Abstract
Objectives
To explore how Health Care Practitioners (HCPs) made decisions about the implementation of DHTs in their clinical practice before and during the COVID-19 pandemic.
Design
A multi-methods study, comprising semi-structured 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 Digital Health Technologies (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 (e.g., 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 level influence 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.
To explore how Health Care Practitioners (HCPs) made decisions about the implementation of DHTs in their clinical practice before and during the COVID-19 pandemic.
Design
A multi-methods study, comprising semi-structured 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 Digital Health Technologies (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 (e.g., 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 level influence 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.
| Original language | English |
|---|---|
| Article number | e080055 |
| Journal | BMJ Open |
| Volume | 14 |
| Issue number | 3 |
| Early online date | 5 Mar 2024 |
| DOIs | |
| Publication status | Published - 5 Mar 2024 |
Bibliographical note
Publisher Copyright:© Author(s) (or their employer(s)) 2024.