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The adoption of online health care services has been found very difficult globally: an estimated 45 per cent of services fail on account of resistance from health care professionals. In a study by Aalto University and Terveyskylä that has just been published, numerous factors for facilitating the adoption of the services have been discovered. The information will help in launching new online health care services in the future.

The study focused on the Terveyskylä.fi online service used within specialised Finnish private health care to offers health care related information and support for citizens, along with tools for health care professionals. In addition to virtual houses focusing on different health issues, accessible to everyone, Terveyskylä includes digital care paths for certain patient groups. 'Since there are new digital care paths on the way, we wanted to gather lessons from the first care paths to benefit the later ones,' says Research Fellow and the first writer of the article Sari Kujala.

The researchers interviewed employees of the university hospitals of Helsinki, Turku, Oulu, Tampere and Kuopio, inquiring after their experiences regarding the adoption of services. The interviewees were mainly nurses responsible for the adoption of the digital care paths in their place of work. They were selected among different care paths and different hospitals for the purpose of gathering lessons from a range of environments.

Based on the results they gathered, the researchers conclude that when new digital services are introduced in health care, it is essential to include professionals of health care and information technology as well as experts on usability in the design process. Involving patients, which is often considered a difficult feat, is also important.

'If we can involve even the smallest group for testing, for example, the feedback will help us to improve the usability of services. It would also useful to include professionals of user-centered design or service design. They can identify hidden needs that the users are unable to report as well as combine the needs of the different parties into solutions. Patients can be included as part of the treatment on a continuous basis on a small scale, but also in collaboration with patient organisations, thesis workers and researchers,' Kujala says.

Education and instructions in a key role

The study also states that services and changes related to them must be communicated continuously. Adequate training must be provided to professionals, along with guidance on how to use the services, and any concerns they raise must be taken seriously. User feedback should also be collected and the services tested at all stages in order to enable continuous improvement of the services and to ensure that everyone can understand the services. It is necessary to recognise that adopting services takes time and resources. This is why the adoption should be planned well and not the responsibility of just one person within an organisation.

'Professionals are motivated by services that make it easier to work – for example, having to enter data only once – as well as help patients. According to the interviewees, interest has been shown towards a digital care path that helps to identify a serious skin symptom from home with the help of the patient sending a photograph,' Kujala says.

Researchers have known for a long time that motivating health care professionals as well as patients to use new online health care services is difficult. 'The introduction of new digital services causes stress in a hectic care work environment, and professionals have not always received enough support in the change.'

Yet digital services do, when functioning properly, help to offer better services and support for professionals in their work. Services also cost Finland a great deal. Therefore, it is important to get professionals as well as patients to use them. Doctors and nurses do not always remember to communicate about the services to their patients. According to Kujala, this would be important: according to research, having a professional recommend services to their patients has a huge impact on the use of the services.

The study is a part of the DigiIN project, which seeks to get all people involved in a digital society by renewing the service culture. The study is funded by the Strategic Research Council (SRC). The research article was recently published in the Journal of Medical Internet Research. Link to article:

Further information

Sari Kujala
Research Fellow, Aalto University
Vice Chair, DigiIN
Tel. +358 50 3862 768
sari.kujala@aalto.fi
www.digiin.fi