Introduktion og støtte til borgeres anvendelse af 'Min Læge' En forandring i almen praksis

Abstract

Baggrund: I Danmark foregår en demografisk udvikling, som udfordrer sundhedsvæsenet økonomisk. For at imødekomme dette er en digitalisering af det danske sundhedsvæsen påbegyndt, hvor kontakten til almen praktiserende læge er digitaliseret ved den digitale patientportal ‘Min Læge’-applikationen. Digitale sundhedskompetencer ses som en væsentlig forudsætning for at anvende digitale patientportaler. Der er dog risiko for at øge den sociale ulighed i sundhed, da der ses flere sociale determinanter for lave digitale sundhedskompetencer. Litteraturen viser imidlertid, at introduktion og støtte fra de sundhedsprofessionelle i almen praksis kan overkomme flere barrierer for anvendelsen af digitale patientportaler. Formål: Formålet er at undersøge forandringspotentialet for, hvordan introduktion og støtte til borgeres anvendelse af ‘Min Læge’ kan implementeres i almen praksis, med henblik på at øge anvendelsen af ‘Min Læge’ for borgere med lave digitale sundhedskompetencer. Metode: I et tværsnitsstudie på baggrund af data fra HLS19 identificeres sammenhængen mellem social støtte og anvendelsen af digitale patientportaler blandt personer med høje og lave digitale sundhedskompetencer. Et systematisk litteraturstudie udarbejdes for at identificere fremmende og hæmmende faktorer for implementeringen af en forandring i almen praksis. Mekanismer og kontekstuelle betingelser for, at de sundhedsprofessionelle kan implementere introduktion og støtte i ‘Min Læge’, identificeres gennem kvalitative individuelle interviews. Resultater: Tværsnitsstudiet viser, at der ikke er sammenhæng mellem social støtte og anvendelsen af digitale patientportaler blandt personer med høje og lave digitale sundhedskompetencer. Gennem det systematisk litteraturstudie identificeres tidligere implementering af forandringer; modstand på forandring; udbrændthed og engagement; kommunikation og information; involvering af de sundhedsprofessionelle i beslutninger; og praktiske forhold, som faktorer, der påvirker implementeringen. Af interviewundersøgelsen med de sundhedsprofessionelle i almen praksis er der identificeret fem hovedtemaer, herunder meningsfuld forandring; organisatoriske ressourcer for forandring; tidligere erfaringer med forandringer i almen praksis; organisationskultur og strategiske overvejelser for succesfuld implementering. Konklusion: Det konkluderes, at der er flere elementer herunder individuelle forhold, organisatoriske relationer og organisatoriske ressourcer, som skal være til stede for, at introduktion og støtte kan implementeres succesfuldt i almen praksis. Der er dog behov for mere forskning til udvikling og implementering af tiltaget samt dets effekt på anvendelsen af ‘Min Læge’ for personer med lave digitale sundhedskompetencer.

Background: A demographic development is taking place in Denmark, which is financially challenging the health care system. A digitalization of the Danish healthcare system has begun to cater to this, where the contact to general practitioners has been digitized through the digital patient portal application ‘Min Læge’. Digital health literacy is seen as an essential prerequisite for using digital patient portals. However, there is a risk of increasing social inequity in health, as many social determinants are seen for low digital health literacy. Meanwhile, the literature shows that the introduction and support of healthcare professionals in general practice can overcome several barriers to the use of digital patient portals. Aim: The aim is to investigate the potential for change in how introduction and support for patients' use of ‘Min Læge’ can be implemented in general practice, in order to increase the use of ‘Min Læge’ for patients with low health competencies. Method: A cross-sectional study based on data from HLS19 identifies the relationship between social support and the use of digital patient portals among individuals with high and low digital health competencies. A systematic literature study has been made to identify promoting and inhibiting factors for the implementation of a change in general practice. Mechanisms and contextual conditions for health professionals to implement introduction and support in ‘Min Læge’ are identified through qualitative individual interviews. Results: The cross-sectional study shows that there is no correlation between social support and the use of digital patient portals among people with high and low digital health competencies. Through the systematic literature study, the following are identified as factors influencing the implementation: earlier implementation of changes; resistance to change; burnout and commitment; communication and information; involvement of healthcare professionals in decisions; and practical conditions. From the interview survey with the health professionals in general practice, five main themes have been identified, including meaningful change; organizational resources for change; previous experience with changes in general practice; organizational culture and strategic considerations for successful implementation. Conclusion: It can be concluded that there are several elements including individual factors, organizational relations and organizational resources that must be present for an introduction and support to be successfully implemented in general practice. However, more research is needed for the development and implementation of the initiative as well as its effect on the use of ‘Min Læge’ for people with low digital health competencies.

A master thesis from Aalborg University

Introduktion og støtte til borgeres anvendelse af 'Min Læge' En forandring i almen praksis

[Introduction and support for patients' use of 'Min Læge' - a change in general practice]