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Digitalization affects all areas of society, including the health care sector. However, the digitalization of health care provision is progressing slowly compared to other sectors. In the professional and political literature, physicians are partially portrayed as digitalization sceptics. Thus, the role of physicians in this process requires further investigation. The theory of “digital natives” suggests a lower hurdle for younger generations to engage with digital technologies.
The objective of this study was to investigate the role of physicians in the process of digitalizing health care provision in Germany and to assess the age factor.
We conducted a large-scale study to assess the role of this professional group in the progress of the digital transformation of the German health care sector. Therefore, in an anonymous online survey, we inquired about the current digital penetration of the personal working environment, expectations, attitude toward, and concerns regarding digitalization. Based on these data, we studied associations with the nominal variable age and variations across 2 age groups.
The 1274 participants included in the study generally showed a high affinity towards digitalization with a mean of 3.88 on a 5-point Likert scale; 723 respondents (56.75%) stated they personally use mobile apps in their everyday working life, with a weak tendency to be associated with the respondents’ age (η=0.26). Participants saw the most noticeable existing benefits through digitalization in data quality and readability (882/1274, 69.23%) and the least in patient engagement (213/1274, 16.72%). Medical practitioners preponderantly expect further improvements through increased digitalization across almost all queried areas but the most in access to medical knowledge (1136/1274, 89.17%), treatment of orphan diseases (1016/1274, 79.75%), and medical research (1023/1274, 80.30%).
Respondents defined their role in the digitalization of health care provision as ambivalent: “scrutinizing” on the one hand but “active” and “open” on the other. A gap between willingness to participate and digital sovereignty was indicated. Thus, education on digitalization as a means to support health care provision should not only be included in the course of study but also in the continuing process of further and advanced training.
The theoretical description of digitalization in health care promises the potential to improve quality of care, save time, streamline documentation, and support access through natural forms of interface design [
Digitalization is a disruptive change that affects all areas of society [
The importance of the human factor in health care processes is highlighted in the concept of health care–providing institutions as “expert organizations” [
The purpose of this study was to examine the role of physicians in the digital transformation of health care with a specific focus on the variable of age. Therefore, the following 3 research questions were investigated: (1) How do physicians perceive opportunities and risks of the digital transformation of their working environment? (2) How do physicians see their own role in digitalizing health care provision? (3) What role does age play in the perception of digitalization of health care provision and the personal role within this process?
In order to examine these issues, a nationwide survey among physicians in Germany was conducted.
The survey was designed in an iterative manner by scientists in the field of digital health and members of the Bündnis Junge Ärzte (BJÄ, Alliance of Young Physicians), a union of representatives of young physicians from 25 medical associations and medical societies in Germany. We followed the survey principles outlined by Dillman et al [
On the survey landing page, we describe the survey topics and length, goals and target group, and the inquiring organizations, and provide information on the data handling according to the European General Data Protection Regulation (GDPR). The survey was voluntary, nonincentivized, and fully anonymous. None of the participant information requested could be used to identify the participant, and no technical identifiers (eg, IP address) were stored. To start the survey, participants were required to express consent to the procedure. The first survey section included demographic questions related to the respondent’s age, gender, professional position and type of employment, medical specialization, and general digital affinity derived from items provided by the technology affinity questionnaire from Karrer et al [
The target group of the survey was practicing and prospective physicians. In order to effectively use the distribution channels of the BJÄ for acquiring a convenience sample, the survey was held open. To prevent multiple participation, a cookie was set with submission of the questionnaire. The survey was administered from October 16, 2020, to December 18, 2020, via the online survey platform LimeSurvey. During this period, the survey was publicly available and repeatedly announced through various online and personal channels, including social media accounts (Twitter, LinkedIn, Facebook), press releases, and mailing lists from the BJÄ and its 25 member associations, as well as magazines and newsletters for the health care sector. Furthermore, the personal approaches of the professional networks of the actors involved were used. We provided a dedicated URL redirect which led to the survey via a link. The first contact points with participants were professional networks, or a personal or direct approach via medical associations, all mainly through online channels.
We included only those questionnaires that were complete and from respondents with a professional background as medical practitioners. The latter included physicians either in training or in practice in the health care sector. Responses from medical practitioners in retirement or employed in the industrial context, as well as actors with other professional backgrounds were thus excluded from further analysis. From 1940 initial questionnaires, 651 were excluded due to incompletion or missing values, resulting in a completion rate of 66.44%. A further 15 questionnaires were then excluded due to the aforementioned exclusion criteria, resulting in 1274 included data sets.
The main outcome variables of the survey were the perceived digitalization hindrances, the anticipated role of digitalization in the future health care process, and the respondent’s role within this change process. The first aspect was assessed through multiple-choice questions, while the latter 2 were assessed with both single-choice and multiple-choice questions. All mentioned outcome variables were assigned to nominal scales. Descriptive variables included nominal scales (gender, working environment, medical specialization), ordinal scales (professional level, Likert-type digital affinity), interval (Likert scale digital affinity), and ratio scales (age). In order to examine the relation between the outcome variables and age as the primary covariate, we carried out statistical parametric tests for metric scales and nonparametric tests for investigating the association of categorical and metric variables [
The total of 1274 complete and included responses comprised 567 (44.51%) female respondents. The age of the respondents ranged from 22 to 67 years (mean 45.09, SD 12.06). The professional level of the respondents included first level, medical students (24/1274, 1.88%); second level, physicians in specialist training (328/1274, 25.75%); third level, medical specialists with <5 years professional experience (180/1274, 14.13%); fourth level, medical specialists with >5 years professional experience (732/1274, 57.46%); and other (10/1274, 0.78%). The 2 major shares of respondent’s working environment was split approximately evenly, with one-half working in clinical environments (593/1274, 46.55%) and one-half in physician’s offices (594/1274, 46.62%), with 87 others (6.83%). The 5 most-represented medical specializations were general internal medicine (184/1274, 14.44%), dermatology and venerology (138/1274, 10.83%), ophthalmology (133/1274, 10.44%), urology (122/1274, 9.58%), and general medicine (103/1274, 8.08%). Further demographic data of the respondents are depicted in
Respondent’s demographics (N=1274).
Characteristic | Value, n (%) | |||
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Female | 567 (44.51) | ||
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Male | 706 (55.42) | ||
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Other | 1 (0.08) | ||
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≤35 years | 382 (29.98) | ||
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36-45 years | 290 (22.76) | ||
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46-55 years | 276 (21.66) | ||
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≥56 years | 326 (25.59) | ||
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First: medical student | 24 (1.88) | ||
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Second: specialist training | 328 (25.75) | ||
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Third: specialist <5 years | 180 (14.13) | ||
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Fourth: specialist >5 years | 732 (57.46) | ||
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Other | 10 (0.78) | ||
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593 (46.62) | ||
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University hospital | 192 (32.43) | |
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Public hospital | 165 (27.87) | |
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Nonprofit hospital | 134 (22.64) | |
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Privat hospital | 92 (15.54) | |
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No answer | 9 (1.52) | |
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594 (46.55) | ||
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Self-employed | 465 (78.28) | |
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Employee | 129 (21.72) | |
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Other | 87 (6.83) | ||
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Full-time | 1008 (79.12) | ||
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Part-time | 227 (17.82) | ||
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Marginal employment | 13 (1.02) | ||
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No answer | 26 (2.04) |
The demographic factor “digitalization affinity” was also measured. For this, 4 suitable theses from a general technology affinity questionnaire [
For further investigation, we also split the respondents into 2 groups: based on the age limit of the BJÄ and the definition of the German medical associations, we placed participants who were 45 years of age and younger into group 1 (672/1274, 52.75%) and those who were older than 45 years into group 2 (602/1274, 47.25%).
The digital affinity variable, comprising 4 five-point Likert-type items within a Likert scale resulted in a moderate tendency toward a positive perception of digitalization. The mean score across all respondents was 3.88 (SD 0.67). In the following subsections (
First, we identified the status quo of use of digital systems in the respondents’ everyday working life. We queried the 4 segments of internal process support (including applications and data administration), interorganizational data exchange, professional communication, other digital services for internal organization (that do not directly concern patients, such as professional training or e-learning, duty planning, worktime recording), and other services addressed to patients (eg, appointment scheduling, virtual consultation hours, medication plan, access to patient data, mobile apps).
The digitalization of internal processes was led by functional diagnostics (radiography, laboratory), with 749/1187 (68.72%, adjusted by the share of respondents who stated that this was not relevant for them) respondents indicating that they organize completely or predominantly digitally. This was directly followed by the areas of patient admission (749/1090, 68.71%), operating room (398/616, 64.61%), and intensive care (207/418, 49.52%). Care unit (240/637, 37.68%) and patient discharge (264/716, 36.87%) were the least digitally organized areas. The adjusted percentages of responses are shown in
Status quo: respondents' assessment of digitalization of internal processes.
Interorganizational data exchange still is a primarily paper-based process, as only 132 of 1259 respondents (10.48%) stated they receive data completely or predominantly digitally from other service providers, while 161 of 1258 (12.80%) transfer data themselves mainly in a digital format to other service providers.
As expected, regarding professional communication, the phone call was still the predominant tool for interaction, as 1248 of 1274 respondents indicated using it for professional communication (97.96%). Fax (1082/1274, 84.93%), mail (967/1274, 75.90%), and email (976/1274, 76.61%) were also used by a substantial majority. Meanwhile, medical platforms (115/1274, 9.03%), messaging apps for specific medical purposes (142/1274, 11.15%), and generic messaging apps (332/1274, 26.06%) were ranked at the bottom of the list.
Patient distant digital services use was relatively widespread: 1006 participants (78.96%) stated that they used digital services for professional training or e-learning, 776 (60.91%) planned their duty in a digital system, and 579 (45.45%) recorded their worktime electronically.
Interestingly, services addressed to patients did not show a high degree of dissemination. Digitalized appointment scheduling ranked highest, with 24.49% (312/1274) of the respondents stating that they offered this service, followed by the provision of an electronic medication plan (235/1274, 18.45%), access to personal data (228/1274, 17.90%), virtual consultation (203/1274, 15.93%), and mobile apps (47/1274, 3.67%). The provision of none of these services without mentioning alternatives in use was the only option selected more frequently (580/1274, 45.53%). One question was then aimed at the proactive offering of health-related data for assessment through patients themselves, acquired by, for instance, wearables or apps. Of the 1274 respondents, 51 (4%) indicated experiencing this regularly, 197 (15.46%) occasionally, 448 (35.16%) sporadically, and 553 (43.41%) had never encountered this situation. Of the 696 respondents who had encountered self-acquired patient data to a varying extent, 41 (5.90%) generally refused to incorporate this kind of information into their medical investigation, 314 (45.11%) stated they verify only acutely relevant data, and 341 (48.99%) indicated being generally open to data from consumer products provided by the patient.
We queried perceptions regarding the already existing benefits of digitalization and untapped potential in the 7 categories of data quality and readability, data availability, data generation, transparency, patient engagement, work structuring, and reconciliation of family and working life, and responses varied considerably. Affirming the comparatively low usage of digital services for patients, only 213 of 1274 respondents (16.72%) already noticed benefits through digitalization in the category of patient engagement. An only slightly higher perception of utility was indicated for transparency, while data quality and readability and data availability were indicated to have received the most benefit thus far. However, the believed untapped potential exceeded the already noticeable benefit in all queried categories. Data availability, generation, and quality or readability ranked highest while optimism for digitalization improving everyday working life (working structure and reconciliation of family and working life) was also present, but not quite on the same level. The detailed data concerning the perceived benefits and potential of digitalization are displayed in
Shares of respondents who see noticeable benefits and untapped potential through digitalization across different categories.
The next 2 multiple choice questions queried obstructions and constraints in digitalization regarding the user and technology side. For the user side, we asked the respondents to indicate whether they perceived 5 different items to be a “major hindrance” for digitalization. Almost half of the respondents (626/1274, 49.14%) stated a lack of noticeable saving of time to be a major impeding factor. Slightly fewer respondents considered insufficient digital literacy or sovereignty (530/1274 41.60%), fear of surveillance (508/1274, 39.87%), and an unwillingness to change (461/1274, 36.19%) to also be hindrances. Fear of loss of importance was indicated to be a major limiting factor by 99 respondents (7.77%), and 210 respondents stated they did not perceive these hindrances to be present in themselves or their age group. When “other” was indicated, these responses referred to data security concerns, loss of trust between patients and physicians, and insufficient user integration.
The most-frequently chosen major technical hindrance was “insufficient system integration” (798/1274, 62.64%). Almost half of the respondents perceived insufficient software functionality (575/1274, 45.13%) to be a major issue, followed by insufficient hardware (503/1274, 39.48%), insufficient budget (453/1274, 35.56%), legal concerns regarding the exchange of medically sensitive data (341/1274, 26.77%), and insufficient cooperation by system providers (247/1274, 19.39%). When “other” was indicated, these response referred to data security concerns, system availability or performance issues, and a lack of user-centered system design.
Subsequently, the respondents provided an assessment of their familiarity with the current trending topics regarding digitalization of the health care sector in Germany. This included electronic health and electronic patient records, telematics infrastructure, telemedicine, the eHealth act, the digital health care act (DGV), and digital health apps (DiGA). For each topic, participants were required to indicate if it was completely unknown, basically known, or completely understood by them. The distributions of responses across these 7 topics are summarized in
Respondents' assessment of familiarity with current trending digitalization topics.
Of the 1274 respondents, 723 (56.75%) stated that they personally used mobile apps in their everyday work life. The most mentioned field of use was pharmaceutical information (516/723, 71.37%) and diagnosis (386/723, 53.39%), followed by training (317/723, 43.85%) and communication (300/723, 41.49%). When asked whether they trust in digital health apps, 425 stated yes (33.36%), 196 stated no (15.38%), and 653 stated “that depends” (51.26%).
Only a small portion of respondents (223/1274, 17.50%) stated that they had recommended specific mobile health apps to their patients. Of the 1051 respondents who had not yet recommended an app, 420 (39.96%) stated that their reasons for not having done so included “insufficient validity”, 286 (27.21%) stated it was “not relevant in my area,” and 266 (25.31%) indicated “insufficient data protection.” However, 80.46% (1025/1274) of the participants expect mobile or digital health apps to play a role in health care provision in the future.
Regarding the main sources of information for mobile or digital health apps, 812 (63.74%) indicated medical societies as the main source, 671 (52.67%) the internet, and 622 (48.82%) colleagues. A much smaller proportion of respondents indicated public bodies (182/1274, 14.29%) and developers (104/1274, 8.16%) as playing important roles in information acquisition.
In the section, “Future,” the survey participants were first asked to rate their expectation for the impact of digitalization on 10 health care provision–related areas from “worsening” over “no change” to “improving.”. The highest positive expectations were shown in the areas “access to knowledge” (1136/1274, 89.17%), “medical research” (1023/1274, 80.30%), and “treatment of rare diseases” (1016/1274, 79.75%). The greatest doubts were expressed in the areas of “physician-patient relationship” (397/1274, 31.16%), “administration” (265/1274, 20.80%), and “attractiveness of the profession” (237/1274, 18.60%; see
Expected impact of digitalization on health care provision (N=1274).
Area | Worsening, n (%) | No change, n (%) | Improving, n (%) |
Early detection of diseases | 51 (4) | 549 (43.09) | 674 (52.91) |
Medical quality | 156 (12.24) | 422 (33.12) | 696 (54.63) |
Access to knowledge | 10 (0.78) | 128 (10.05) | 1136 (89.17) |
Treatment of rare diseases | 8 (0.63) | 250 (19.62) | 1016 (79.75) |
Administration | 265 (20.80) | 207 (16.25) | 802 (62.95) |
Patient adherence | 91 (7.14) | 691 (54.24) | 492 (38.62) |
Physician-patient relationship | 397 (31.16) | 672 (52.75) | 205 (16.09) |
Interdisciplinary collaboration | 78 (6.12) | 334 (26.22) | 862 (67.66) |
Attractiveness of the profession | 237 (18.60) | 644 (50.55) | 393 (30.85) |
Medical research | 20 (1.57) | 231 (18.13) | 1023 (80.30) |
Subsequently, the respondents rated their attitude towards upcoming changes through digitalization from “mainly positive” (567/1274, 44.51%) to “with mixed feelings” (557/1274, 43.72%) to “mainly negative” (130/1274, 10.20%).
When asked for multiple adjectives to describe their personal role in digitalizing health care provision, 36.50% (465/1274) of respondents assessed themselves as “scrutinizing,” 30.06% (383/1274) as “active,” 29.51% (376/1274) as “open,” and 25.20% (321/1274) as “critical.” Only 1.73% (22/1274) stated that they were “indifferent.”
A Pearson correlation coefficient (
We assumed that the already existing penetration of digital systems, mainly queried in the section, “Status Quo,” was substantially dependent on other factors (eg, working environment, financial situation of the employing organization, career stage). Thus, we focused this investigation on areas presumably in the sphere of influence of the respondents.
Regarding the communication medium of choice, no noticeable differences were found between the 2 age groups. Fax was used by 86.61% (582/672) of group 1 and 83.01% (500/602) of group 2, specific medical messaging apps were used by 10.42% (70/672) of group 1 and 11.96% (72/602) of group 2, and generic messengers were used by 26.34% (177/672) of group 1 and 25.75% (155/602) of group 2.
The perception of already noticeable benefit through digitalization was almost equally distributed in the 2 age groups. In the 7 queried categories (data quality and readability, data availability, data generation, transparency, patient participation, work structuring, and reconciliation of family and working life) an average of 41.48% (279/672, SD 22.71%) of age group 1 stated that they already noticed benefits of digitalization while an average of 41.03% (247/602, SD 18.53%) in age group 2 stated the same. Moreover, the
Association between noticed benefits and potentials across categories and affirmation numbers per group.
Category | Association with age ( |
Group 1, n (%) (N=672) | Group 2, n (%) (N=602) | |
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Data quality/readability | 0.08 | 486 (72.32) | 396 (65.78) |
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Data availability | 0.05 | 449 (66.82) | 362 (60.13) |
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Data generation | 0.08 | 372 (55.36) | 298 (49.50) |
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Transparency | 0.00 | 160 (23.81) | 139 (23.09) |
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Patient participation | 0.03 | 115 (17.11) | 98 (16.28) |
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Work structuring | 0.11 | 201 (29.91) | 241 (40.03) |
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Reconciliation of family and working life | 0.09 | 168 (25) | 195 (32.39) |
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Data quality/readability |
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601 (89.43) | 417 (69.27) |
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Data availability |
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638 (94.94) | 474 (78.74) |
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Data generation | 0.16 | 614 (91.37) | 494 (82.06) |
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Transparency |
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533 (79.32) | 367 (60.96) |
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Patient participation |
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518 (77.08) | 339 (56.31) |
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Work structuring |
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534 (79.46) | 343 (56.98) |
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Reconciliation of family and working life |
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478 (71.13) | 275 (45.68) |
aItalics indicate a significant difference between the 2 age groups.
The attitude toward patient-provided consumer data was generally positive in both groups: of the respondents who had encountered this, 94.38% (336/356) in group 1 were willing to incorporate these data into their medical investigation while 93.82% of group 2 (319/340) showed the same willingness. A negligible association between age and willingness was found to be related to the willingness to incorporate this type of data (
Regarding the perception of major hindrances for digitalization on the user side, the 2 groups showed differences in 3 categories. The ratings in lacking noticeable saving of time, insufficient digital literacy or sovereignty, and no perception of such hindrances in themselves and their age group showed a weak association in the
Association of respondents’ perception of major hindrances for digitalization with age and the agreement numbers per age group.
Hindrance | Association with age ( |
Group 1, n (%) (N=672) | Group 2, n (%) (N=602) | |
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Insufficient digital literacy/sovereignty |
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223 (33.18) | 307 (51) |
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Lack of willingness to change | 0.01 | 247 (36.76) | 214 (35.55) |
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Lack of noticeable saving of time |
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260 (38.69) | 366 (60.80) |
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Fear of loss of importance | 0.02 | 57 (8.48) | 42 (6.98) |
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Fear of surveillance | 0.15 | 222 (33.04) | 286 (47.51) |
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No such hindrances |
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172 (25.60) | 38 (6.31) |
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Insufficient hardware |
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343 (51.04) | 160 (26.58) |
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Insufficient software functionality | 0.08 | 323 (48.07) | 252 (41.86) |
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Insufficient system integration | 0.10 | 444 (66.01) | 354 (58.80) |
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Insufficient budget | 0.03 | 186 (27.68) | 144 (23.92) |
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Insecurity with legal framework regarding data exchange | 0.05 | 164 (24.40) | 177 (29.40) |
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Insufficient cooperation by system providers | 0.12 | 99 (14.73) | 148 (24.58) |
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No such hindrances | 0.08 | 8 (1.19) | 16 (2.66) |
aItalics indicate a significant difference between the 2 age groups.
The distribution of familiarity with current trending topics regarding digitalization of the health care sector in Germany across age groups 1 and 2 is displayed in
Respondents' assessment of familiarity with current trending digitalization topics by age group. DiGA: Digitale Gesundheitsanwendungen.
Respondents’ personal use of mobile apps in their everyday working life was more common in age group 1 (456/672, 67.86%) than in group 2 (267/602, 44.35%), which showed a weak tendency (
The fields of use also showed differences between the 2 groups. The use of mobile apps for information on pharmaceuticals and as a diagnosis aid showed a weak association with the age (
Association of professional usage fields of mobile apps and occurrence per age group.
Professional usage fields of mobile apps | Association with age ( |
Group 1, n (%) (N=672) | Group 2, n (%) (N=602) |
Communication | 0.03 | 148 (41.49) | 152 (56.93) |
Training | 0.13 | 195 (42.76) | 122 (45.69) |
Information on pharmaceuticals |
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354 (77.63) | 162 (60.67) |
Diagnosis |
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264 (57.89) | 122 (45.69) |
aItalics indicate a significant difference between the 2 age groups.
Regarding trust in digital health apps, we also saw a tendency of group 1 to have more confidence in these (yes: 305/672, 45.39%; no: 42, 6.25%; that depends: 325, 48,36%) compared to group 2 (yes: 120/602, 19.93%; no: 154, 25.58%; that depends: 328, 54.49%). The
The recommendation rate of mobile health apps to patients did not relate noticeably with respondent age (
As an important source of information, the internet (
The assessment of the expected impact of digitalization on 10 health care provision–related areas showed a generally positive attitude. Mixed emotions became apparent regarding the physician-patient relationship, administration, and the attractiveness of the profession. In
Expected impact of digitalization on health care provision by age group.
The subsequent rating of the personal attitude towards upcoming changes through digitalization also showed a weak association with the age (
In this study, one of the main stakeholder groups when it comes to digitalizing health care provision, physicians, showed a general affinity toward digitalization, with a negative linear tendency with decreasing age of the participants. Considering length and complexity of the questionnaire, the completion rate of 66.44% confirms a high interest of the sample in the enquired topic [
The penetration of already existing digital process support was found to be heterogeneous for intraorganizational process areas, while interorganizational processes in general are still primarily paper based.
Also, digital services for professional communication have not yet reached a high adoption rate, with no association to users’ age. Other services for organizing working life, such as duty planning or e-learning, show relatively widespread use. This contrasts with digital offers for patients, which reach a maximum usage rate of a quarter of the respondents for appointment scheduling, while other services show much lower proportions. Meanwhile, more than half of the respondents indicated that they had experienced proactive offering of self-acquired data by patients, with the majority being willing to incorporate these data into medical decision-making. The age groups did not show differences in this regard.
The greatest perceived benefits of digitalization were data quality and readability. Perceived benefits were not associated with respondents’ age. However, participants saw untapped potential in all queried areas, with a relation with age to all categories except for data generation.
As major hindrances for digitalization, participants indicated a lack of a noticeable saving of time, followed by insufficient digital literacy or sovereignty as the dominant human factors. The association with the nominal variable of age in the category of insufficient digital literacy or sovereignty and no perception of such hindrances in respondents and their age group was noteworthy. Regarding technology, age groups agreed in most areas on its relevance, and rated insufficient system integration as the major obstacle. Only insufficient hardware was identified more frequently in group 1 compared to group 2, with a weak association with the nominal age.
Familiarity of the respondents with current trending topics regarding digitalization of the health care sector varied widely and seemed to decrease with recency of the discussion or initiative. Interestingly, age group 1 considered themselves to be less well informed across almost all topics. The association with the variable age was only relevant in the 3 topic areas of telematics infrastructure, the eHealth act, and the digital health care act.
More than half of the participants stated that they use mobile apps within their profession, with a weak tendency of an increasing adoption rate with decreasing age. Across all participants, most stated that the use of mobile apps was for information on pharmaceuticals, which was also weakly associated with age. Interestingly, the recommendation rate of mobile health apps to patients did not relate noticeably with the age (η=0.02), but was equally not very common. Only a share of 17.50% stated that they had recommended mobile health apps to patients. Insufficient services available was the main reason for not having done so yet for all participants, while insufficient data protection was a little more relevant for group 2 compared to group 1. The general belief of relevance of mobile apps for future health care provision was weakly associated with decreasing age.
The peer group “colleagues” as a source of information on mobile or digital health applications was slightly more important for younger respondents, while medical societies were the most relevant for all participants.
Respondents exhibited mainly positive expectations concerning the impact of digitalization on specific areas of health care. In particular, access to knowledge, medical research, and the treatment of rare diseases were associated with respondent optimism. Mixed feelings were expressed regarding the physician-patient relationship, administration, and attractiveness of the profession. The latter 3 categories, as well as medical quality, patient adherence, interdisciplinary collaboration, and early detection of diseases, showed a weakly increased optimism with the decreasing age of the respondents. The general attitudes toward upcoming changes through digitalization were split fairly evenly, with one-half having mainly positive feelings and the other having rather mixed feelings. The positive trend was once again weakly associated with age.
Regarding describing adjectives, being “critical” of digitalization was more associated with increased age, while being “open” was associated with decreased age. Indifference towards digitalization was hardly existent.
This study is subject to limitations due to participant selection and thus representativeness. With the first contact point being the digital channels of professional networks, a selection bias can be assumed [
Additionally, the partitioning of responses for the investigation of association was based on the age limit of the BJÄ and the definition of the German medical associations. To complement this presentation of results, a calculation of the eta coefficient incorporated the nominal value of age as an independent variable, where applicable.
Physicians are emotionally involved in digitalizing health care provision, and they predominantly see opportunities as positive but also differentiated. The lower the involvement of second or third parties, such as patients or intersectoral service providers, was apparent, and the lower the GDPR sensitivity was assumed, and the higher was the apparent adoption rate of digital services. However, despite existing data security concerns, generic messaging apps were also found to be acceptable for professional communication from a quarter of the respondents, which supports the need for convenient and seamless solutions. Additionally, the need to personally perceive benefits through digitalization, like the saving of time, was expressed. Interestingly, this was more present with increasing age, which indicates an expectation of an automated and effortless transition. For younger generations, the handling of digital technology may be already inherent, and the conversion burden may thus not seem as onerous as that perceived by older colleagues. This theory might be supported by participants’ critical assessment of digital literacy or sovereignty as a field of development, which was increasingly perceived as a major hindrance for digitalization with increasing age. Query related to the current trending topics regarding digitalization of the sector confirmed the presence of an education gap. However, this was slightly more prevalent with decreasing age. Information and education on digitalization as a mean to support health care provision should thus not only be included in the course of study, but also in the continuing process of further and advanced training. Medical societies, statutory health insurance companies, and professional associations were mentioned as desired and trustworthy information providers. This also raises the question of determination and empowerment: when legislative initiatives are unknown, how does the profession want to participate in shaping digital health?
The role physicians see for themselves in the digitalization of health care provision was mainly described as “scrutinizing,” “active,” and “open.” This represents the ambivalence and inner conflict between observant expectation and active participation. The role of individual physicians as multipliers and stakeholders of digitalization within their scope of operation should be acknowledged, as well as the general willingness to participate in this process. On the other hand, the need for guidance and orientation through trustworthy organizations has a right to be instituted in the self-administered health care sector. The incorporation of physicians into the digitalization of their working environment is essential for a functional cocreation of future processes. However, digitalization is a multidisciplinary process [
Survey translation.
Bündnis Junge Ärzte (Alliance of Young Physicians)
Digitale-Versorgung-Gesetz (digital health care act)
Digitale Gesundheitsanwendungen (digital health applications)
General Data Protection Regulation
None declared.