Stakeholders’ perspectives on Digital Transformation in Healthcare and Electronic Patients Records

Background: The SwissHealth2030 strategy stimulates technological and digital transformation within the Swiss healthcare system. Electronic Patients Records (EPR) show signifi cant potential for improving healthcare delivery, yet uptake remains challenging. This study aimed to (1) document EPR use patterns and user profi les in the Canton of Vaud, and (2) explore patients’ and professionals’ perceptions on digitalization and EPR implementation. Methods: This mixed method study included a retrospective case-control study (Phase 1) comparing EPR early adopters with matched non-users at a Swiss University Hospital (N = 324). In Phase 2, interviews and focus group discussions were organized with patients (users and non-users, N = 24) and health professionals (N = 17). Data were transcribed 'ad verbatim' and analysed using thematic analysis. Results: Quantitative data (324/1638 participants; response rate 19.3 %) revealed early adopters were predominantly male (72.6 % vs. 59.4 %, p = 0.035) and with higher education levels. Despite a majority being dissatisfi ed (54.8 %), most recommended EPR (67.7 %), citing low provider participation (in particular general practitioners) as their main concern. Qualitative analysis identified themes infl uencing patients’ EPR adoption: contextual environment, health literacy, perceptions and motivations, and digital skills. The primary factor influencing EPR registration was having a chronic medical condition and wanting to control one's health. For professionals, obstacles emerged at macro (data protection and reimbursement issues), meso (organisational factors), and micro levels (digital competencies, motivation). Conclusions: Early EPR adopters were highly educated individuals with chronic diseases and frequent health service users (cared for by a multitude of health professionals). They had the expectation of improved information transmission between healthcare providers, even if the patient was unable to access it. Despite implementation challenges, users believe in its potential value. Both patients and professionals have high expectations for the EPR that the current tool does not fulfi ll. To accelerate its implementation, promoting factors need to be identifi ed across macro, meso and micro levels. Early adopters could become implementation ambassadors, while professional enthusiasm requires enhancement. Educational environments should strengthen digital skills training, and opportunities to address attitudes towards technology. Policymakers should reconsider incentives to encourage rather than hinder implementation.