This study found that overall, the shift to electronic form was not only tolerated, but in most cases, the shift was preferred. Specifically, staff found the electronic form to be a useful tool and were overall easier, faster, and more accurate to use than paper forms.
Implementation of modern digital interventions, despite its variety of advantages (such as optimizing and improving documentation), is also associated with individual barriers (6). In this study, the new digital tool was preferred in most parameters. However whether such implementations have a positive effect or not, might depend on numerous factors, such as the context in which the technology is applied, its function, and how it was implemented (13). The participants in our study reported a preference towards the electronic form, which may indicate improved buy-in. Further, from a function perspective, the electronic form was more ideal for researchers, easier and faster to use for the staff, and potentially less agitating for clients.
When implementing organizational changes in healthcare, promotion of a “shared vision” and buy-in is important (14). This was supported in an assessment of the Norwegian THN program, where the researchers found that the adoption and uptake of the THN intervention was biggest where organizational (staff, leader and clients) buy-in was most prominent (10). The social environment at the workplace should also be drawn to attention as a positive atmosphere might help improving reactions to digitalization (15). When promoting the new electronic form, the researchers believed that the form would be easier to use, and that it would minimize workload related to the program’s data collection scheme. This is supported by the results of this study, with staff preferring the electronic form. The simplicity of the electronic form appeared to also offer an improved client visit, as one respondent reported that the clients don’t get agitated by “a stack of paper” when using the electronic form. One study monitoring pain found that electronic diaries were reliable, valid, and preferred by patients over paper diaries (16). This study did not interview clients and their perspectives from the electronic form, although the speed and ease of it (as experienced by the staff) may give an indication that they may also prefer it.
For researchers, electronic data collection has been found by others to be more accurate and cost-effective (17–19). From a research perspective, the real-time collection of electronic data into a database is faster than collecting and entering paper forms, and interactive validation (i.e., software that facilitates entry of ‘correct’ answers) allows for pre-defined ranges of expected values and logical skip patterns to be integrated in a way that paper forms cannot (9). Several studies have also shown that electronic questionnaires are more accurate in terms of generating complete data and have fewer missing values than paper questionnaires (20–22).