Attitudes towards telemedicine in pregnancy monitoring: A questionnaire survey among health care professionals in Germany (Preprint)

BACKGROUND Pregnant women have a high demand for fetal monitoring and reassurance. Consequently, they use a variety of health applications in pregnancy and tend to visit emergency departments for objectively non-urgent consults. However, the potential of electronic Health (eHealth) and mobile Health (mHealth) solutions is clinically hardly used to prevent non-urgent emergency consultations. To implement modern care solutions a better understanding of the attitudes, fears and hopes of health care professionals towards eHealth and mHealth is needed. OBJECTIVE The aim of this study was to investigate the attitudes of health care professionals in obstetrics towards telemedicine. METHODS A quantitative web based survey among health care professionals in Germany was conducted. The participants included nurses, midwives and physicians of all age groups and job positions working in hospitals with various level of care. The questionnaire comprised 24 questions capturing study population characteristics, views about emergency consultations in obstetrics, attitude towards telemedicine, job satisfaction and sleeping behavior. RESULTS 244 health care professionals participated in the online survey. In general, health care professionals are skeptical (72.9%; n=170) about the use of telemedicine in obstetrics, however, 55.8% (n=130) recognize its potential. Physicians are optimistic with 72% (n=62) considering the use of applications (apps) for pregnancy monitoring reasonable by contrast to just 36% (n=47) of non-physicians (P<.001). Significantly more non-physicians reject such developments categorically, 58% (n=75) compared to 27% (n=24) of physicians (P<.001). We also found, that obstetricians with more than ten years of work-experiences are more skeptical. 49% (n=18) of them believe that telemedicine could reduce non-urgent emergency consultations compared to 73.2% (n=106) among obstetricians with less than 5 years of experience (P=.006). Our survey revealed a high job satisfaction among health care professionals in obstetrics and a prevalence of regular sleeping problems of 46% (n=91). Surprisingly, both job satisfaction and sleeping problems were independent from the number of night shifts served per month (P=.77 and P=.99 respectively). Yet, 56.6% (n=112) of the survey participants thought they would be happier in their job if they had to work fewer night shifts per month. CONCLUSIONS Our study reveals an ambivalent attitude towards telemedicine among health care professionals in obstetrics. Efforts to promote the use of telemedicine should concentrate on nurses and midwives since this group is most skeptical about it in Germany. By contrast, particularly young physicians recognize the potential of apps for patient care and would like to use such technology in pregnancy monitoring.