General and dermatological population's use and acceptance of digital health in Germany - a representative survey.

Publisher: Blackwell Country of Publication: Germany NLM ID: 101164708 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1610-0387 (Electronic) Linking ISSN: 16100379 NLM ISO Abbreviation: J Dtsch Dermatol Ges Subsets: MEDLINE

Original Publication: Berlin : Blackwell, 2003-

Skin Diseases*/epidemiology ; Skin Diseases*/diagnosis ; Skin Diseases*/therapy ; Telemedicine*/statistics & numerical data ; Patient Acceptance of Health Care*/statistics & numerical data; Humans ; Germany ; Female ; Male ; Adult ; Middle Aged ; Young Adult ; Aged ; Surveys and Questionnaires ; Adolescent ; Digital Health

Background and Objectives: Adoption and acceptance of digital health services (DHS) in the German population and in persons with skin diseases is unclear. Both factors were analyzed in this survey.
Methods: A standardized survey with items on digital competences and attitudes, use and acceptance of DHS was applied to a representative sample of the German adult population. Bivariate and multivariate analyses were conducted.
Results: Out of 2,101 participants, 29.9% reported having had skin diseases in the last 12 months. Among them, adoption and acceptance were at 43.6% and 52.3%, respectively. Both values are significantly higher compared to participants without skin diseases (29.2%; p < 0.01 and 45.5%; p < 0.01). 18.9% of participants with a skin disease used digital diagnostic support, but only 9.7% applied it for a skin disease (p < 0.01). For all participants, with and without skin disease, the DHS most commonly used were passive health monitoring (14.3%) and diagnostic support (11.5%), telemedicine was least used (4.7% video-consultation, 2.5% store-and-forward). Use and acceptance were associated with young age, education, low data privacy concerns, digital confidence, having a skin disease, and high severity of skin disease.
Conclusions: DHS for skin diseases are used rarely but have a high potential.
(© 2024 The Authors. Journal der Deutschen Dermatologischen Gesellschaft published by Wiley‐VCH GmbH on behalf of Deutsche Dermatologische Gesellschaft.)

Shaw T, McGregor D, Brunner M, et al. What is eHealth (6)? Development of a Conceptual Model for eHealth: Qualitative Study with Key Informants. J Med Internet Res. 2017;19(10):e324.
Esch T, Mejilla R, Anselmo M, et al. Engaging patients through open notes: an evaluation using mixed methods. BMJ Open. 2016;6(1):e010034.
World Health Organization. Global strategy on digital health 2020–2025. Available from: https://apps.who.int/iris/handle/10665/344249 [Last accessed October 17, 2022].
Kassenärztliche Bundesvereinigung. Gesundheitsdaten: Behandlungsfallzahl je Arzt bleibt weitgehend konstant. Available from: https://gesundheitsdaten.kbv.de/cms/html/17023.php [Last accessed October 17, 2022].
Pilz AC, Zink A, Schielein MC, et al. Despite large choice of effective therapies: Individuals with psoriasis still seem undertreated. J Dtsch Dermatol Ges. 2021;19(7):1003‐1011.
Krensel M, Augustin M, Rosenbach T, Reusch M. Waiting time and practice organization in dermatology. J Dtsch Dermatol Ges. 2015;13(8):812‐814.
Richard MA, Paul C, Nijsten T, et al. Prevalence of most common skin diseases in Europe: a population‐based study. J Eur Acad Dermatol Venereol. 2022;36(7):1088‐1096.
Kis A, Augustin M, Augustin J. Regional healthcare delivery and demographic change in Germany ‐ scenarios for dermatological care in 2035. J Dtsch Dermatol Ges. 2017;15(12):1199‐1209.
Augustin M, Wimmer J, Biedermann T, et al. Praxis der Teledermatologie. J Dtsch Dermatol Ges. 2018;16(Suppl 5):6‐57.
Augustin M, Strömer K, Dittmann M. S2k‐Leitlinie Teledermatologie. Available from: https://www.awmf.org/leitlinien/detail/ll/013‐097.html [Last accessed July 28, 2021].
Bundy C, Pinder B, Bucci S, et al. A novel, web‐based, psychological intervention for people with psoriasis: the electronic Targeted Intervention for Psoriasis (eTIPs) study. Br J Dermatol. 2013;169(2):329‐336.
Svendsen MT, Andersen F, Andersen KH, et al. A smartphone application supporting patients with psoriasis improves adherence to topical treatment: a randomized controlled trial. Br J Dermatol. 2018;179(5):1062‐1071.
van Os‐Medendorp H, Koffijberg H, Eland‐de Kok PC, et al. E‐health in caring for patients with atopic dermatitis: a randomized controlled cost‐effectiveness study of internet‐guided monitoring and online self‐management training. Br J Dermatol 2012;166(5):1060‐1068.
Schaeffer D, Berens EM, Gille S, et al. Gesundheitskompetenz der Bevölkerung in Deutschland vor und während der Corona Pandemie: Ergebnisse des HLS‐GER 2. Available from: https://pub.uni‐bielefeld.de/record/2950305 [Last accessed January 02, 2023].
Schaeffer D, Gille S, Berens EM, et al. Digitale Gesundheitskompetenz der Bevölkerung in Deutschland Ergebnisse des HLS‐GER 2. Gesundheitswesen 2023;85(4):323‐331.
Klein TM, Augustin M, Kirsten N, Otten M. Attitudes towards using electronic health records of patients with psoriasis and dermatologists: a cross‐sectional study. BMC Med Inform Decis Mak. 2020;20(1):344.
Greis C, Meier Zürcher C, Djamei V, et al. Unmet digital health service needs in dermatology patients. J Dermatolog Treat. 2018;29(7):643‐647.
Statistisches Bundesamt (Destatis). Wirtschaftsrechnungen – Private Haushalte in der Informationsgesellschaft – Nutzung von Informations‐ und Kommunikationstechnologien (Mikrozensus‐Unterstichprobe zur Internetnutzung). Available from: https://www.destatis.de/DE/Themen/Gesellschaft‐Umwelt/Einkommen‐Konsum‐Lebensbedingungen/IT‐Nutzung/Publikationen/Downloads‐IT‐Nutzung/private‐haushalte‐ikt‐2150400227004.pdf?__blob=publicationFile [Last accessed January 11, 2023].
Benson T. Digital innovation evaluation: user perceptions of innovation readiness, digital confidence, innovation adoption, user experience and behaviour change. BMJ Health Care Inform. 2019;26(1):0.
Dinev T, Xu H, Smith JH, Hart P. Information privacy and correlates: an empirical attempt to bridge and distinguish privacy‐related concepts. Eur J Inf Syst. 2013;22:295‐316.
Soellner R, Huber S, Reder M. The Concept of eHealth Literacy and Its Measurement: German Translation of the eHEALS. J Media Psychol. 2014;26(1):29‐38.
Venkatesh V, Morris MG, Davis GB, Davis FD. User acceptance of information technology: Toward a unified view. MIS Quarterly. 2003;27(3):425‐478.
Philippi P, Baumeister H, Apolinario‐Hagen J, et al. Acceptance towards digital health interventions ‐ Model validation and further development of the Unified Theory of Acceptance and Use of Technology. Internet Interv. 2021;26:100459.
Klein TM, Augustin M, Otten M. How should electronic health records be designed? A cross‐sectional study in patients with psoriasis. BMC Med Inform Decis Mak. 2019;19(1):218.
Ceney A, Tolond S, Glowinski A, et al. Accuracy of online symptom checkers and the potential impact on service utilisation. PLoS One. 2021;16(7):e0254088.
Tison GH, Sanchez JM, Ballinger B, et al. Passive Detection of Atrial Fibrillation Using a Commercially Available Smartwatch. JAMA Cardiol. 2018;3(5):409‐416.
Basch E, Deal AM, Kris MG, et al. Symptom Monitoring With Patient‐Reported Outcomes During Routine Cancer Treatment: A Randomized Controlled Trial. J Clin Oncol. 2016;34(6):557‐565.
Schafer JL. Multiple imputation: a primer. Stat Methods Med Res. 1999;8(1):3‐15.
De Santis KK, Jahnel T, Sina E, et al. Digitization and Health in Germany: Cross‐sectional Nationwide Survey. JMIR Public Health Surveill. 2021;7(11):e32951.
The IQVIA Institute. Digital Health Trends 2021. Innovation, evidence, regulation, and adoption. Available from: https://www.iqvia.com/insights/the‐iqvia‐institute/reports/digital‐health‐trends‐2021 [Last accessed July 22, 2021].
Schomakers EM, Lidynia C, Ziefle M. Listen to My Heart? How Privacy Concerns Shape Users’ Acceptance of e‐Health Technologies. IEEE International Conference on Wireless and Mobile Computing, Networking And Communications (WiMob). 2019:306‐311.
Princi E, Kramer NC. Out of Control – Privacy Calculus and the Effect of Perceived Control and Moral Considerations on the Usage of IoT Healthcare Devices. Front Psychol. 2020;11:582054.
Snoswell CL, Whitty JA, Caffery LJ, et al. Direct‐to‐consumer mobile teledermoscopy for skin cancer screening: Preliminary results demonstrating willingness‐to‐pay in Australia. J Telemed Telecare. 2018;24(10):683‐689.
von Weinrich P, Kong Q, Liu Y. Would you zoom with your doctor? A discrete choice experiment to identify patient preferences for video and in‐clinic consultations in German primary care. J Telemed Telecare. 2022: 1357633X221111975 [Online ahead of print].
Albrecht M, Otten M, Sander M. PraxisBarometer Digitalisierung 2021. Stand und Perspektiven der Digitalisierung in der vertragsärztlichen und ‐psychotherapeutischen Versorgung. Available from: https://www.kbv.de/media/sp/IGES_PraxisBaroDigit2021_Kurzbericht.pdf [Last accessed Januar 11, 2022].
Elsner P. Teledermatology in the times of COVID‐19 – a systematic review. J Dtsch Dermatol Ges. 2020;18(8):841‐845.
Phillips EA, Himmler SF, Schreyögg J. Preferences for e‐Mental Health Interventions in Germany: A Discrete Choice Experiment. Value Health. 2021;24(3):421‐430.
Savira F, Robinson S, Toll K, et al. Consumer preferences for telehealth in Australia: A discrete choice experiment. PLoS One. 2023;18(3):e0283821.
Bundesministerium für Arzneimittel und Medizinprodukte. Das DiGA‐Verzeichnis. Antworten zur Nutzung von DiGA. Available from: https://diga.bfarm.de/de [Last accessed October 02, 2023].
Facharztmagazine R. Hausstaubmilbenallergie: Ein‐Stärken‐Aufdosierung vereinfacht zugelassene AIT. Allergo J. 2023;32:62‐63.
Techniker Krankenkasse bietet digitalen Hautcheck an. Available from: https://www.aerzteblatt.de/nachrichten/118180/ Techniker‐Krankenkasse‐bietet‐digitalen‐Hautcheck‐an [Last accessed: October 02, 2023].
Otten M, Greis C, Reinders P, et al. Patient and physician outcomes of a store‐and‐forward teledermatology application in Germany. J Eur Acad Dermatol Venereol. 2023; 38(2): e148‐e151.
Cheng C, Gearon E, Hawkins M, et al. Digital Health Literacy as a Predictor of Awareness, Engagement, and Use of a National Web‐Based Personal Health Record: Population‐Based Survey Study. J Med Internet Res. 2022;24(9):e35772.
Takeshita J, Grewal S, Langan SM, et al. Psoriasis and comorbid diseases: Epidemiology. J Am Acad Dermatol 2017;76(3):377‐390.
Silverberg JI. Comorbidities and the impact of atopic dermatitis. Ann Allergy Asthma Immunol. 2019;123(2):144‐151.
Samuels DV, Rosenthal R, Lin R, et al. Acne vulgaris and risk of depression and anxiety: A meta‐analytic review. J Am Acad Dermatol. 2020;83(2):532541.
Oh YS, Cho Y. Examining the relationships between resources and online‐ health information seeking among patients with chronic diseases and healthy people. Soc Work Health Care. 2015;54(2):83‐100.
Watts G. COVID‐19 and the digital divide in the UK. Lancet Digit Health. 2020;2(8):e395‐e396.
Robinson L, Cotten SR, Hiroshi O, et al. Digital inequalities and why they matter. Inf Commun Soc. 2015;18(5):569‐582.
Reitzle L, Schmidt C, Färber F, et al. Perceived Access to Health Care Services and Relevance of Telemedicine during the COVID‐19 Pandemic in Germany. Int J Environ Res Public Health. 2021;18(14):7661.
Eurostat. Households ‐ level of internet access: online data code: ISOC_CI_IN_H. Available from: https://ec.europa.eu/eurostat/databrowser/view/ISOC_CBS/default/table?lang=en&category=isoc.isoc_c.isoc_cb [Last accessed: January 02, 2023].
König R, Seifert A, Doh M. Internet use among older Europeans: an analysis based on SHARE data. Univers Access Inf Soc. 2018;17:621‐633.
Fox G, Connolly R. Mobile health technology adoption across generations: Narrowing the digital divide. Inf Syst. 2018;28:995‐1019.
Bidmon S, Terlutter R. Gender Differences in Searching for Health Information on the Internet and the Virtual Patient‐Physician Relationship in Germany: Exploratory Results on How Men and Women Differ and Why. J Med Internet Res 2015;17(6):e156.
Elena‐Bucea A, Cruz‐Jesus F, Oliveira T, Coelho PS. Assessing the Role of Age, Education, Gender and Income on the Digital Divide: Evidence for the European Union. Inf Syst Front. 2021;23:1007‐1021.
White A, de Sousa B, de Visser R, et al. The State of Men's Health in Europe. Extended Report. Available from: https://www.ismh.org/uploads/8/3/4/4/83443650/the_state_of_mens_health_in_europe.pdf [Last accessed January 12, 2023].

Keywords: Acceptance; Digital health; Digital health literacy; Skin disease; Usage

Date Created: 20241118 Date Completed: 20241118 Latest Revision: 20241118

20241119

10.1111/ddg.15454

39555644