Impact of Digitalization on Pediatric Practice and Childhood Health Care in Spain: Nationwide Survey Study

Health care digitalization and pediatric information and communication technology have facilitated the use of telemedicine and digital communication tools in pediatric practice, improving accessibility and efficiency. Meanwhile, artificial intelligence (AI) is emerging as a promising tool in medicine. However, the rapid adoption of these technologies has raised concerns regarding reliability and ethics.

This study examines the level of digitalization in pediatric consultations and explores the perspectives of health care professionals (HCPs) on digital technologies in patient care, analyzing differences by age group, health care management, and institution type.

An observational, cross-sectional survey was conducted among Spanish HCPs dedicated to pediatric care. Participants completed an 18-question web-based questionnaire evaluating their use of digital communication tools, perceptions of online health information, and opinions on AI in clinical practice. Statistical analyses compared responses across age groups, health care management type, and institution type.

A total of 495 pediatric specialists participated (female: 273/495, 58.2%; aged >45 y: 324/495, 69.8%). Most participants worked in urban settings (409/469, 87.2%), in primary care (243/313, 77.6%), and in the public sector (253/464, 54.5%). The telephone remained the most used communication channel (462/481, 96.1%), followed by email (290/481, 60.3%) and WhatsApp (139/481, 28.9%). Private-sector HCPs used digital platforms more frequently than public-sector HCPs, including email (136/206, 66% vs 135/247, 54.7%; P=.02), Instagram (23/206, 11.2% vs 5/247, 2%; P<.001), WhatsApp (105/206, 51% vs 26/247, 10.5%; P<.001), and Facebook (18/206, 8.7% vs 3/247, 1.2%; P<.001). Nearly all respondents (417/437, 95.4%) believed that parents were increasingly seeking health information online, yet a considerable proportion (158/458, 34.5%) reported that parents rarely consulted them about reliable sources. Overall, 85.4% (410/480) agreed that the internet and social media raise many questions among parents, while only 7.5% (35/465) believed that the information found is generally reliable. Nearly half of the participants (232/443, 48.5%) proactively suggested trustworthy digital resources, while 44.1% (211/443) did so only when asked. Younger respondents (P=.002), public-sector HCPs (P=.005), and primary care specialists (P=.004) were significantly more likely to offer this guidance, with scientific society resources being the most frequently recommended (402/430, 93.5%). We found that 78.6% (369/470) of participants were familiar with AI, with private-sector HCPs demonstrating greater knowledge than public-sector HCPs (P=.003). Overall, 59.6% (279/468) agreed that AI could significantly improve medicine, a view more commonly held by private-sector HCPs (P=.005). However, 94.8% (306/323) expressed ethical concerns, and 89.8% (422/470) wished to receive AI-related training.

The survey highlights the increasing use of digital communication tools in pediatric practice, with private-sector HCPs leading adoption. While AI is viewed as promising, ethical dilemmas remain, underscoring the need for training. Limited confidence in online health information highlights the importance of strengthening digital literacy among both HCPs and parents to optimize patient care.