A Qualitative Study of the Barriers and Opportunities for Adoption of Web-Portals for Doctors and Patients in Russia

Abstract

The use of Web portals has several benefits. They have been proven to enhance communication between patients and health care professionals, allow patients to play a more active role in their own treatment and self-management, increase self-efficiency. Doctors can access patients' medical data and give recommendations to the patients. Some evidence of positive outcomes has been reported including improved clinical indicators and reduced health service use, as well as enhanced feelings of security and increased satisfaction with health and social care services. However, a number of studies have demonstrated that these types of solutions often fail to be successfully implemented and adopted within routine healthcare. The goal of the study was to analyze attitude of tuberculosis patients and doctors and identify perceived opportunities and barriers to operate a Web portal. The perceptions of 30 tuberculosis patients and 18 doctors (10 general practitioners and 8 phthisiatricians) from Tomsk, Russia were collected through semi-structured interviews. The responses were analyzed using grounded theory and thematic analysis, in order to understand the participants' opinions and attitudes towards accepting tuberculosis web-portal in the treatment and rehabilitation process. We have recognized core topics that represented the participants' responses. These core topics indicated that most respondents mentioned "the potential of tuberculosis web-portal to establish a better communication between doctors and patients" and "the increased health status of the patients" as the most valuable outcomes of adopting the tool. Both doctors and patients also expressed their opinions on the usability of the solutions, with no significant concerns reported about its usability. The main barrier we identified was different expectations of doctors and patients: doctors expected that the portal would decrease the amount of paper work and will help them to quickly react in acute cases, however, the patients were disappointed that the portal did not allow them to be able to reach doctors on the 24/7 basis and have a consultation whenever they felt they needed it. Finally, our findings disclosed that participants appreciated the perceived clinical utility of the portal, which could further have an influence on their intention to use it. The findings from our reported study in the area of tuberculosis treatment and rehabilitation suggested that the participants generally accepted the introduction of web-portal for the purpose of reporting health status and getting recommendation from the doctors as an alternative to the traditional doctor visits.

Keywords: EHR; Evaluation; Grounded theory; Qualitative study; Web portal.