Australia’s medical specialists have a strong foundation for eHealth adoption and use, but are far from realising its full potential. Specialists have the skills and tools needed to support self-contained eHealth use, but lack the connectivity, IT support and conviction required to engage in a way that integrates care across networks to drive patient-focused outcomes. Although improved connectivity is critical for advancing the impact of eHealth, it is often only perceived as relevant by specialists embedded in hospitals or other multidisciplinary care settings where coordination is an essential part of the care process.
Most medical specialists are focused on the effective delivery of their intervention and the efficiency of their practice. Improvements in end-to-end patient care across the entire care delivery pathway are often a secondary benefit rather than a primary driver for eHealth adoption. However, perceptions vary widely among specialists. For many, concerns about productivity losses from system downtimes and other factors remain a major barrier. Others believe that eHealth enables them to deliver better quality care more efficiently, and have had firsthand experience in overcoming barriers and realising benefits.
A deeper understanding of these perspectives is needed to leverage the experience and enthusiasm of early adopters to influence system-wide change. Adoption strategies (see Section 7 below) will require reductions in real and perceived operational barriers, matched by compelling practice-based evidence supporting the change.
These attitudes vary not only according to the personality and IT-engagement of the individual specialist, but also according to their operating environment, the nature of their work and the business model of their practice. If those in an emergency ward, for example, are expected to update patient records on the IT infrastructure provided, then they will do so. Private practice surgeons who work more independently, and for whom any IT failure or distraction is costly, are often less enthusiastic. While comparing specialties helps explain some of the differences between observed eHealth adoption levels, there is still a high degree of heterogeneity with respect to adoption within most specialties.
To help understand these variations, we analysed the eHealth readiness of Australia’s medical specialists along three dimensions:
- Their infrastructural readiness (their operating environment, as well as their IT hardware, software and connections)
- Their aptitudinal readiness (depth of skills and capability to use eHealth solutions); and
- Their attitudinal readiness (willingness to use current and future eHealth solutions).
We found consistently strong infrastructural and aptitudinal readiness for basic, self-contained computer applications, but differences emerged when more connected applications were considered, and these were amplified by differences in attitudinal readiness.
The following section provides an assessment of overall readiness across the dimensions of infrastructure, aptitude and attitude, and explores the primary barriers and drivers for adoption. Additional detail at the specialty segment level is provided in Appendix 3.