Perspectives of Family Physicians on Computer-assisted Screening for Psychosocial Risks

Background: Despite existing knowledge on the effectiveness of computer-assisted screening for psychosocial risks, little is known about the perspectives of healthcare providers who use the interactive eHealth applications. Methods: We conducted in-depth qualitative interviews with 10 family physicians (seven female and three male) who used such an intervention in a randomized trial at a multi-disciplinary clinic. All transcribed interview data was coded and analyzed using techniques of analytic induction and constant comparison. Interpretation was facilitated by insights gained from the social exchange perspective. Results: Three overarching themes emerged in relation to computer-assisted screening: perceived benefits, perceived concerns or challenges, and feasibility. Physicians unanimously acknowledged the potential of computer screening to open dialogue on psychosocial health risks. They also appreciated the general facilitative roles of the tool such as time-efficiency by screening of risks prior to the consultation, and triggering of patients' self-reflections on the risks. In the context of ongoing physician-patient relationships, physicians expressed concerns or challenges about the impact of computer screening on visit time, patient readiness to talk about psychosocial issues when the purpose of the visit was different, and the suitability of such screening for all visits to detect new risk-information. In terms of feasibility, physicians displayed general acceptance of the screening tool but considered it most feasible for periodic health checkups and follow-up visits. Their perceived feasibility was influenced by the perceived concerns/challenges and the resources needed at the clinic- (staff training, space, confidentiality) and organizational-level (time, commitment and money). Conclusion: Implications for future research and policy are discussed for the implementation of such eHealth applications.