Patient Adoption of Digital Use Cases in Family Medicine and a Nuanced Implementation Approach for Family Doctors:...

Digital use cases describe the application of technology to achieve specific outcomes. Several studies in health care have examined patients' overall attitudes toward digitalization and specific use cases. However, these studies have failed to provide a comparison of patient acceptance criteria between inherently different digital use cases in family medicine.

To address this research gap, this paper aimed to assist family doctors in selecting digital use cases by comparing the underlying patient adoption factors and in driving usage of these use cases by presenting a differentiated implementation approach.

Adapting an established Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire to 4 digital use cases in family medicine, we surveyed a large cross-sectional sample of adults living in Germany. The results of the web-based survey were then analyzed via descriptive statistics, ANOVA, and hierarchical regression models to compare the effects of sociodemographic and technology acceptance factors on the intention to use a specific use case.

Our web-based survey included 1880 participants. Of these 1880 participants, only 304 (16.2%) agreed that the degree of digitalization is important when selecting a family practice. However, more digitally literate participants attributed greater importance to this criterion (B=0.226, SE 0.023; β=.223; P<.001), and digital literacy was found to be dependent on age (Welch F_3,968.29=53.441; P<.001). Regarding sociodemographic characteristics, only digital literacy demonstrated a significant effect on the intention to use for all use cases, particularly scheduling doctor appointments online (B=0.322, SE 0.033; β=.408; P<.001). Furthermore, performance expectancy was the strongest predictor of the intention to use for all use cases, while further effects of technology acceptance factors depended on the use case (receiving medical consultations via video: B=0.603, SE 0.049; β=.527; P<.001; scheduling doctor appointments online: B=0.566, SE 0.043; β=.513; P<.001; storing personal medical information via electronic health records: B=0.405, SE 0.047; β=.348; P<.001; and providing personal information before consultation digitally [digital anamnesis]: B=0.434, SE 0.048; β=.410; P<.001). To illustrate, perceived privacy and security had an effect on the intention to use electronic health records (B=0.284, SE 0.040; β=.243; P<.001) but no effect on the intention to use video consultations (B=0.068, SE 0.042; β=.053; P=.10).

In the selection and implementation of digital use cases, family doctors should always prioritize the perceived value of the digital use case for the patient, and further criteria might depend on the digital use case. Practice owners should therefore always harmonize the introduction of digital use cases with their own patient care strategies. Not every digital innovation fits every strategy and therefore every practice.