Preferences of Patients With Musculoskeletal Disorders Regarding the Timing and Channel of eHealth and Factors Influencing Its Use: Mixed Methods Study

Abstract

Background: Implementation of eHealth is progressing slowly. In-depth insight into patients' preferences and needs regarding eHealth might improve its use.

Objective: This study aimed to describe when patients want to use eHealth, how patients want to communicate and receive information digitally, and what factors influence the use of eHealth in clinical practice.

Methods: A multimethod study was conducted. Two meetings of ~5.5 hours with plenary information sessions and focus groups were held with 22 patients from the rheumatology, orthopedics, and rehabilitation departments of a Dutch hospital specialized in musculoskeletal disorders. Assignments were performed during the focus groups in which qualitative (eg, semistructured interview questions) and quantitative (ie, voting and ranking factors) data were collected.

Results: The way patients want to use eHealth varies between patients and moments of a patient's care pathway. Patients' digital channel preferences depended on the need for interaction with a health care provider (HCP). The interaction need is in turn influenced by the degree to which information or communication is specific to an individual patient and leads to consequences for the patient. The 5 most important factors influencing the use of eHealth were access to medical information (eg, electronic health records), perceived control over disease management, correctness and completeness of information, data security, and access to information or an HCP at any time. The 5 least important factors influencing eHealth use were help with using digital devices, having internet or equipment, digital skills, attitude or emotions toward eHealth, and societal benefits.

Conclusions: Patients identified opportunities for using eHealth during all moments of their care pathway. However, preferences for eHealth varied between patients and phases in the care pathway. As a consequence, eHealth should be tailored to fit individual patients' preferences but also the need for interaction regarding different topics by offering a variety of digital channels with a gradient of interaction possibilities. Furthermore, digital skills and access to the internet might become less important to focus on in the future. Improving eHealth use by patients may be achieved by providing patients access to correct and safe (medical) information and more control over their care.

Keywords: COM-B; Capability, Opportunity, Motivation and Behavior Model; arthritis; chronic diseases; chronic illness; citizen; citizen science; civic; digital hospital services; eHealth; focus group; health tech; kinesio; multiple methods; musculoskeletal; musculoskeletal disorders; orthopedic; perspectives; physio; preferences; rehabilitation; rheuma; rheumatoid arthritis; semistructured interview; society; telehealth; telemedicine; thematic analysis.