Connecting the dots: Patient experience and digital health tech in primary care

The adoption of digital health technologies in primary care have increased exponentially over the past few decades. These advancements aim to improve patient-centeredness and provider-to-provider care coordination. However, it’s critical to assess how these technologies impact the patient experience. Recognizing this gap, researchers from McMaster University’s Department of Health Research Methods, Evidence, and Impact (HEI) have published findings that identify associations between patient experience and digital health technologies in primary care. This research was led by Zain Pasat as an eHealth MSc student for his thesis. He is now a Health Research Methodology PhD student. Authors include Andrew Costa, Cynthia Lokker, and Jean-Eric Tarride, who are all HEI faculty members and McMaster Institute for Research on Aging (MIRA) members.

Understanding digital health technologies

When we talk about “digital health technologies,” we’re referring to tools and systems that use digital technology to improve healthcare. Specifically, digital health technologies can enhance the experience of patients and improve the communication between patients and providers. This includes electronic medical record (EMR) systems, virtual visits through telehealth platforms, mobile health apps, and more.

Efforts to adopt digital health technologies in Ontario have been ongoing for decades. As mentioned in the study, by 2019, 85% of family doctors were using EMR systems, and over 600,000 virtual visits were conducted through the Ontario Telemedicine Network from 2008 to 2014. However, these efforts were fragmented, and the use of virtual visits was still very low prior to the COVID-19 pandemic, making up only 1.2% of primary care visits in 2019.

Evaluating digital health technologies

There is a growing need to evaluate the benefits of digital health technologies for people with differing levels of health knowledge and comfort using technology. Past studies mainly tested if these tools provided value for users under controlled conditions, not how they perform in everyday situations with diverse users.

The research team’s objective was to examine if pre-pandemic digital health technologies improved the primary care experience for Ontarians aged 16 years or older. They used a cohort of 2,692 participants and gathered data through the Health Care Experience Survey. This cross-sectional survey, conducted by the Institute for Social Research at York University, is used by the Ontario Ministries of Health and Long-Term Care, and researchers, to measure access and experience across the healthcare system.

Identifying connections

The study found that digital health technologies might not be the main factor affecting patient experience. Instead, other factors related to healthcare providers seem to have a bigger impact on how patients feel about their care. Digital health technologies are enablers rather than solutions and providers need to do more than just introduce these technologies; they also need to support their use and make sure they’re integrated effectively into healthcare practices.

Even though there was no clear connection between broad digital health technologies and better patient experiences, EMR systems and telehealth access were unique. Patients who could access their health records online were 65% less likely to say that their primary care provider didn’t know their medical history well, and patients who accessed telehealth reported similar or improved experiences and communication with their healthcare provider.

The study also noted that “system-wide adoption of digital health technologies may introduce health equity and digital literacy concerns. Older adults lacking computer skills or with severe illness and individuals with poor socioeconomic status, cognitive impairments, or disabilities related to language and understanding face additional barriers to accessing technology and digital health.”

“Although digital health is not the sole answer to patient-centred care, it is an enabler which has seen dramatic uptake in recent years. As we continue to digitize primary care, we must be mindful of social factors influencing experience and patient-provider communication to ensure all patients equitably benefit and minimize the growing impact of the digital divide,” said Pasat, lead author of the study.

“Our findings highlight the role of digital health technologies in improving patient experience in primary care and emphasize the importance of continued evaluation. This will ensure equitable access and meaningful use for all users – patients and providers,” said Costa, HEI associate professor and senior author of the study.

Access the study to learn more.

This work was supported by the Schlegel Research Chair in Clinical Epidemiology & Aging at McMaster University.

Andrew Costa is Canada Research Chair in Integrated Care for Seniors.

Jean-Eric Tarride is the McMaster Chair in Health Technology Management.

Pasat, Z., Sinn, C.-L. J., Rahman, B., Gayowsky, A., Lokker, C., Tarride, J.-E., Alarakhia, M., & Costa, A. P. (2024). The relationship between patient experience and real-world digital health access in primary care: A population-based cross-sectional study. PloS One, 19(5), e0299005–e0299005. https://doi.org/10.1371/journal.pone.0299005