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Abstract

Background: The 2017 Australian Digital Health Agency (ADHA) Strategy is based on the underlying assumption that digitaltechnology in health care environments is ubiquitous. The ADHA Strategy views health professionals, especially nurses, asgrappling with the complexity of installing and using digital technologies to facilitate personalized and sustainable person-centeredcare. Yet, ironically, the 2018 debate over how to enroll Australians into the national electronic health record system and itsalteration from an opt-in to an opt-out model heightened public and professional concern over what constituted a “safe, seamlessand secure” health information system. What can be termed a digital technology paradox has emerged where, although it is widelyacknowledged that there are benefits from deploying and using digital technology in the workplace, the perception of risk rendersit unavailable or inaccessible at point of care. The inability of nurses to legitimately access and use mobile technology is impedingthe diffusion of digital technology in Australian health care environments and undermining the 2017 ADHA Strategy.Objective: This study explored the nature and scope of usability of mobile technology at point of care, in order to understandhow current governance structures impacted on access and use of digital technology from an organizational perspective.Methods: Individual semistructured interviews were conducted with 6 representatives from professional nursing organizations.A total of 10 interview questions focused on factors that impacted the use of mobile technology for learning at point of care.Seven national organizations and 52 members from the Coalition of National Nursing and Midwifery Organisations were invitedto participate. Interviews were recorded and transcribed verbatim. Data analysis was systematic and organized, consisting of trialcoding; member checking was undertaken to ensure rigor. A codebook was developed to provide a framework for analysis toidentify the themes latent in the transcribed data. Nurses as stakeholders emerged as a key theme.Results: Out of 6 participants, 4 female (67%) and 2 male (33%) senior members of the nursing profession were interviewed.Each interview lasted between 17 and 54 minutes, which reflected the knowledge of participants regarding the topic of interestand their availability. Two subthemes, coded as ways of thinking and ways of acting, emerged from the open codes. Participantsprovided examples of the factors that impacted the capacity of nurses to adopt digital technology from an emic perspective. Therewere contributing factors that related to actions, including work-arounds, attentiveness, and experiences. Nurses also indicatedthat there were attitudes and influences that impacted thinking regarding access and use of mobile technology at point of care.Conclusions: Nurses are inadequately prepared for the digital future that has now arrived in health care environments. Nursesdo not perceive that they are leaders in decision making regarding digital technology adoption, nor are they able to facilitatedigital literacy or model digital professionalism.

Item Type:	Article
Authors/Creators:	Mather, C and Cummings, E and Gale, F
Keywords:	digital, health policy, digital professionalism, nursing education
Journal or Publication Title:	JMIR Nursing
Publisher:	JMIR Publications Inc.
ISSN:	2562-7600
DOI / ID Number:	https://doi.org/10.2196/14279
Copyright Information:	© Carey Mather, Elizabeth Cummings, Fred Gale. Originally published in JMIR Nursing Informatics https://nursing.jmir.org), 01.08.2019. This is an open-access article distributed under the terms of the Creative Commons Attribution License(https://creativecommons.org/licenses/by/4.0/), 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 http://www.jmir.org/, as well as this copyright and license information must be included.
Related URLs:	Google Scholar: Mather, C UTAS Profile: Mather, C Google Scholar: Cummings, E UTAS Profile: Cummings, E Google Scholar: Gale, F UTAS Profile: Gale, F
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