E-health provides opportunities for healthcare employees

The Dutch government has included a sum of € 162 million in the budget in order to accelerate the technological developments in the care sector. With it, the cabinet tries to prevent staff shortages from getting out of control. Emma Pullen and Merijn Bruijnes from the Utrecht University School of Governance (USG) conducted  an exploratory research project into the relationship between various, digital applications (also called: ‘e-health’) and retaining professionals in the healthcare sector. Is e-health the ideal solution? That seems to depend on both the type of technology and the healthcare context. In any case, there are opportunities which can be capitalised on, says Emma Pullen.

Dutch healthcare is under increasing pressure. The demand for healthcare is growing, because of the rising life expectancy and the increasing age, among other things. But the supply of healthcare is not increasing in line with the demand for healthcare. In 2040, according to a report from the SER, one in four professionals would have to be working in the healthcare sector in order to be able to meet the demand for care, but it seems unlikely that this need can be met.

Technological innovations and Dutch healthcare

Policy makers are confronted with complex puzzles when it comes to sustainable arrangement of the Dutch healthcare landscape. E-health is one of the possible solution paths to handle this issue. But what is e-health, concretely?

E-health is a wide concept, but it at least involves the use of the Internet or technology to retain or improve health and public well-being, the quality of care services and results, and the efficiency and reduction of paperwork in healthcare. In this, you can think along the lines of:
 

• Digital communication platforms (which connect care workers with each other)
• Health apps (in which medical data is collected or reminders for medication use are facilitated)
• Care robots (which provide support for physical tasks or have social functions)
• Sensor technology (for instance used to detect falling hazards)

For their exploratory research, researchers Emma Pullen and Merijn Bruijnes focus on a VVT institution, an organisation for both nursing and care homes (intramural) as well as home care (extramural), which uses various e-health technologies. The care professionals in the various locations of this care institution and in home care use the aforementioned types of technology.

In extramural care, the emphasis is on digital communication platforms, with which contact with other caregivers and clients' relatives is facilitated. Besides this, motion sensors and robots are used in intramural healthcare. In client-accommodation spaces, sensors keep the care professionals up to date, for instance the moment a client gets out of bed, and robots are present in the form of robot cats and dogs. These robots turn out to be popular: at the various locations, clients are cuddling with or talking to the social robots in the common rooms.

For instance, a robot cat fulfils a special function for clients, Emma Pullen states. It providers them with warmth, distraction and feelings of security. This has consequences for the way in which professionals look at the use of such technologies. To them, it is important that they can provide good care to clients. If e-health helps them with that, it's meaningful to professionals. At the same time, our research shows that care workers are intrinsically motivated to do the right thing for their clients; that's centre stage to them.

Indirect effect on job satisfaction and autonomy

The researchers therefore conclude that the use of e-health is not directly related to professionals' wish to keep working in healthcare. The care professionals questioned for this exploratory research project do experience that the use of e-health indirectly contributes to that wish, specifically because of a positive connection with the experienced job satisfaction and autonomy. Precisely job satisfaction and autonomy are of importance to the wish to remain employed in healthcare.

Digital communication platforms, health apps and sensor technology are appreciated by the questioned care professionals

Digital communication platforms, health apps and sensor technology are appreciated by the professionals because they believe these contribute to the quality of healthcare and access to information. This simplifies their tasks and increases their job satisfaction. Although care robots are on the rise, only a small number of respondents recognises a comparable effect of this technology on their job satisfaction.

The connection with the experienced autonomy is less unequivocal. Health care sector employees experience an increase in this on the one hand, especially when the technology supports the care professional with information via digital communication platforms or provides the possibility to prioritise tasks, for instance thanks to sensors. On the other hand, some care professionals indicate they can also work independently without e-health. Besides this, some of them actually experience less autonomy the moment e-health is used, for instance because clients' relatives can read reports too via digital communication platforms.

We'll have to further explore the meaning of digital applications through time, and in various places

A first inventory of care professionals' experiences

The statement that the use of e-health can make a positive contribution to care professionals' wish to continue to be employed in the care sector is nuanced by Pullen and Bruijnes' findings. The added value of care technology is not to be overestimated, they conclude. All in all, the type of e-health and the context in which this is implemented seem to influence care professionals' experiences. So it is important to not use e-health as an umbrella term, but to instead look well at the impact of specific applications.

It is important to not use e-health as an umbrella term

Pullen and Bruijnes' research served as a first exploration of the field, and knew a number of limitations. Because the research was carried out at one VVT institution, it needs to be seen as an inventory of care professionals' experiences around various e-health applications, with the observance of possibly different experiences in other healthcare institutions. Large or larger-scale research can show how the respondents' experiences in this research project relate to healthcare professionals' experiences in other care institutions. The researchers therefore expressly speak out in favour of this.

The question remains: is e-health the ideal solution or not? The future will tell, Pullen says, but there are at least opportunities which can be capitalised on. We'll have to go and look for creative ways to let the care sector function in the upcoming years. “We'll have to further explore the meaning of digital applications in this through time, and in various places.

More information

The article (in Dutch) ‘E-health: een gouden vondst voor zorgprofessionals? Een kwalitatief onderzoek naar de ervaringen van zorgprofessionals met het gebruik van e-health’ is published in Beleid en Maatschappij. From January 2025 onwards, it will be available open access.

Would you like to know more about this research? If you do, please contact Emma Pullen (e.r.pullen@uu.nl) or Merijn Bruijnes (m.bruijnes@uu.nl).