‘Having to learn this so late in our lives…’ Swedish elderly patients’ beliefs, experiences, attitudes and expectations of e-health in primary health care

Figures & data

Table 1. Example of text condensation and coding.

Meaning unit	Condensed meaning unit	Initial coding	Final coding (sub-category)	Category
‘I feel safe now, they call me for example every three months…and they check the blood sugar and everything…if it is all right I feel happy with it, I mean…it won´t turn into a disaster in three months, so I get this little check-up…’	I feel safe with regular visits every three months for my diabetes	Security with regular visits at the PHCC	Do not fix what is not broken	E-health-a solution for a non-existing problem?
‘In my case, having these chronic diseases…it demands that I come here once a year to see the doctor, and once more to see a nurse. So I haven't had any contact with this e-health yet.’	Having chronic illnesses demands doctor and nurse visits every year, buy I don’t have any experience of e-health yet.	Lack of experiences of digital tools	Lack of experiences or knowledge of digital tools	Elderly’s experiences of e-health
‘Because I hate everything with computers, I am almost allergic to them, so I don't want to see myself in that world’	I hate computers and I don´t want to use them	Aversion to technology	Lack of interest for digital tools and aversion to technology	Lack of will, skills, self-trust or mistrust in the new technology
‘I have understood, after following the debate many times, when it comes to health care, that they work in different systems in different places, for example hospitals and primary health care centers…without any connection so to speak…’	The health care system uses different IT systems without any connection to each other	Lack of communication between IT systems in health care	Poor communication between health care IT systems	Organizational barriers
‘I am not very good at this…but I think I am online maybe an hour a day…and google stuff, if it's not names it might be something else, and I have looked at medical pictures….But it is dangerous too… actually I don't sit and think that I might be ill with this and that…but you can still get some advice…’	I am often on line and google medical information. I do not imagine myself sick but I look for advice on line.	Positive with seeking medical information from the internet	Curiosity and interest for digital tools and technical solutions	Wanting and needing to move forward
‘The risk with putting so much (money) on applications and stuff like this, is that you might need to cut down on personnel a bit…and maybe shut down a health care center…and then more cut offs might come…as they believe that personnel is expensive…’	The risk with putting so much resources on technology is that it might lead to health care personnel cut offs	Concerns about use of resources and costs	Accessibility, costs and other risks with e-health	Concerns to be addressed for making e-health a good solution
‘It is an advantage if you can do it (online booking), because many times when you call, for example now, during the whole December…it´s been sixteen people before me on the telephone queue every time I´ve called. It´s been very disturbing…’	It is an advantage to be able to book online when it is a long queue on the telephone line.	Advantage with online booking as a complement to ordinary telephone booking	Online booking as a complement	Potential advantages with e-health versus ordinary health care
‘But maybe after a couple of months I need to get in contact with her (the GP), and the process gets bigger and longer, and I need to come down here and make an appointment…instead I could get in contact by phone, or maybe sending a photo with my phone…But usually I think it is nicer to have the physical contact.’	It is nicer to have physical visits but digital contact in between visits would get me more rapidly in contact with my GP.	Need for digital consultations	Need for digital consultations in certain situations	Need for speed, access and correct comprehensive information

Table 2. Patients’ characteristics.

Primary Health Care Center	Age	Sex	Education
PHCC no 1	73	female	Secondary school^a
	78	female	Secondary school^a
	67	male	High school^b
	80	female	Secondary school^a
	70	male	Secondary school^a
	77	male	High school^b
PHCC no 2	75	female	High school^b
	76	male	Secondary school^a
	72	male	Secondary school^a
	75	female	University
	68	female	Secondary school^a
	73	female	Secondary school^a
PHCC no 3	80	male	University
	65	male	High school^b
	66	female	Secondary school^a

^aHas completed 9 years of education.

^bHas completed 12 years of education.

Table 3. Categories and subcategories.

Category	Subcategories
E-health – a solution for a non-existing problem?	Do not fix what is not broken Problems today that e-health might solve Importance of accessibility to physician regardless of contact way
Elderly’s experiences of e-health	Positive experience and knowledge about digital tools Lack of experiences and knowledge Unmet expectations of e-health Dislike of text messages for health monitoring and life style advices
Lack of will, skills, self-trust or mistrust in the new technology	Mistrust in knowledge and know how about technology in elderly Too high knowledge demands on elderly Insecurity and fear with technology in today’s system The ageing body as a barrier Lack of interest for digital tools and aversion to technology
Organizational barriers	Lack of IT competence in health care organizations Who is responsible when IT systems fail? Poor communication between health care organizations' IT systems Disappointment over poor IT systems Mistrust in e-health from health care organizations
Wanting and needing to move forward	Cannot stop development Curiosity and interest for digital tools and technical solutions Need for help and information concerning e-health To learn on older days
Concerns to be addressed for making e-health a good solution	Lack of triage with online booking Accessibility, costs, and other risks with e-health Lack of time for physicians despite e-health Insecurity with e-health in emergency situations
Potential advantages with e-health versus ordinary health care	Better access with video consultations Practical and safe with a comprehensive drug list in the mobile E-health a future way to reduce bureaucracy, demands and time Online booking as a complement Advantages of digital tools for some
Need for speed, access and correct comprehensive information	Expectations of higher accessibility with e-health Need for fast e-health accessibility in emergency situations Importance of trustworthy information online Expectations of lab results online Need for comprehensive drug list Need for digital consultation in certain situations