University of Oulu

Saukkonen, P., Elovainio, M., Virtanen, L., Kaihlanen, A.-M., Nadav, J., Lääveri, T., Vänskä, J., Viitanen, J., Reponen, J., & Heponiemi, T. (2022). The interplay of work, digital health usage, and the perceived effects of digitalization on physicians’ work: Network analysis approach. Journal of Medical Internet Research, 24(8), e38714.

The interplay of work, digital health usage, and the perceived effects of digitalization on physicians’ work : network analysis approach

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Author: Saukkonen, Petra1; Elovainio, Marko1,2; Virtanen, Lotta1;
Organizations: 1Finnish Institute for Health and Welfare , Helsinki , FI
2Department of Psychology and Logopedics , Faculty of Medicine , University of Helsinki , Helsinki , FI
3Infectious Diseases and Meilahti Vaccine Research Center MeVac , Inflammation Center , University of Helsinki and Helsinki University Hospital , Helsinki , FI
4Department of Computer Science , Aalto University , Espoo , FI
5Finnish Medical Association , Helsinki , FI
6Medical Research Centre Oulu , Oulu University Hospital and University of Oulu , Oulu , FI
7Research Unit of Medical Imaging , Physics and Technology , University of Oulu , Oulu , FI
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1 MB)
Persistent link:
Language: English
Published: JMIR Publications, 2022
Publish Date: 2023-02-02


Background: In health care, the benefits of digitalization need to outweigh the risks, but there is limited knowledge about the factors affecting this balance in the work environment of physicians. To achieve the benefits of digitalization, a more comprehensive understanding of this complex phenomenon related to the digitalization of physicians’ work is needed.

Objective: The aim of this study was to examine physicians’ perceptions of the effects of health care digitalization on their work and to analyze how these perceptions are associated with multiple factors related to work and digital health usage.

Methods: A representative sample of 4630 (response rate 24.46%) Finnish physicians (2960/4617, 64.11% women) was used. Statements measuring the perceived effects of digitalization on work included the patients’ active role, preventive work, interprofessional cooperation, decision support, access to patient information, and faster consultations. Network analysis of the perceived effects of digitalization and factors related to work and digital health usage was conducted using mixed graphical modeling. Adjusted and standardized regression coefficients are denoted by b. Centrality statistics were examined to evaluate the relative influence of each variable in terms of node strength.

Results: Nearly half of physicians considered that digitalization has promoted an active role for patients in their own care (2104/4537, 46.37%) and easier access to patient information (1986/4551, 43.64%), but only 1 in 10 (445/4529, 9.82%) felt that the impact has been positive on consultation times with patients. Almost half of the respondents estimated that digitalization has neither increased nor decreased the possibilities for preventive work (2036/4506, 45.18%) and supportiveness of clinical decision support systems (1941/4458, 43.54%). When all variables were integrated into the network, the most influential variables were purpose of using health information systems, employment sector, and specialization status. However, the grade given to the electronic health record (EHR) system that was primarily used had the strongest direct links to faster consultations (b=0.32) and facilitated access to patient information (b=0.28). At least 6 months of use of the main EHR was associated with facilitated access to patient information (b=0.18).

Conclusions: The results highlight the complex interdependence of multiple factors associated with the perceived effects of digitalization on physicians’ work. It seems that a high-quality EHR system is critical for promoting smooth clinical practice. In addition, work-related factors may influence other factors that affect digital health success. These factors should be considered when developing and implementing new digital health technologies or services for physicians’ work. The adoption of digital health is not just a technological project but a project that changes existing work practices.

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Series: Journal of medical internet research
ISSN: 1439-4456
ISSN-E: 1438-8871
ISSN-L: 1439-4456
Volume: 24
Issue: 8
Article number: e38714
DOI: 10.2196/38714
Type of Publication: A1 Journal article – refereed
Field of Science: 217 Medical engineering
Funding: This study was supported by the Strategic Research Council of the Academy of Finland (project 327145) and the Ministry of Social Affairs and Health (project 414919001). ME was supported by the Academy of Finland (project 339 390). The authors would like to express their gratitude to all physicians who responded to the questionnaire as well as the Finnish Medical Association for collaboration.
Copyright information: ©Petra Saukkonen, Marko Elovainio, Lotta Virtanen, Anu-Marja Kaihlanen, Janna Nadav, Tinja Lääveri, Jukka Vänskä, Johanna Viitanen, Jarmo Reponen, Tarja Heponiemi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.