Do People Trust in Robot-Assisted Surgery? Evidence from Europe.

(1) Background: The goal of the paper was to establish the factors that influence how people feel about having a medical operation performed on them by a robot. (2) Methods: Data were obtained from a 2017 Flash Eurobarometer (number 460) of the European Commission with 27,901 citizens aged 15 years and over in the 28 countries of the European Union. Logistic regression (odds ratios, OR) to model the predictors of trust in robot-assisted surgery was calculated through motivational factors, using experience and sociodemographic independent variables. (3) Results: The results obtained indicate that, as the experience of using robots increases, the predictive coefficients related to information, attitude, and perception of robots become more negative. Furthermore, sociodemographic variables played an important predictive role. The effect of experience on trust in robots for surgical interventions was greater among men, people between 40 and 54 years old, and those with higher educational levels. (4) Conclusions: The results show that trust in robots goes beyond rational decision-making, since the final decision about whether it should be a robot that performs a complex procedure like a surgical intervention depends almost exclusively on the patient's wishes.

Determinants of Catalan public primary care professionals' intention to use digital clinical consultations (eConsulta) in the post-COVID-19 context: optical illusion or permanent transformation?

BACKGROUND: During lockdown due to the COVID-19 pandemic, telemedicine has become a necessary component of clinical practice for the purpose of providing safer patient care, and it has been used to support the healthcare needs of COVID-19 patients and routine primary care patients alike. However, this change has not been fully consolidated. OBJECTIVE: The objective of this study was to analyse the determinants of healthcare professionals' intention to use the eConsulta digital clinical consultations tool in the post-COVID-19 context. METHODS: A literature review of the Technology Acceptance Model (TAM) allowed us to construct a theoretical model and establish a set of hypotheses derived from it about the influence that a variety of different factors relating to both healthcare professionals and the institutions where they work had on those professionals' intention to use eConsulta. In order to confirm the proposed model, a mixed qualitative and quantitative methodology was used, and a questionnaire was designed to serve as the data collection instrument. The data were analysed using univariate and bivariate analysis techniques. To confirm the theoretical model, exploratory factor analysis and binary logistic regression were applied. RESULTS: The most important variables were those referring to perceived benefits (B=2.408) and the type of use that individuals habitually made of eConsulta (B=0.715). Environmental pressure (B=0.678), experience of technology (B=0.542), gender (B=0.639) and the degree of eConsulta implementation (B=0.266) were other variables influencing the intention to use the tool in the post-COVID-19 context. When replicating the previous analysis by professional group, experience of technology and gender in the physician group, and experience of the tool's use and the centre where a professional works in the nurse group, were found to be of considerable importance. CONCLUSIONS: The implementation and use of eConsulta had increased significantly as a consequence of the COVID-19 pandemic, and the majority of the healthcare professionals were satisfied with its use in practice and planned to incorporate it into their practices in the post-COVID-19 context. Perceived benefits and environmental pressure were determining factors in the attitude towards and intention to use eConsulta.

Using Digital Platforms to Promote Blood Donation: Motivational and Preliminary Evidence from Latin America and Spain.

The lack of blood donors is a global problem that prevents the demand for blood prompted by an ageing population and increased life expectancy from being met. The aim of this study was to conduct an initial exploration of the reasons for using digital platforms in blood donation. Using a Theory of Planned Behaviour (TPB) framework, microdata for 389 participants from Latin American countries and Spain, and Partial Least Square-Structural Equation Modelling (PLS-SEM), the study obtained three main prediction paths. The first two started from feelings of trust in the digital community and a positive mood state associated with a modern lifestyle, and they were linked to attitudes and behavioural control in the explanation of the intention to donate and actual blood donation. The third path started from modern lifestyles, and was linked to the subjective norm in the prediction of intention and actual donation. These paths represent one of the very first attempts to predict intentions of donation and collaborative donation by taking a PLS-SEM approach. By determining the paths underpinning collaborative blood donors' motives, the results of this study provide strong support for the usefulness of the TPB model within the context of digital platform use and blood donation.

Routine Health Information Systems in the European Context: A Systematic Review of Systematic Reviews.

(1) Background: The aim of this study is to provide a better understanding of the requirements to improve routine health information systems (RHISs) for the management of health systems, including the identification of best practices, opportunities, and challenges in the 53 countries and territories of the WHO European region. (2) Methods: We conducted an overview of systematics reviews and searched the literature in the databases MEDLINE/PubMed, Cochrane, EMBASE, and Web of Science electronic databases. After a meticulous screening, we identified 20 that met the inclusion criteria, and RHIS evaluation results were presented according to the Performance of Routine Information System Management (PRISM) framework. (3) Results: The reviews were published between 2007 and 2020, focusing on the use of different systems or technologies and aimed to analyze interventions on professionals, centers, or patients' outcomes. All reviews examined showed variability in results in accordance with the variability of interventions and target populations. We have found different areas for improvement for RHISs according to the three determinants of the PRISM framework that influence the configuration of RHISs: technical, organizational, or behavioral elements. (4) Conclusions: RHIS interventions in the European region are promising. However, new global and international strategies and the development of tools and mechanisms should be promoted to highly integrate platforms among European countries.

Modeling and Predicting Outcomes of eHealth Usage by European Physicians: Multidimensional Approach from a Survey of 9196 General Practitioners.

BACKGROUND: The literature has noted the need to use more advanced methods and models to evaluate physicians' outcomes in the shared health care model that electronic health (eHealth) proposes. OBJECTIVE: The goal of our study was to design and evaluate a predictive multidimensional model of the outcomes of eHealth usage by European physicians. METHODS: We used 2012-2013 survey data from a sample of 9196 European physicians (general practitioners). We proposed and tested two composite indicators of eHealth usage outcomes (internal practices and practices with patients) through 2-stage structural equation modeling. Logistic regression (odds ratios, ORs) to model the predictors of eHealth usage outcomes indicators were also calculated. RESULTS: European general practitioners who were female (internal practices OR 1.15, 95% CI 1.10-1.20; practices with patients OR 1.19, 95% CI 1.14-1.24) and younger-aged <35 years (internal practices OR 1.14, 95% CI 1.02-1.26; practices with patients OR 1.32, 95% CI 1.13-1.54) and aged 36-45 years (internal practices OR 1.16, 95% CI 1.06-1.28; practices with patients OR 1.21, 95% CI 1.10-1.33)-had a greater propensity toward favorable eHealth usage outcomes in internal practices and practices with patients. European general practitioners who positively valued information and communication technology (ICT) impact on their personal working processes (internal practices OR 5.30, 95% CI 4.73-5.93; practices with patients OR 4.83, 95% CI 4.32-5.40), teamwork processes (internal practices OR 4.19, 95% CI 3.78-4.65; practices with patients OR 3.38, 95% CI 3.05-3.74), and the doctor-patient relationship (internal practices OR 3.97, 95% CI 3.60-4.37; practices with patients OR 6.02, 95% CI 5.43-6.67) had a high propensity toward favorable effects of eHealth usage on internal practices and practices with patients. More favorable eHealth outcomes were also observed for self-employed European general practitioners (internal practices OR 1.33, 95% CI 1.22-1.45; practices with patients OR 1.10, 95% CI 1.03-1.28). Finally, general practitioners who reported that the number of patients treated in the last 2 years had remained constant (internal practices OR 1.08, 95% CI 1.01-1.17) or increased (practices with patients OR 1.12, 95% CI 1.03-1.22) had a higher propensity toward favorable eHealth usage outcomes. CONCLUSIONS: We provide new evidence of predictors (sociodemographic issues, attitudes toward ICT impacts, and working conditions) that explain favorable eHealth usage outcomes. The results highlight the need to develop more specific policies for eHealth usage to address different realities.

Digital health in the Americas: advances and challenges in connected health.

In 2005, all WHO Member States pledged to fight for universal health coverage (UHC). The availability of financial, human and technological resources seems to be necessary to develop efficient health policies and also to offer UHC. One of the main challenges facing the health sector comes from the need to innovate efficiently. The intense use of information and communication technologies (ICTs) in the health field evidences a notable improvement in results obtained by institutions, health professionals and patients, principally in developed countries. In the Americas, the relationship between economic development and health innovation is not particularly evident. Data from 19 of 35 countries surveyed in the 2015 Third Global Survey on eHealth for the region of the Americas were analysed. 52.6% of the countries of the Americas have a national policy or strategy for UHC. 57.9% of the countries in the sample indicate that they have a national eHealth policy or strategy, but only 26.3% have an entity that supervises the quality, safety and reliability regulations for mobile health applications. The survey data indicate that high-income and low-income to middle-income countries show higher percentages in relation to the existence of entities that promote innovation. These countries also exceed 60%-compared with 40% and 50% in lower-income countries-in all cases regarding the use of eHealth practices, such as mobile health, remote patient monitoring or telehealth. 100% of low-income countries report offering ICT training to healthcare professionals, compared with 83% of wealthy countries and 81% of middle-income to high-income countries.

The spanish versión of the job crafting scale / Versión española de la Escala Job Crafting

Background: A literature review reveals that there is no measure of job crafting available in Spanish. This paper presents the translation, adaptation and validation of a scale to measure job crafting behaviors (i.e. the Spanish Job Crafting Scale - SJCS; Tims, Bakker, & Derks, 2012). Methods: The scale was applied to a sample of 896 employees in Spain (52.26% women and 47.4% men). We tested the reliability and factorial validity of the 21-item instrument. Results: After confirmatory factor analysis (CFI=.858, TLI= .838, IFI= .860, RMSEA= .067), the results show a structure consisting of four factors: Increasing structural job resources; Decreasing hindering job demands; Increasing social job resources; Increasing challenging job demands. These four factors demonstrate adequate reliability and evidence of validity with others scales that refer to Engagement at Work and Proactivity. Conclusion: The questionnaire may be a useful tool for the assessment of job crafting and for future research in Spanish speaking countries (AU)

Antecedentes: una revisión de la literatura revela que no existen instrumentos de medida del job crafting en lengua española. Este artículo presenta la traducción, adaptación y validación de una escala para medir el comportamiento del job crafting (Spanish Job Crafting Scale -SJCS; Tims, Bakker, & Derks, 2012). Método: la escala fue aplicada a una muestra de 896 empleados (52,6% mujeres y 47,4% hombres). Se han testeado la fiabilidad y la validez factorial de un instrumento con 21 ítems. Resultados: después de realizar análisis confirmatorio (CFI= .858, TLI= .838, IFI= .860, RMSEA= .067), los resultados obtenidos confirman una estructura constituida por cuatro factores: Aumento de los recursos estructurales del empleo, Disminución de las demandas de trabajo, Aumento de los recursos sociales del empleo, Creciente demanda de desafíos en el trabajo. Estos cuatro factores tienen una fiabilidad adecuada y se constatan evidencias de validez con otras escalas que hacen referencia al Engagement en el trabajo y la Proactividad. Conclusiones: el cuestionario puede ser una herramienta útil para la evaluación del job crafting y para su uso en la investigación en el contexto de los países de lengua española (AU)

The Spanish version of the Job Crafting Scale.

BACKGROUND: A literature review reveals that there is no measure of job crafting available in Spanish. This paper presents the translation, adaptation and validation of a scale to measure job crafting behaviors (i.e. the Spanish Job Crafting Scale – SJCS; Tims, Bakker, & Derks, 2012). METHODS: The scale was applied to a sample of 896 employees in Spain (52.26% women and 47.4% men). We tested the reliability and factorial validity of the 21-item instrument. RESULTS: After confirmatory factor analysis (CFI=.858, TLI= .838, IFI= .860, RMSEA= .067), the results show a structure consisting of four factors: Increasing structural job resources; Decreasing hindering job demands; Increasing social job resources; Increasing challenging job demands. These four factors demonstrate adequate reliability and evidence of validity with others scales that refer to Engagement at Work and Proactivity. CONCLUSION: The questionnaire may be a useful tool for the assessment of job crafting and for future research in Spanish speaking countries.

DETERMINANTS OF THE INTENTION TO USE TELEMEDICINE: EVIDENCE FROM PRIMARY CARE PHYSICIANS.

OBJECTIVES: While most studies have focused on analyzing the results of telemedicine use, it is crucial to consider the determinants of its use to fully understand the issue. This article aims to provide evidence on the determinants of telemedicine use in clinical practice. METHODS: The survey targeted a total population of 398 medical professionals from a healthcare institution in Spain. The study sample was formed by the ninety-three primary care physicians who responded. Using an extended Technology Acceptance Model and microdata for the ninety-six physicians, binary logistic regression analysis was carried out. RESULTS: The analysis performed confirmed the model's goodness-of-fit, which allowed 48.1 percent of the dependent variable's variance to be explained. The outcomes revealed that the physicians at the healthcare institution placed greater importance on telemedicine's potential to reduce costs, and on its usefulness to the medical profession. The perception of medical information security and confidentiality and the patients' predisposition toward telemedicine were the second explanatory factors in order of importance. A third set of moderating effects would appear to corroborate the importance of the physicians' own opinions. CONCLUSIONS: These results have revealed the need for a dynamic approach to the design of telemedicine use, especially when it targets a variety of end-users. Hence, the importance of conducting studies before using telemedicine, and attempting to identify which of the above-mentioned predictors exert an influence and how.

Modelling and Predicting eHealth Usage in Europe: A Multidimensional Approach From an Online Survey of 13,000 European Union Internet Users.

BACKGROUND: More advanced methods and models are needed to evaluate the participation of patients and citizens in the shared health care model that eHealth proposes. OBJECTIVE: The goal of our study was to design and evaluate a predictive multidimensional model of eHealth usage. METHODS: We used 2011 survey data from a sample of 13,000 European citizens aged 16-74 years who had used the Internet in the previous 3 months. We proposed and tested an eHealth usage composite indicator through 2-stage structural equation modelling with latent variables and measurement errors. Logistic regression (odds ratios, ORs) to model the predictors of eHealth usage was calculated using health status and sociodemographic independent variables. RESULTS: The dimensions with more explanatory power of eHealth usage were health Internet attitudes, information health Internet usage, empowerment of health Internet users, and the usefulness of health Internet usage. Some 52.39% (6811/13,000) of European Internet users' eHealth usage was more intensive (greater than the mean). Users with long-term health problems or illnesses (OR 1.20, 95% CI 1.12-1.29) or receiving long-term treatment (OR 1.11, 95% CI 1.03-1.20), having family members with long-term health problems or illnesses (OR 1.44, 95% CI 1.34-1.55), or undertaking care activities for other people (OR 1.58, 95% CI 1.40-1.77) had a high propensity toward intensive eHealth usage. Sociodemographic predictors showed that Internet users who were female (OR 1.23, 95% CI 1.14-1.31), aged 25-54 years (OR 1.12, 95% CI 1.05-1.21), living in larger households (3 members: OR 1.25, 95% CI 1.15-1.36; 5 members: OR 1.13, 95% CI 0.97-1.28; ≥6 members: OR 1.31, 95% CI 1.10-1.57), had more children <16 years of age (1 child: OR 1.29, 95% CI 1.18-1.14; 2 children: OR 1.05, 95% CI 0.94-1.17; 4 children: OR 1.35, 95% CI 0.88-2.08), and had more family members >65 years of age (1 member: OR 1.33, 95% CI 1.18-1.50; ≥4 members: OR 1.82, 95% CI 0.54-6.03) had a greater propensity toward intensive eHealth usage. Likewise, users residing in densely populated areas, such as cities and large towns (OR 1.17, 95% CI 1.09-1.25), also had a greater propensity toward intensive eHealth usage. Educational levels presented an inverted U shape in relation to intensive eHealth usage, with greater propensities among those with a secondary education (OR 1.08, 95% CI 1.01-1.16). Finally, occupational categories and net monthly income data suggest a higher propensity among the employed or self-employed (OR 1.07, 95% CI 0.99-1.15) and among the minimum wage stratum, earning ≤€1000 per month (OR 1.66, 95% CI 1.48-1.87). CONCLUSIONS: We provide new evidence of inequalities that explain intensive eHealth usage. The results highlight the need to develop more specific eHealth practices to address different realities.

Dispositional Employability and Online Training Purchase. Evidence from Employees' Behavior in Spain.

This article explores the relationship between dispositional employability and online training purchase. Through a sample of 883 employees working for enterprises in Spain, and a using principal component analysis and binomial logit probabilistic models, the research revealed two main results. First, it was found that dispositional employability is characterized by five factors: "openness to changes at work," "career motivation and work resilience," "work and career proactivity," "optimism and engagement at work," and "work identity." Second, the research also found a double causality in the relationship analysis between dispositional employability and online training purchase. However, this causality is not direct. In explaining dispositional employability, certain motivations and types of behavior of employees participating in online training are significant. In particular, greater sensitivity toward career-related personal empowerment, a greater predisposition toward developing new experiences at work, and a greater awareness of the fact that positive job outcomes are related to preparation conscientiousness. In explaining online training purchase, employees who are more motivated and who better identify with their jobs are more likely to pay. Moreover, employees who spend more time on training and have less contact with new trends in their jobs, find it hard to keep calm in difficult situations, and have a greater predisposition toward effort, and preference for novelty, variety and challenges at work are more likely to purchase online training.

Understanding the discriminant factors that influence the adoption and use of clinical communities of practice: the ECOPIH case.

BACKGROUND: The aim of the study presented in this article is to analyse the discriminant factors that have an influence on the use of communities of practice by primary and specialist healthcare professionals (physicians and nurses) for information sharing. Obtaining evidence from an ex-ante analysis to determine what factors explain healthcare professionals' clinical community of practice use allows aspects of its use to be identified. METHODS: A theoretical model based on a modified technology acceptance model was used as the analysis tool, and a discriminant analysis was performed. An ad-hoc questionnaire was designed and sent to a study population of 357 professionals from the Badalona-Sant Adrià de Besòs Primary Care Service in Catalonia, Spain, which includes nine primary care centres and three specialist care centres. The study sample was formed by the 166 healthcare professionals who responded. RESULTS: The results revealed three main drivers for engagement in a CoP: First, for the whole sample, perceived usefulness for reducing costs associated with clinical practice was the factor with the greatest discriminant power that distinguished between users and non-users, followed by perceived usefulness for improving clinical practice quality, and lastly habitual social media website and application use. Turning to the two sub-samples of healthcare professions (physicians and nurses, respectively), we saw that the usefulness stemming from community of practice use changed. There were differences in the levels of motivation of healthcare professionals with regards to their engagement with CoP. While perceived usefulness for reducing costs associated with clinical practice was the main factor for the physicians, perceived usefulness of the Web 2.0 platform use for communication for improving clinical practice quality and perceived ease of use were the main factors for the nurses. CONCLUSIONS: In the context of communities of practice, the perception of usefulness of Web 2.0 platform use for communication is determined by organisational, technological and social factors. Specifically, the position that professionals have within the healthcare structure and particularly the closer healthcare professionals' activity is to patients and their professional experience of using social networks and ICTs are crucial to explaining the use of such platforms. Public policies promoting Web 2.0 platform use for communication should therefore go beyond the purely technological dimension and consider other professional and social determinants.

Drivers of telemedicine use: comparative evidence from samples of Spanish, Colombian and Bolivian physicians.

BACKGROUND: The aim of the study presented in this article is to analyse the determinants of telemedicine use. To that end, the study makes two basic contributions. First, it considers six working hypotheses in the context of technology acceptance models (TAMs). Second, it uses data obtained for three samples of physicians from three different countries (Spain, Colombia and Bolivia). Obtaining and comparing evidence on an international scale allows determinants of telemedicine use to be evaluated across different contexts. METHODS: In Bolivia, the survey was conducted in hospitals and health care centres of the urban and rural districts of the municipality of Sucre, in a population comprising a total of 350 physicians. In Spain, the survey population consisted of medical professionals of all profiles affiliated with health care within the Canary Islands Health Service, comprising a total of 356 physicians. Finally, in Colombia, it was conducted in the Society of Surgery Service at San José Hospital of Bogotá, in a population comprising a total of 184 physicians. Using an extended TAM and survey data from 510 physicians (113 in Spain, 118 in Colombia and 279 in Bolivia), binary logistic regression analysis was performed. RESULTS: In the three samples, it was found that the physician's level of information and communication technology (ICT) use in his/her personal life was the variable that had the highest explanatory power regarding telemedicine use. In the Spanish sample, the physicians' perceived ease-of-use of ICTs in clinical practice and propensity to innovate were the two other variables that determined telemedicine use, whereas in the Colombian and Bolivian samples, it was the level of optimism about ICTs. CONCLUSION: The results facilitated a more complete model that includes personal, usability, and innovatory aspects in the explanation of Telemedicine use in Spain, whereas the results for the Latin American samples indicated a more primary model in the explanation of Telemedicine use, which was completed by an optimism factor that did not emerge in the Spanish sample.

Spanish adaptation of the internal functioning of the work teams scale (QFI-22) / Adaptación al español de la escala de Funcionamiento Interno de los Equipos de Trabajo (QFI-22)

BACKGROUND: The aim of this article is to develop the Spanish adaptation of the internal functioning of Work Teams Scale (QFI-22). METHODS: The scale was adapted from the French version, and was applied to a sample of 1,055 employees working for firms operating in Spain. The article analyses the internal structure (exploratory and confirmatory factor analysis) and internal consistency, and provides convergent validity evidence of the scale. RESULTS: The QFI-22 scale shows the same internal structure as the original. Factor analysis confirmed the existence of two factors: interpersonal support and team work management, with good internal consistency coefficients (α1 = .93, α2 = .92). Regarding validity evidence, the QFI-22 scale has significant correlations with other correlates and alternative scales used for comparison purposes. The two factors correlated positively with team vision, participation safety, task orientation and support for innovation (Team Climate Inventory, TCI scale), with progressive culture (Organisational Culture, X-Y scale), and with creating change, customer focus and organisational learning (Denison Organizational Culture Survey, DOCS scale). In contrast, the two factors correlated negatively with traditional culture (X-Y scale). CONCLUSION: The QFI-22 scale is a useful instrument for assessing the internal functioning of work teams

ANTECEDENTES: el objetivo del artículo es adaptar al español la escala de Funcionamiento Interno de los Equipos de Trabajo (QFI-22). MÉTODO: se adaptó la versión francesa y se aplicó a una muestra de 1.055 empleados. Se analizaron la estructura interna (análisis factorial exploratorio y análisis factorial confirmatorio), la consistencia interna y evidencias de validez convergente de la escala investigada. RESULTADOS: QFI-22 muestra la misma estructura interna que la versión original. El análisis factorial confirma la existencia de dos factores: apoyo interpersonal y gestión del trabajo en equipo, con buenos coeficientes de consistencia interna (α1= ,93; α2= ,92). En cuanto a las evidencias de validez, la escala ha obtenido evidencias de relaciones significativas con otros correlatos y escalas de contraste. Los dos factores correlacionan positivamente con la visión, seguridad en la participación, orientación a la tarea y ayuda a la innovación (escala TCI, Team Climate Inventory); con la cultura progresista (escala X-Y de cultura organizativa), y con la orientación al cambio, orientación al cliente, y aprendizaje organizativo (escala Denison Organizational Culture Survey, DOCS); y negativamente con la cultura tradicional (escala X-Y). CONCLUSIÓN: la escala QFI-22 se configura como un instrumento útil para la evaluación del funcionamiento interno de los equipos de trabajo

Spanish adaptation of the internal functioning of the Work Teams Scale (QFI-22).

BACKGROUND: The aim of this article is to develop the Spanish adaptation of the internal functioning of Work Teams Scale (QFI-22). METHODS: The scale was adapted from the French version, and was applied to a sample of 1,055 employees working for firms operating in Spain. The article analyses the internal structure (exploratory and confirmatory factor analysis) and internal consistency, and provides convergent validity evidence of the scale. RESULTS: The QFI-22 scale shows the same internal structure as the original. Factor analysis confirmed the existence of two factors: interpersonal support and team work management, with good internal consistency coefficients (α1 = .93, α2 = .92). Regarding validity evidence, the QFI-22 scale has significant correlations with other correlates and alternative scales used for comparison purposes. The two factors correlated positively with team vision, participation safety, task orientation and support for innovation (Team Climate Inventory, TCI scale), with progressive culture (Organisational Culture, X-Y scale), and with creating change, customer focus and organisational learning (Denison Organizational Culture Survey, DOCS scale). In contrast, the two factors correlated negatively with traditional culture (X-Y scale). CONCLUSION: The QFI-22 scale is a useful instrument for assessing the internal functioning of work teams.

Improving integrated care: modelling the performance of an online community of practice.

INTRODUCTION: THIS ARTICLE AIMS TO CONFIRM THE FOLLOWING CORE HYPOTHESIS: a Community of Practice's use of a Web 2.0 platform for communication between primary and hospital care leads to improved primary care and fewer hospital referrals. This core hypothesis will be corroborated by testing a further five partial hypotheses that complete the main hypothesis being estimated. METHODS: An ad-hoc questionnaire was designed and sent to a sample group of 357 professionals from the Badalona-Sant Adrià de Besòs Primary Care Service in Catalonia, Spain, which includes nine primary care centres and three specialist care centres. The study sample was formed by 159 respondents. The partial least squares methodology was used to estimate the model of the causal relationship and the proposed hypotheses. RESULTS: It was found that when healthcare staff used social networks and information and communication technologies professionally, and the more contact hours they have with patients, the more a Web 2.0 platform was likely to be used for communication between primary and hospital care professionals. Such use led to improved primary care and fewer hospital referrals according to the opinions of health professionals on its use. CONCLUSIONS: The research suggests that the efficiency of medical practice is explained by the intensity of Web 2.0 platform use for communication between primary and specialist care professionals. Public policies promoting the use of information and communication technologies in communities of practice should go beyond the technological dimension and consider other professional, organisational and social determinants.