Article
What drives the acceptance of digital health applications in medical students? Results from a cross-sectional survey
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Authors
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Lorenz Harst
- Universitätsklinikum Carl Gustav Carus Dresden, Zentrum für Evidenzbasierte Gesundheitsversorgung, Dresden, Deutschland
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Patrick Timpel
- Universitätsklinikum Carl Gustav Carus Dresden, Medizinische Kinik und Poliklinik III, Prävention und Versorgung des Diabetes, Dresden, Deutschland
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Sigrid Müller
- Universitätsklinikum Carl Gustav Carus Dresden, Zentrum für Evidenzbasierte Gesundheitsversorgung, Dresden, Deutschland
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Jochen Schmitt
- Universitätsklinikum Carl Gustav Carus Dresden, Zentrum für Evidenzbasierte Gesundheitsversorgung, Dresden, Deutschland
| Published: | September 25, 2020 |
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Outline
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Background and state of the art: Digital health applications are increasingly used in health care delivery (Lantzsch et al. 2018), as they supposedly improve care processes and clinical outcomes (Eysenbach 2001).
The successful implementation and continuous use of digital health applications highly depend on their acceptance by health care providers. Studies show that the most important predictor for provider acceptance is perceived usefulness (Harst et al. 2019). Current medical students are part of a user group commonly called digital natives and therefore more prone to use telemedicine applications in the future work than current practitioners. However, the acceptance of digital health by medical students has not been studied so far.
Research questions and aim: The present study analyzes
- 1.
- which criteria of “perceived or expected usefulness” German medical students see fulfilled by telemedicine and
- 2.
- in how far these assessments drive their acceptance of five prototypical digital health applications.
Methods: A cross-sectional survey using a structured online questionnaire addressing 1.180 students of a German faculty of medicine was conducted. Acceptance of five prototypical applications according to the evidence tiers NICE Framework was measured on a five-point Likert scale. Assessments of usefulness as well as demographics, phase of study and plans for the professional future were used as predictors. A factor analysis was conducted to summarize what constitutes usefulness according to students.
Results: Overall, 116 of 1,180 students took part in the survey (participation rate 9.8%), all of them past the pre-clinical phase of their study. The majority (59.5%) of them were female; average age was 25.3 years.
On average, the most accepted digital health tools were Electronic Health Records (4.53) and Tele-monitoring systems (4.25), while tools for support in diagnosis (2.95) and therapeutic measures (2.88) were less accepted. Usefulness of digital health is expected rather in the improvement of care processes (e.g. reduced waiting times) than in the improvement of clinical and patient reported outcomes.
Factor analysis leads to three clearly disjunctive factors of perceived usefulness: improvement of patient-centered care, improvement of care processes, relief for the health care system.
Regression analysis reveals that acceptance of the prototypical applications is partly linked to the study progress, but also to assessments of usefulness, e.g. in being cost-effective or allowing for faster diagnosis. Another explanatory factor for acceptance according to students is the digital infrastructure in the region where the participating students intend to settle.
Discussion: Students have a clear understanding of the potentials of digital health applications: They are unsure about clinical benefits, especially of digital monitoring, which is in line with current evaluation studies (Timpel et al. 2019). Instead, they clearly see benefits for care processes, which is supported by the evaluation of, e.g., tele-stroke systems (Baratloo et al. 2018).
Practical Implications: Our findings may be used to adapt teaching formats to ultimately improve uptake of digital health applications by future medical doctors.
