Since patients have a right to informed medical decision-making [1], and providing tailored information is an essential part of health care [2], physicians are required to meet their patients’ needs for adequate, high-quality information [3]. However, physicians often lack the time to provide their patients with detailed information during the consultation [4,5]. Further, an increasing amount of false or misleading information, particularly prevalent during the COVID-19 pandemic [6], poses a challenge in providing accurate health care. These barriers emphasize the need to rethink physician-patient communication in general and consider new ways of providing high-quality health information to patients.

The digital age, characterized by advances in information and communication technology [7,8], offers new opportunities for information provision that could help to supplement the traditional relationship between health professionals and their patients [9]. For example, face-to-face physician-patient communication could be extended to the digital provision of health information, enabling physicians to meet their patients’ needs for high-quality information regardless of time and place. Such a digital health information service (DHIS) is also in line with global objectives of strengthening health care and improving patient education through the implementation of digital health technologies [10,11]. It can be understood as a web-based platform through which physicians can provide their patients with information tailored to their individual disease or health situation (eg, on symptoms, medical examinations, treatment options, prevention, and early detection measures) in addition to the explanations given during the consultation. Thus, patients receive tailored, high-quality information from their most trusted source of health information [12,13] that can be accessed via a computer or mobile phone, enabling them to autonomously build an adequate knowledge base for informed decision-making.

A basic requirement for realizing the potential of a DHIS in overcoming barriers to information provision and complementing routine health care is physicians’ acceptance of such a service [14,15]. Existing studies on digital health interventions revealed mixed results regarding physicians’ willingness to engage with digital services. On the one hand, physicians in Germany perceived great opportunities from health apps with regard to prevention, reminder, and lifestyle support features [16] and showed high use of internet-related technologies for patient support [17]. On the other hand, prior studies showed a moderate acceptance of mobile apps for disease management [18] and a rather low acceptance of eHealth interventions in inpatient routine care [19].

Based on the heterogeneous state of research, this study aimed to examine physicians’ intentions to provide a DHIS to their patients as well as identify facilitating factors and barriers. The study was guided by the extended unified theory of acceptance and use of technology (UTAUT2) [20], which is a widely accepted theory for understanding physicians’ adoption of digital health interventions [21,22] and informing eHealth implementation [23].

To identify facilitating factors and barriers of physicians’ intentions to provide a tailored DHIS in line with hypotheses 1 to 7, we conducted a blockwise multiple linear regression analysis. The first block considered the control variables age, gender, and DHIS experience. In the second block, the theoretically derived factors were included.

The study received ethical approval from the Central Ethics Committee at Leibniz University Hannover (review number: EV LUH 19/2021). All participants were informed about the content of the survey prior to their participation and provided informed consent. No personally identifiable information was collected. Participants recruited through the commercial online access panel received financial compensation from the market research company in accordance with its standard remuneration rates. There were no further compensations. All methods were performed in accordance with the Declaration of Helsinki. The study was reported in accordance with the American Psychological Association Journal Article Reporting Standards for quantitative research.

The current study examined physicians’ intentions to provide a tailored DHIS for their patients. Our findings revealed that the physicians surveyed showed moderate intentions, with the majority (n=197, 54.1%) being rather willing to provide such a service. Guided by the theoretical framework of the UTAUT2, we identified factors that are associated with their intentions. Perceived usefulness for job performance, perceived usefulness for patients, and personal innovativeness were positively associated with their intentions to provide a DHIS, while perceived ease of use, social influence, facilitating conditions, price value, and habit were not significantly associated with their intentions.

The analysis revealed that the tested model, based on the UTAUT2, accounted for 56.8% of the variance. Nevertheless, the effectiveness of this framework in explaining physicians’ intentions to provide a DHIS is questionable, as only 3 out of the 9 integrated factors contributed significantly to variance explanation. Physicians’ perceived usefulness for job performance and perceived usefulness for patients were most strongly associated with their intentions to provide a DHIS, which is in line with prior research on health professionals’ intentions to use health-related technology in general [18,19,28].

Furthermore, the inclusion of personal innovativeness within the UTAUT2 framework demonstrated a positive association with physicians’ intentions to provide a DHIS. This finding strengthens the suggestion to integrate the personal innovativeness construct into models explaining physicians’ intentions to engage with digital services. Such an implication is also supported in prior studies on both patients’ [33,34] and physicians’ [37] acceptance of digital health technologies. As an interim conclusion, it can therefore be stated that performance expectancy, separated for job performance and patient outcomes, and personal innovativeness could serve as basic factors for a robust model.

The majority of theoretically derived factors were not associated with physicians’ intentions to provide a tailored DHIS. First, perceived ease of use did not prove to be relevant, indicating that in the specific context of a tailored DHIS, its implementation might be worth any effort, as digital health information is a “common good” [10] that should be accessible to everyone [11]. In this regard, Zhai et al [39] point out that physicians usually have a high workload and therefore might not mind spending more time on familiarization with a new service that could diminish their workload. In addition, the fact that perceived ease of use is not a key determinant of physicians’ intentions could be related to the sample of the online access panel, which may be more digitally savvy and therefore perceive fewer difficulties in the context of handling DHIS. The potential value of integrating perceived ease of use into a model for explaining physicians’ intentions to provide a DHIS should thus be explored with a less digitally savvy sample.

Second, social influence—the perception that patients or colleagues think one should provide a DHIS—was irrelevant to the physicians’ intentions. However, the mean scores of these variables were mediocre, indicating that norms regarding the provision of a DHIS might not be established and thus be less influential. Indeed, digital health services are not yet widely used in Germany [43]. In this regard, our study found that only 15.4% (n=56) of respondents had already provided a comparable service to their patients. The inclusion of social influence as a potential determinant of physicians’ intention to provide a DHIS could therefore be fruitful at a later stage, when the relevant norms are more established in Germany.

In addition, facilitating conditions were not related to physicians’ intentions to provide a DHIS. This finding suggests that having the necessary infrastructure such as technical resources and support might not be relevant until the actual implementation of such a service, which is in line with the first version of the UTAUT framework [24]. Moreover, physicians may already have a good infrastructure in this respect. For example, a DHIS only requires computer and internet access, which is available in the majority of German practices and hospitals. In addition, the presumably digitally savvy participants of an online access panel may also have the technical know-how to use a DHIS. Therefore, it may be worthwhile to investigate the significance of facilitating conditions within a less digitally savvy sample, while also considering the digital infrastructure of the respective medical facilities.

Furthermore, price value, as measured in this study, was not related to physicians’ intentions to provide a DHIS. The item used reflected physicians’ preference for the service to be free of charge, rather than the traditional UTAUT2 definition of price value, which captures the trade-off between perceived benefits and costs. While many physicians indicated that the service should be free of charge, this does not allow us to conclude the influence of actual costs on their intention to provide a DHIS. Previous studies often did not include price value when examining usage intentions of health-related technologies, as it may be less relevant in professional health care contexts [27,31,33,38]. This highlights the need for context-specific adaptations when specifying models to explain physicians’ intentions to use digital health technologies.

Habit was also not related to physicians’ intentions to provide a DHIS. Thus, familiarity with digital technologies in general is not relevant in the context of a DHIS. This result could be attributed to our measurement. As DHIS are not yet widely used in Germany [43], we asked about physicians’ habits regarding digital technologies in general and not about the perceived routine of using a DHIS in particular. Thus, integrating habit in handling a DHIS as a determinant of physicians’ intentions to provide such a service appears less meaningful until DHIS are more established in Germany.

Our study is not without limitations. First, as we conducted a cross-sectional survey, it is not possible to draw causal conclusions. Second, our study is not representative of all physicians in Germany. Since we focused on physicians working in practices and did not stratify by their expertise, physicians in hospitals and other medical institutions as well as certain specialties are underrepresented in this study. Hence, a potential bias may exist, given that a DHIS may be considered more beneficial for certain disciplines. In addition, the majority of the surveyed physicians were participants in an online access panel and are possibly more digitally savvy, which does not necessarily reflect the perspective of most physicians in Germany.

Third, the physicians assessed their intentions to provide a DHIS solely based on a textual description of its features, which introduced the service in general terms and presented it as easy to use. They did not have the opportunity to try it out with their patients, and item-level responses may reflect assumptions based on the vignette rather than experience with a system. As a result, intentions reported in this study may not fully correspond to the actual provision of a DHIS. Although this approach is common in survey-based technology acceptance research, it may limit the validity of our findings. Future research should test a DHIS in practice, focusing on specific specialties to improve the quality of usage prediction by evaluating the actual use in a particular context (eg, cardiology) rather than intentions in general. Experimental or longitudinal designs could be used to allow for causal inferences and to explore the effectiveness of such a service on patient outcomes and physicians’ job performance.

A fourth limitation concerns the theoretical framework applied in this study. Although UTAUT2 has been widely used in health care research, it is a consumer-oriented acceptance model that may not fully capture the professional and organizational context of physicians as users of digital health technologies. We partly addressed this limitation by adapting the model to the study context, for example, by excluding hedonic motivation. Nevertheless, future research should consider extending acceptance models to more explicitly reflect physicians’ professional roles and decision-making contexts. Although hedonic motivation was excluded based on theoretical and contextual considerations, future studies could empirically examine its relevance in professional health care settings to determine whether enjoyment contributes to physicians’ acceptance of DHIS.

There are several practical implications that can be derived from our findings. First, when promoting a DHIS to physicians, the personal value for improving their daily work life, patient communication, and patient outcomes should be addressed. In detail, it should be explained that a DHIS can save time during the medical consultation and has great potential to support patients’ decision-making by providing important, tailored health information. Second, physicians with a positive attitude toward digital innovation may support dissemination by sharing experiences and demonstrating use cases at medical congresses or other professional events, thereby increasing awareness of DHIS options. In addition, a digital information service and its potential could be presented in national medical journals, which could contribute to the establishment of social norms. Another sustainable approach to promote the provision of digital health information is the implementation of eHealth in professional education. At last, in the sense of empowerment and patient-centered care, patients could be encouraged to claim their right to be adequately informed and to directly ask their physicians for digital health information. Furthermore, the effects of providing a tailored DHIS on patient outcomes need to be examined in more detail to provide comprehensive evidence.

In conclusion, the perspective of the majority of surveyed physicians suggests that a tailored DHIS seems to be a promising way to provide additional health information and thus enhance face-to-face physician-patient communication. The key determinants of physicians’ intentions to provide such a service—perceived usefulness for improving job performance and patient outcomes as well as physicians’ personal innovativeness—underscore the importance of addressing these aspects when supporting its implementation. Future research should aim to identify additional determinants to further advance the development of a more comprehensive model and focus efforts to establish DHIS in Germany.