Sociotechnical Challenges of Digital Health in Nursing Practice During the COVID-19 Pandemic: National Study

Background: The COVID-19 pandemic has accelerated the use of digital health innovations, which significantly impacted nursing practice. However, still little is known about nurses’ current knowledge and expertise in digital health and how this has changed during the pandemic. Objective: This study explores nurses’ readiness and expertise gap in using digital health services implemented during the pandemic and the expectations for graduate nurses' digital health capabilities. Methods: Five groups of nurses (chief nursing information officers, nurses, clinical educators, nurse representatives at digital health vendor companies, and in the government) involved in the digital health pipeline, from the design to evaluation within and outside the clinical settings, were interviewed. They were asked about a) their experience of digital health during the pandemic and their sociotechnical challenges; b) their expectations of the digital health capabilities of emerging nurses to overcome these challenges. Interviews were deductively analysed based on eight sociotechnical themes. Results: Sixteen participants were interviewed. Human factors and workflows were the key sociotechnical challenges. Nurses’ lack of knowledge and involvement in digital health design, development, implementation, and evaluation led to inefficient use of these technologies during the pandemic. They expected the emerging workforce to be digitally literate and actively engaged in digital health interventions. Conclusions: Nurses should be involved in digital health interventions to efficiently use these technologies and provide safe and quality care. Collaborative efforts between policymakers, vendors, and clinical and academic industries can leverage digital health capabilities in nursing workforce.