Determinants of Catalan Public Primary Care Professionals' Intention to Use Digital Clinical Consultations (eConsulta) in the Post-COVID-19 Context: Mixed Methods Study

Background: Telemedicine has become a necessary component of clinical practice for the purpose of providing safer patient care during lockdowns due to the COVID-19 pandemic. It has been used to support the health care needs of patients with COVID-19 and routine primary care patients alike. However, this change has not been fully consolidated. Objective: The objective of this study was to analyze the determinants of health care professionals' intention to use the eConsulta digital clinical consultation tool in the post-COVID-19 context. Methods: A literature review of the Technology Acceptance Model allowed us to construct a theoretical model and establish a set of hypotheses on the influence of a variety of different factors relating to health care professionals, as well as the institutions where they work, on their intention to use eConsulta. In order to confirm the proposed model, a mixed qualitative and quantitative methodology was used, and a questionnaire was designed to serve as the data collection instrument. The data were analyzed using univariate and bivariate analysis techniques. To confirm the theoretical model, exploratory factor analysis and binary logistic regression were applied. Results: The most important variables were related to perceived benefits (B=2.408) and the type of use that individuals habitually made of eConsulta (B=0.715). Environmental pressure (B=0.678), experience with technology (B=0.542), gender (B=0.639), and the degree to which eConsulta had been implemented (B=0.266) were other variables influencing the intention to use the tool in the post-COVID-19 context. When replicating the previous analysis according to professional group, experience with technology and gender in the physician group, and experience with tool use and the center where a professional worked in the nurse group, were found to be of considerable importance. Conclusions: The implementation and use of eConsulta had increased significantly as a consequence of the COVID-19 pandemic, and the majority of health care professionals were satisfied with its use in practice and planned to incorporate it into their practices in the post-COVID-19 context. Perceived benefits and environmental pressure were determining factors in their attitude toward and intention to use eConsulta.