A study by Aalto University and Health Village found that it is important to involve IT and health care professionals as well as patients in the development of services.
Internationally, the introduction of online health care services has been found to be very difficult: an estimated 45% of services fail due to the resistance of health care professionals. A recent study by Aalto University and Health Village identified a number of factors that facilitate the implementation of services. This information will help the launch of new online services in healthcare in the future.
The study focused on the Finnish Health Village web service for specialised health care that provides health care information and support for citizens and tools for health care professionals. Health Village includes virtual houses that focus on different health problems, and Health Village has also developed digital treatment paths for certain patient groups. “As there were more new digital treatment paths in the works, we wanted to gather information on what people had learned from the first digital treatment paths so that they could be used for the future ones”, says Aalto University researcher and the first author of the article Sari Kujala.
The researchers interviewed employees from university hospitals in Helsinki, Turku, Oulu, Tampere and Kuopio and asked about their experiences with the implementation. The interviewees were mainly nurses responsible for introducing digital treatment paths in their own workplaces. The interviewees were selected from different treatment paths and from different hospitals in order to collect information from various environments.
Based on the results, the researchers found that when new electronic services are introduced in health care, it is essential that planning involves the professionals of health care as well as information technology and usability. Patient involvement is also important although it is often considered difficult.
“For example, if we can get even a small group for testing, their feedback will help us develop services that are easier to use. In addition, it would be useful to have help from experts in user-centred design or service design. They can identify hidden needs that users can’t tell us about and combine the needs of different parties to create solutions. Patients can be included continuously on a small scale as part of provided care, but also in cooperation with patient organisations, thesis authors and researchers”, Kujala says.
The study also notes that constant communication about the services and related changes is important. Professionals must be provided with sufficient training and guidance in the use of the services, and the concerns they raise must be taken seriously. It is also beneficial to collect user feedback and test services at all stages so that the services can be developed continuously and to ensure, for example, that the services are understandable to everyone. It is essential to be aware that implementation takes time and resources. For this reason, implementation should be planned carefully and it should not be made the responsibility of a single person.
“Professionals are motivated by services that streamline their work – only having to input data once, for example – and help patients. According to the interviewees, one thing that has had people excited is a digital treatment path that helps identify a serious skin symptom using a photograph sent by a patient at home”, Kujala says.
Researchers have long known that it is difficult to motivate both health care professionals and patients to use new online health care services. “Implementing new electronic services causes strain in urgent care, and professionals have not always been adequately supported in the change.”
However, when they work correctly, electronic services help to provide a better service and facilitate professionals’ work. Services also incur many costs to Finland. For these reasons, it is important to get both professionals and patients to use them. Doctors and nurses do not always remember to tell their patients about the services. According to Kujala, however, sharing information is important: studies have shown that a professional recommending services to their patients has a major impact on the use of the services.
The study is part of the Strategic Research Council-funded DigiIN project that aims to include everyone in the digital society by reforming service culture.
The research article was published recently in the Journal of Medical Internet Research.
Applying and Extending the FITT Framework to Identify the Challenges and Opportunities of Successful eHealth Services for Patient Self-Management: Qualitative Interview Study.