The Interplay of Work, Digital Health Usage, and the Perceived Effects of Digitalization on Physicians’ Work: Network Analysis Approach

• Published in: Journal of medical Internet research 2022-08, Vol.24 (8), p.e38714-e38714
• Main Authors: Saukkonen, Petra, Elovainio, Marko, Virtanen, Lotta, Kaihlanen, Anu-Marja, Nadav, Janna, Lääveri, Tinja, Vänskä, Jukka, Viitanen, Johanna, Reponen, Jarmo, Heponiemi, Tarja
• Format: Article
• Language: English
• Subjects: Access; Analysis; Archives & records; Clinical decision making; Clinical medicine; Cooperation; COVID-19; Decision making; Decision support systems; Digitization; Electronic health records; Electronic records; Employment; Empowerment; Evidence-based medicine; Health information; Health services; Information systems; Interdependence; Interdisciplinary aspects; Interprofessional cooperation; Medical care; Medical informatics; Medical records; Network analysis; Original Paper; Participation; Patient education; Patient information; Patients; Perceptions; Physicians; Public sector; Quality management; Questionnaires; Response rates; Specialization; Telemedicine; Web portals; Women; Work environment
• ISSN: 1438-8871; 1439-4456; 1438-8871
• DOI: 10.2196/38714

In health care, the benefits of digitalization need to outweigh the risks, but there is limited knowledge about the factors affecting this balance in the work environment of physicians. To achieve the benefits of digitalization, a more comprehensive understanding of this complex phenomenon related to the digitalization of physicians’ work is needed. The aim of this study was to examine physicians’ perceptions of the effects of health care digitalization on their work and to analyze how these perceptions are associated with multiple factors related to work and digital health usage. A representative sample of 4630 (response rate 24.46%) Finnish physicians (2960/4617, 64.11% women) was used. Statements measuring the perceived effects of digitalization on work included the patients’ active role, preventive work, interprofessional cooperation, decision support, access to patient information, and faster consultations. Network analysis of the perceived effects of digitalization and factors related to work and digital health usage was conducted using mixed graphical modeling. Adjusted and standardized regression coefficients are denoted by b. Centrality statistics were examined to evaluate the relative influence of each variable in terms of node strength. Nearly half of physicians considered that digitalization has promoted an active role for patients in their own care (2104/4537, 46.37%) and easier access to patient information (1986/4551, 43.64%), but only 1 in 10 (445/4529, 9.82%) felt that the impact has been positive on consultation times with patients. Almost half of the respondents estimated that digitalization has neither increased nor decreased the possibilities for preventive work (2036/4506, 45.18%) and supportiveness of clinical decision support systems (1941/4458, 43.54%). When all variables were integrated into the network, the most influential variables were purpose of using health information systems, employment sector, and specialization status. However, the grade given to the electronic health record (EHR) system that was primarily used had the strongest direct links to faster consultations (b=0.32) and facilitated access to patient information (b=0.28). At least 6 months of use of the main EHR was associated with facilitated access to patient information (b=0.18). The results highlight the complex interdependence of multiple factors associated with the perceived effects of digitalization on physicians’ work. It seems that a high-quality EHR syst