, Scott P. Digital health and care: emerging from pandemic times. BMJ Health Care Inform. 2023;30:e100861. doi: 10.1136/bmjhci-2023-100861

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  Conflict of Interest:
  None declared.

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