eHealth competency needs in the Mekong border region: a GLMM analysis of primary care personnel in Nong Khai, Thailand

The digital transformation of health systems is crucial for enhancing healthcare delivery, particularly in border areas like Nong Khai province, Thailand, situated along the Mekong River. This strategic region faces unique challenges in cross-border disease surveillance and health data interoperability between Thailand and the Lao People’s Democratic Republic (Lao PDR). Consequently, healthcare personnel in this area require robust eHealth competencies to manage these complexities effectively. This study aimed to identify the determinants associated with the need for eHealth competency development among healthcare personnel working in the primary care network of a border province along the Mekong River. A cross-sectional analytical study was conducted among 460 healthcare personnel in Nong Khai province. Data were collected using a structured questionnaire assessing socio-economic status , social support, organizational innovation management , and digital intelligence (DQ). Generalized Linear Mixed Models (GLMM) were employed to analyze the factors associated with high needs for eHealth competency development, accounting for the clustering effects of professional differences within the health service network. The study found that 53.26% of personnel reported a high need for eHealth competency development. The GLMM analysis revealed that personnel working in Sub-district Health Promoting Hospitals (SHPHs) were significantly more likely to require training compared to those in community hospitals (Adjusted Odds Ratio [AOR] = 1.82; 95% CI: 1.08–3.05; p = 0.023). Strong predictors of development needs included an organizational climate conducive to innovation (AOR = 4.03; 95% CI: 2.27–7.15; p < 0.001) and continuous learning systems (AOR = 1.95; 95% CI: 1.09–3.49; p = 0.024). Furthermore, specific components of digital intelligence, including skills in cyberbullying management (AOR = 3.77; 95% CI: 2.14–6.66; p < 0.001), screen time management (AOR = 2.67; 95% CI: 1.42–5.03; p = 0.002), and privacy management (AOR = 2.19; 95% CI: 1.14–4.21; p = 0.019), were significantly associated with higher needs for competency development. A substantial proportion of primary care personnel in the Mekong border region require eHealth upskilling, particularly those in peripheral sub-district health hospitals. To effectively implement national eHealth policies, interventions should extend beyond technical training to foster an innovative organizational culture and enhance digital resilience, specifically focusing on data privacy and cyber-safety skills.