Exploring the perspectives of primary care providers on use of the electronic Patient Reported Outcomes tool to support goal-oriented care: a qualitative study

BMC Medical Informatics and Decision Making

Hardeep Singh¹  Carolyn Steele Gray²  Farah Tahsin²  Ross Upshur³  Jason Xin Nie⁴  Walter P. Wodchis⁵  Sarah Harvey⁶  Kednapa Thavorn⁷  Brian McKinstry⁸ 

[1] Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada;Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, Canada;March of Dimes Canada, Toronto, Canada;Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada;Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, M5T 3M6, Toronto, ON, Canada;Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada;Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, M5T 3M6, Toronto, ON, Canada;Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada;Institute for Better Health, Trillium Health Partners, L5B 1B8, Mississauga, ON, Canada;Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, M5T 3M6, Toronto, ON, Canada;Institute for Better Health, Trillium Health Partners, L5B 1B8, Mississauga, ON, Canada;Logibec Inc., 1751, Richardson Street, Suite 1.060, H3K 1G6, Montréal, QC, Canada;Ottawa Hospital Research Institute, K1Y 4E9, Ottawa, ON, Canada;School of Epidemiology and Public Health, University of Ottawa, K1N 6N5, Ottawa, ON, Canada;Usher Institute, University of Edinburgh, EH16 4UX, Edinburgh, UK;

关键词: Implementation science;    Primary health care;    Digital technology;   

DOI  :  10.1186/s12911-021-01734-0

来源: Springer

【 摘 要 】

BackgroundDigital health technologies can support primary care delivery, but clinical uptake in primary care is limited. This study explores enablers and barriers experienced by primary care providers when adopting new digital health technologies, using the example of the electronic Patient Reported Outcome (ePRO) tool; a mobile application and web portal designed to support goal-oriented care. To better understand implementation drivers and barriers primary care providers’ usage behaviours are compared to their perspectives on ePRO utility and fit to support care for patients with complex care needs.MethodsThis qualitative sub-analysis was part of a larger trial evaluating the use of the ePRO tool in primary care. Qualitative interviews were conducted with providers at the midpoint (i.e. 4.5–6 months after ePRO implementation) and end-point (i.e. 9–12 months after ePRO implementation) of the trial. Interviews explored providers’ experiences and perceptions of integrating the tool within their clinical practice. Interview data were analyzed using a hybrid thematic analysis and guided by the Technology Acceptance Model. Data from thirteen providers from three distinct primary care sites were included in the presented study.ResultsThree core themes were identified: (1) Perceived usefulness: perceptions of the tool’s alignment with providers’ typical approach to care, impact and value and fit with existing workflows influenced providers’ intention to use the tool and usage behaviour; (2) Behavioural intention: providers had a high or low behavioural intention, and for some, it changed over time; and (3) Improving usage behaviour: enabling external factors and enhancing the tool’s perceived ease of use may improve usage behaviour.ConclusionsMultiple refinements/iterations of the ePRO tool (e.g. enhancing the tool’s alignment with provider workflows and functions) may be needed to enhance providers’ usage behaviour, perceived usefulness and behavioural intention. Enabling external factors, such as organizational and IT support, are also necessary to increase providers’ usage behaviour. Lessons from this study advance knowledge of technology implementation in primary care.Trial registrationClinicaltrials.gov Identified NCT02917954. Registered September 2016, https://www.clinicaltrials.gov/ct2/show/study/NCT02917954

【 授权许可】

CC BY