#6762 “PRIMUM NON NOCERE”: DIGITAL TOOLS AND MENTAL LOAD IN CLINICIANS AND PATIENTS: THE “E3 TASK FORCE” PROJECT
Authors: Bagnis Corinne Isnard 
Published: June 2023

Abstract

Background and Aims
The Covid 19 pandemia has been an extremely potent enhancer of digital health solutions spreading. Telemedicine was already available in France before SARS-COV2, but not used as a standard of care. It seems like when sticking to the expressed needs and objectives, the implementation of digital solutions became a reality with a high level of acceptability. Since e-health is spreading and the commercial offer of digital solutions dramatically increasing, it seems critical to predict the impact of those new tools on mental load of users in order to make sure digital solutions really bring better quality of care together with quality of life (patients) or profesional life (health care professionals).

Method
Assistance publique -Hôpitaux de Paris launched in 2022 an ambitious project focusing on digital innovation at Hotel Dieu, making the largest hospital in Europe also an active promotor of digital health. This project includes an Innovation Hub, a large incubator for Start-ups, and (among others) the Digital Medical Hub (DMH). DMH is combining an academic platform dedicated to promoting scientific research on E-health and an open innovation structure promoting transformation strategies for e-health projets. Academic DMH initiated (March 2022) an innovative project aiming at defining what are the critical parameters involved into the lived experience of e-health users (clinicians and patients) with regard to mental load. This project included 3 steps: 1) a “consensus of experts” strategy conducted through meetings allowing the group to provide a list of the main dimensions impacting the (positive or negative) changes observed on daily life and mental load. The group includes neurosciences experts, clinicians (nephrologist, cardiologist, psychiatrist), e-health and digital solution experts, neuroergonomics and ergonomics experts, work psychologists, health economy specialist, market access experts). The following task of the group is to identify among those dimensions, those that are measurable or propose a way to evaluate them. 2) In paralell, a large opinion barometer is spread among health care professionals (HCP), digital entrepreneurs, and stakeholders in the field of health in ordre to collect over 500 answers allowing to describe expectations, fears and representations about e-Health implementation in France. 3) The last step of our research project is experimental with semi structured interviewing of health care profesionals in two different hospitals to explore the experience of actors exposed to digital solutions usage daily. The expert group conducting this research has turned into a Task Force to build the research plan for the next steps, after publishing the first conclusions of this work in the form of a “white book”.

Results
A white paper is under review describing the dimensions identified by the consensus of experts group as impacting mental load of HCP and, when available, the tools for quantitaive assessment of impact. The resultst of the pinion barometers witll be available in June and the qualitative study if ongoing.

Conclusion
Sharing this experience is shedding light on the importance for the Nephrology community to think about how to take part to the digital revolution in the field of Nephrology. There is incredible need for training and teaching to develop a commun culture about digital health. Patients and profesionals should explore and express needs for digital tools in order to act as promoters of the digital transformation of health system.