Those charged with the responsibilities of advancing Australia’s national eHealth strategies should take heart from this report. There is nothing in the findings that presents a philosophical or otherwise insurmountable barrier to eHealth adoption by medical specialists. Almost all have the connectivity and know-how to take up an eHealth solution that has proven its worth in the market. For most, it is simply an operational decision: will a proposed solution be a cost-effective improvement to the efficiency with which the specialist contributes to patient care.
On the basis of this research, we would now answer our three anchor questions as follows.
1. Medical specialists are ready to adopt eHealth technologies that either improve their practice’s operational efficiency or improve clinical care, but are not yet ready to use eHealth in a way that connects and coordinates care within the entire health ecosystem.
Australia’s medical specialists have a strong foundation for eHealth adoption and use, but current levels of electronic information sharing indicate that they are far from realising its full potential. Specialists generally take a practice-oriented view, rather than a macro-level perspective to eHealth adoption and benefits. For this reason, current use is often self-contained within a practice or hospital rather than integrated across networks. Medical specialists have the skills and tools needed to support self-contained eHealth use, but most lack the connectivity, IT support and conviction required to adopt eHealth solutions that drive widespread patient-focused clinical outcomes.
2. The leading barriers to eHealth adoption are product-driven concerns about system malfunctions, downtime, and poor usability, all of which jeopardise specialists’ ability to deliver quality care efficiently. Improving product reliability and connectivity will help specialists feel comfortable using eHealth solutions to their full potential.
Specialists are extremely sensitive to operational efficiency risks because they directly affect both patient care and their income (for private fee-for-service specialists). Many specialists also face connectivity constraints, have concerns about privacy and security, and perceive financial costs and risks that exceed the perceived benefits.
Reducing technological barriers will require a joint effort between system vendors, clinicians, and other industry stakeholders such as standards organisations. They will need to improve product functionality and usability, minimise the risk and impact of system error, and improve connectivity and interoperability. Concerns about privacy and security can be overcome through dissemination of accurate information and adherence to universal privacy guidelines. Time and cost concerns can be addressed by reducing real and perceived costs (e.g. through IT support or subsidies) and by increasing real and perceived benefits.
3. eHealth use is largely driven by two demand-related factors: a strong perception of benefits, and pressure from others in a specialist’s working environment. Connecting eHealth use with tangible, relevant benefits and building an influential network of eHealth advocates will best promote future use.
Specialists’ primary objective is to deliver high quality care as efficiently and safely as possible. To the extent that they believe eHealth will advance these objectives, they are incentivised to adopt. These beliefs vary widely between different attitudinal clusters of specialists, however. External pressure is also very powerful, both in convincing specialists of the benefits and in providing the resources and support needed to facilitate adoption. Beyond their immediate environments, specialists are influenced to varying degrees by respected peers, advice from professional bodies, and journal publications.
Increased adoption and effective use can be driven by strengthening the connection between eHealth and the benefits that are most relevant to specialists. This can be accomplished by ensuring eHealth solutions are clearly embedded in overall improvement of care delivery models and processes, establishing specific value propositions to specialists in adopting these new care models and supporting eHealth solutions, and measuring and tracking outcomes and presenting this evidence through credible sources that reach both practitioners and hospital decision-makers.
Based on these findings, advancing medical specialists’ eHealth adoption in a way that achieves widespread improvements in health outcomes requires shaping the three axes of ecosystem, product, and demand. Addressing a single axis in isolation is likely insufficient to produce significant change. Shaping the ecosystem is critical for establishing an integrated healthcare network that supports and drives change, shaping the product is necessary to overcome adoption barriers and ensure that solutions maintain or enhance specialists’ care delivery processes, and shaping demand provides the necessary incentives to spur adoption and use.