Evaluating Health Care Professionals' Readiness for e-Health Adoption in the Context of the COVID-19 Pandemic: A Georgian Perspective

Abstract

Background:

The COVID-19 pandemic has accelerated the adoption of Electronic health (e-Health), leveraging technologies such as telemedicine, electronic health records, artificial intelligence, and patient engagement platforms. This transformation underscores e-Health's role in providing efficient, patient-centered care. Our study explores health care professionals' readiness for these technologies, emphasizing the need for tailored education in this evolving landscape.

Methods:

In our study, conducted between February and March 2023, we administered a questionnaire-based survey to 500 staff members (82.4% female, 17.6% male) aged 25–70 from medical universities in Tbilisi, Georgia. The structured questionnaire covered topics such as computer literacy, telemedicine awareness, patient data security, and ethical considerations. We employed SPSS v21.0 for data analysis, encompassing descriptive statistics and thematic analysis of open-ended responses.

Results:

Our study included 500 participants categorized into five age groups. Notably, 31% considered themselves computer “experts,” while 69% rated their skills as “intermediate” or “advanced.” Furthermore, 85% used computers professionally, with 33% having practical computer training. Interestingly, 59% expressed interest in information technology training. Regarding e-Health, 15% believed it involves remote communication between health care professionals and patients, while 42% considered it “correct,” and 37% “might be correct.” Concerning its application in managing patients, opinions varied. In terms of e-Health's integration into Georgia's health care, responses ranged. Regarding patient data safety, participants exhibited diverse views. Finally, opinions on the necessity of informed consent for e-Health applications varied among participants.

Conclusions:

Our study explores health care professionals' readiness for e-Health adoption during the COVID-19 pandemic. It reveals varying computer literacy levels, a willingness to learn, differing views on e-Health applications, and mixed opinions on its integration into Georgian health care. These findings emphasize the need for clear e-Health terminology, education, tailored approaches, and a focus on data privacy and informed consent. Overall, e-Health's transformative role in modern health care is underscored.

Introduction

Electronic health (e-Health) unfolds as a dynamic and transformative force within the realm of health care, harnessing the potential of information and communication technologies to redefine the delivery and management of health care services. The COVID-19 pandemic has undeniably ushered in a transformative era in health care, prominently featuring the rise of e-Health as a vital component of the health care ecosystem. As we delve deeper into this epoch, we witness how the pandemic has accelerated the adoption of e-Health technologies, shining a spotlight on their paramount importance in the modern health care landscape.

The pandemic's seismic impact on health care systems worldwide has underscored the urgent need for innovative solutions that can rapidly respond to evolving health care challenges. In this context, e-Health has emerged as a beacon of hope and a catalyst for change. The capabilities of e-Health technologies have been instrumental in managing the crisis on multiple fronts.

Telemedicine and telehealth have been at the forefront, serving as lifelines for patients and health care providers alike. The imperative to minimize in-person contact to curb the virus's spread has made remote consultations and virtual care delivery indispensable.^1,2 Patients have accessed medical advice, received diagnoses, and even monitored chronic conditions from the safety of their homes. Health care providers, on the other hand, have harnessed telemedicine to continue delivering care while adhering to stringent infection control measures.³ This surge in telehealth utilization has not only bridged geographical gaps but also reduced the burden on overwhelmed health care facilities.

The role of e-Health extends beyond telemedicine. Electronic health records (EHRs) have become invaluable tools for tracking and managing COVID-19 cases.⁴ EHRs enable real-time data sharing among health care facilities and authorities, facilitating swift responses to outbreaks and contact tracing efforts.⁵ Health information exchange has proven crucial in ensuring the seamless flow of critical patient data between different health care entities involved in pandemic management.

Furthermore, the pandemic has highlighted the potential of artificial intelligence and data analytics within the realm of e-Health.^6,7 These technologies have played pivotal roles in predicting disease trends, optimizing resource allocation, and even expediting the development of vaccines and treatments. Leveraging big data analytics, health care systems have gained insights into patient populations' vulnerabilities and needs, enabling more targeted interventions. Amid the chaos of the pandemic, electronic prescribing systems have facilitated the safe and efficient dispensing of medications.⁸ These systems have helped patients adhere to treatment regimens and reduced the risks associated with manual prescription processes.

The collaborative potential of e-Health has also come to the fore. Remote patient monitoring systems have enabled health care providers to keep a vigilant eye on patients recovering from COVID-19 at home.⁹ These technologies have contributed to reducing hospital readmissions and easing the burden on health care facilities. Patient engagement through e-Health platforms and portals has empowered individuals to actively participate in their health care.¹⁰ The digital divide, which once hindered equitable access to health care information, has seen efforts to bridge the gap, ensuring that everyone has access to the benefits of e-Health.

Thus, the COVID-19 pandemic has not only expedited the adoption of e-Health technologies but also illuminated their indispensability in modern health care. As we navigate this transformative era, the lessons learned from this crisis will continue to shape the future of health care, where e-Health plays a central role in providing accessible, efficient, and patient-centered care. Although this transformation process is somehow subjective and is dependent on individuals and their eagerness to accept the innovations on a routine basis without pressure of pandemic. Our study aims to investigate the readiness of health care professionals to apply e-Health technologies in their routine practice.

Methods

Our study has been performed in February–March 2023, by utilizing a questionnaire-based survey methodology to collect data from the staff members (500 subjects, 412 [82.4%] females and 88 [17.6%] males) in the age group between 25 and 70 years from the medical universities in Tbilisi, Georgia. The survey was designed as the structured questionnaire to assess basic information (computer literacy, usage frequency, and enrollment in training of computer usage), understanding the role of telemedicine and its practical application, patient data safety, and ethical and legislative aspects of telemedicine. The questionnaire consisted of multiple choice and open-ended questions. The survey was administered electronically to the eligible staff members of the medical university. Participants were provided with clear instructions on how to complete the questionnaire. Informed consent was obtained from each participant before they proceeded with the survey.

Data obtained from the survey were analyzed using statistical software SPSS v21.0 (SPSS, Inc., Chicago, IL). Descriptive statistics, percentages were calculated to summarize the participants' responses. Data from open-ended questions were analyzed thematically to identify recurring themes and insights.

Our study adhered to ethical guidelines and principles. Informed consent was obtained from all participants, ensuring their voluntary participation and data confidentiality. Ethical approval of the study was obtained from the Bioethical International Committee (IRB approval #04-11052023) of Petre Shotadze Tbilisi Medical Academy. All collected data are kept confidential; participants' identities are anonymized to protect their privacy.

Results

According to our findings, study participants are categorized into five distinct age groups: <30 years—40 participants (8%), 30–40 years—47 participants (9.4%), 40–50 years—175 participants (35%), 50–60 years—145 participants (29%), and >60 years—93 participants (18.6%). This stratification allowed a comprehensive analysis of age-related perspectives and possibilities concerning integration of e-Health technologies in daily practice of health care professionals.

One hundred fifty-five (31%) participants self-evaluated their computer literacy level as “expert,” while 345 (69%) as “intermediate” or “advanced.” It is noteworthy that 425 (85%) participants mentioned that “they are using computers professionally—they can communicate with patients and peers using different platforms (i.e., email, chat or messenger, zoom, and etc.),” 75 (15%) participants mentioned that “they are using computers as basic users – they can operate with databases and electronic health care record systems.” A total of 165 (33%) out of 500 (100%) participants were trained on practical usage of computer during their career. However, despite their training status or self-evaluation, 295 (59%) participants express interest and eagerness to attend the information and computer technologies task-focused trainings, while 135 (27%) participants rejected this idea and 70 (14%) participants will decide this later.

Statement “e-Health refers to communication between health care professional and patient remotely, using computer technology”—75 (15%) participants considered as “Absolutely correct,” 210 (42%) participants as “Correct,” 185 (37%) participants as “Might be correct,” 10 (2%) participant as “Probably incorrect,” and 20 (4%) participants declared as “Incorrect.” Participants replies concerning the efficacy of e-Health application for chronic and pediatric patients as well as acute cases are presented in Table 1.

Table 1.

Study Participants Replies on Statements: (a) Electronic Health (e-Health) Is Effective for Chronic Patients' Management; (b) e-Health Is Effective for Acute Cases Management; (c) e-Health Is Effective for Pediatric Patients' Management

PARTICIPANT REPLY STATEMENT	STRONGLY AGREE	AGREE	MAINLY AGREE	NEITHER AGREE NOR DISAGREE	MAINLY DISAGREE	DISAGREE	STRONGLY DISAGREE
e-Health is effective for chronic patients' management	85 (17%)	235 (47%)	145 (29%)	20 (4%)	12 (2.4%)	3 (0.6%)	—
e-Health is effective for acute cases management	30 (6%)	35 (7%)	150 (30%)	40 (8%)	95 (19%)	120 (24%)	30 (6%)
e-Health is effective for pediatric patients' management	35 (7%)	60 (12%)	155 (31%)	10 (2%)	70 (14%)	140 (28%)	30 (6%)

e-Health, electronic health.

With statement “e-Health is an integral component of health care field in Georgia” 75 (15%) participants replied, “Strongly agree,” 95 (19%)—“Agree,” 125 (25%)—“Mainly agree,” 20 (4%)—“Neither agree nor disagree,” 45 (9%)—“Mainly disagree,” 140 (28%)—“Disagree.”

Participants' replies concerning patients' personal data safety and necessity of informed consent obtaining within e-Health applications are presented in Table 2.

Table 2.

Study Participants Replies on Statements: (a) The Safety of Patients' Personal Data Is Ensured Within Electronic Health (e-Health) Applications; (b) Patients' Informed Consent Shall Be Obtained for e-Health Applications

PARTICIPANT REPLY STATEMENT	STRONGLY AGREE	AGREE	MAINLY AGREE	NEITHER AGREE NOR DISAGREE	MAINLY DISAGREE	DISAGREE	STRONGLY DISAGREE
The safety of patients' personal data is ensured within e-Health applications	2 (4%)	18 (49%)	10 (21%)	4 (7%)	30 (6%)	65 (13%)	—
Patients' informed consent shall be obtained for e-Health applications	105 (21%)	290 (58%)	45 (9%)	20 (4%)	20 (4%)	20 (4%)	—

Discussion

Our findings shed light on the perceptions and readiness of health care professionals in the context of e-Health adoption, and it aligns with the broader discussion regarding the role of e-Health, especially in the context of the COVID-19 pandemic.

AGE AND COMPUTER LITERACY

The categorization of participants into distinct age groups provides valuable insights into the demographics of the health care workforce. Notably, participants across different age groups exhibited varying levels of computer literacy, with a significant portion self-evaluating as “intermediate” or “advanced” users. It's encouraging to observe that the majority of participants, regardless of their age or self-evaluated computer skills, use computers professionally to communicate with patients and peers, reflecting the integration of technology into the health care field.¹¹

INTEREST IN TRAINING

A substantial portion of participants expressed eagerness to attend training programs focused on information and computer technologies, emphasizing their recognition of the importance of continuous learning in an evolving health care landscape.¹² This willingness to upskill suggests that health care professionals acknowledge the role of technology in their practice and are open to further integration.

PERCEPTIONS OF E-HEALTH

The participants' perceptions of e-Health, particularly the definition of e-Health as “communication between health care professionals and patients remotely, using computer technology,” vary. While a significant number view it as “correct” or “might be correct,” there's a notable portion that considers it “incorrect” or “probably incorrect.” This variance in perception highlights the need for clear and consistent definitions and understanding of e-Health terminologies within the health care community.¹³

APPLICATION OF E-HEALTH

Participants' views on the effective application of e-Health for managing chronic patients, acute cases, and pediatric patients vary widely. While a significant proportion agree with its effectiveness, some express reservations or neutrality. This diversity in opinions underscores the importance of tailored approaches and evidence-based strategies when implementing e-Health solutions for different patient populations and medical contexts.¹⁴

INTEGRATION OF E-HEALTH

Views on the integration of e-Health into the health care field in Georgia reflect a range of opinions, with some strongly agreeing, agreeing, or mainly agreeing, while others disagree or remain neutral. This diversity of opinions suggests that the integration of e-Health may face varying degrees of acceptance and resistance within the health care system.¹⁵

PATIENT DATA PRIVACY AND INFORMED CONSENT

Concerns related to patient data privacy and the necessity of informed consent within e-Health applications vary among participants. While many agree with the importance of safeguarding patient data and obtaining informed consent, some express neutrality or disagreement. These concerns emphasize the critical need for robust data protection measures and ethical considerations when implementing e-Health systems.¹⁶

In summary, your study provides valuable insights into the perceptions and readiness of health care professionals regarding e-Health adoption. The data highlight the importance of tailored training programs, clear definitions, and evidence-based strategies to facilitate the effective integration of e-Health technologies into health care practice. As the health care landscape continues to evolve, understanding the perspectives of health care professionals is crucial for ensuring successful e-Health implementation and enhancing patient care.

Conclusions

Our study reveals diverse perspectives and readiness among health care professionals regarding e-Health adoption, particularly during the COVID-19 pandemic. Key findings include varying computer literacy levels, a willingness to learn, differing views on e-Health applications, and mixed opinions on its integration into Georgian health care. These results highlight the importance of clear e-Health terminology and education. Our findings emphasize the need for tailored approaches for specific patient groups and medical contexts. They also underline the significance of data privacy and informed consent in e-Health implementations. Overall, e-Health's role in modern health care, accelerated by the pandemic, remains transformative. The findings of our study contribute to an understanding of the health care professionals' readiness, shaping future initiatives, and ensuring quality patient care in Georgia.

Limitations

This study may be subject to response bias, as participation was voluntary. Additionally, the survey's self-reported nature may introduce recall and social desirability biases. Despite these limitations, the study aimed to provide valuable insights into the perceptions and experiences of medical university staff regarding e-Health integration into medical curricula.

Footnotes

Acknowledgment

We express our sincere gratitude to all parties who generously contributed to this study.

Authors' Contribution

All authors equally contribute to present article preparation.

Ethical Approval

Ethical approval for this study was obtained from the Bioethics International Committee of the Petre Shotadze Tbilisi Medical Academy (IRB approval #04-11052023). All procedures conducted in this study adhered to the Helsinki Declaration of 1975, as revised in 2013. Participants were provided with detailed information regarding the study design and objectives.

Consent

Written informed consent was obtained from all participants before their inclusion in the study.

Disclaimer

The content of this article is solely the responsibility of the authors.

Disclosure Statement

No competing financial interests exist.

Funding Information

No funding was received for this article.

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