To connect or not connect: long-term adoption of video consultations, and reasons for discontinuing use.

INTRODUCTION: This study investigates factors related to long-term and short-term adoption of video consultations (VCs) and reasons for discontinuing use among primary care patients. METHODS: A sample of primary care patients using VCs with healthcare providers were invited to take a survey in a cross-sectional study. Participants were asked about their intention to continue to have video consultations in the future, and those indicating no intention to use VCs in the future (short-term adopters) were asked about their reasons for this. Prevalence and statistical differences between long-term and short-term adopters were investigated. RESULTS: There were several statistically significant differences between long-term and short-term adopters (76% vs. 24%). Long-term adopters consisted of more middle-aged individuals (35-54 years) and the majority worked full-time (56%). They had more positive opinions of VCs and used VCs and video meetings for other purposes to a larger extent. They chose VCs because of the lack of time to go to the healthcare centre and because their provider offered them. The most common reason for discontinuing use was a preference for face-to-face consultations, with the youngest age group (16-34 years) reporting this to a larger extent. DISCUSSION: Younger and older age groups may be less likely to continue the use of VCs, potentially preserving the digital divide. Additionally, disparities in using similar technologies might contribute to the digital divide. Moreover, convenience, positive opinions of VCs, and experience with VCs were related to long-term adoption. Further studies are needed to explore non-use, age's influence, and address usability issues.

Patients' Experiences of Initiating Video Consultations.

Implementation and adoption of video consultations (VCs) in healthcare are not straightforward. Experiences of initiating a VC could increase our understanding of adoption by patients. This study aims to report patients' experiences of installing and booking a VC in primary care. Most people found it easy to find and install the VC application. Those with a higher self-reported ability and habit of using digital services and the internet found it easier than those reporting lower ability and habit. About half of our respondents had booked their recent VC themselves, most of whom had done so through a telephone call or the application "Alltid Öppet". The booking process was perceived to be easy by most but more difficult compared to installation. The easy installation process might have led to higher adoption by older people. Nevertheless, during implementation more support should be provided to people with lower digital service and internet use abilities and habits as they might find VC set-up more difficult. More attention should be given to the booking process as it may be a barrier potentially influencing adoption.

Usability of computerised physician order entry in primary care: assessing ePrescribing with a new evaluation model.

BACKGROUND: The incorrect use of medications may result from improper prescribing. The poor interface and design of computerised physician order entry (CPOE) systems may contribute. To improve the quality of electronic drug prescription, ePrescribing, there is a need for an evaluation model that is able to assess the quality of the CPOE, focusing on usability. OBJECTIVE: To develop and apply a model to evaluate the usability of different CPOEs used for ePrescribing in electronic health records (EHRs) in primary care. METHOD: An evaluation model for CPOEs was designed by assembling existing quality criteria for ePrescribing, supplemented with new criteria. The evaluation model was used to assess CPOEs from seven EHRs in primary care. RESULTS: The evaluation model included five categories comprising 73 single criteria. The model was found to be easy to use, and facilitated the assessment process. Evaluation of the EHRs revealed differences and similarities between the systems. None of the CPOEs was perfect in that all of them had distinct shortcomings. The most prominent deficiencies were a non-intuitive interface and incorrect dosage function. CONCLUSION: The model developed might be used not only to evaluate usability in ePrescribing, but also as a basis for studying the usability of other CPOEs. To reduce the risk of drugs being prescribed with incorrect dosages, the most urgent improvement is the development of a more consistent and intuitive interface for the EHRs and an improvement in the dosage function.

Exploring mHealths Fit to Workflow in Homecare - A Case Study in Sweden.

With an ageing population and limited resources in healthcare, many high-income countries such as Sweden see an increase in homecare and mobile work for healthcare professionals. In this case study, we explore how mHealth services can support the everyday work for healthcare professionals when delivering home care in rural areas in Sweden. The studied mHealth application had failed to be adopted among district nurses, despite a great expressed need for mobile tools. The results indicate that the mHealth solution did not live up the healthcare professionals' expectations in terms of providing the same functions as the regular electronic health record systems, and with poor integration into the existing eco-system of eHealth applications. In conclusion, in order for a mHealth application to be successfully implemented in a context where many digital services are already in use, it is not enough to support important activities in the current workflow. The mHealth application will need to be carefully integrated into the existing eco-system of healthcare applications to increase the chances of adoption.