The role of health-care providers in mHealth adoption

Published in: Lancet Digital Health

Health-care providers, the gate keepers of health-care delivery, are important but understudied stakeholders in integrating digital health technologies (DHTs) into routine clinical practice. A doctor’s recommendation goes a long way in encouraging patients to use DHTs, and research increasingly suggests that a desire for DHTs exists among health-care providers.

Despite recent policy recommendations advocating the use of health apps in routine clinical practice, and publication of the National Institute for Health and Care Excellence (NICE) evidence framework for DHTs, such technologies are rarely recommended by health-care providers in practice.

We interviewed groups of digital health experts, practice nurses, allied health professionals, secondary care doctors, and general practitioners to determine the factors important to health-care providers for considering the recommendation of DHTs to patients. Combined with a pragmatic literature review, we identified nine factors which might affect digital decision making among healthcare providers.

Our results suggested that healthcare providers were most concerned about DHTs having a stamp of approval, whether from the National Health Service (NHS), Medicines and Healthcare products Regulatory Agency (MHRA), or otherwise, which received a statistically significantly higher ranking for all attributes except the presence of published studies of safety or clinical effectiveness. The presence of published studies was also valued significantly greater than all other attributes, except for a stamp of approval.

Having personally used a DHT previously and receiving recommendations from other health-care providers were also of some importance to health-care providers, both of which were statistically significantly more important than making DHTs easier to prescribe to patients, such as including them within EMIS Web or SystmOne. The cost of the DHT, whether it was created by health-care providers, the level of unmet need in the condition under consideration, having access to appropriate technology to demonstrate DHTs to patients, and ensuring apps are easy to prescribe did not result in a difference in preferences among health-care providers.

Trusted advocates of digital health such as ORCHA, NHS X, and NICE have a substantial role to play in this process of digital adoption, specifically in ensuring that: health-care providers are well informed of the benefits that digital health can deliver; know how and where to access DHTs that have been proven to be effective; are aware of what level of evidence is appropriate for each kind of DHT available; and that health-care systems understand the current barriers and facilitators to the implementation of digital health among this crucial but understudied stakeholder group.

Read the full research piece here: https://www.thelancet.com/journals/landig/article/PIIS2589-7500(19)30025-1/fulltext