Digital health in Portugal: Exploring perceptions, barriers, and experiences through a focus group study

Digital health in Portugal: Exploring perceptions, barriers, and experiences through a focus group study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Digital health in Portugal: Exploring perceptions, barriers, and experiences through a focus group study Marta Estrela, Catarina Leitão, Pedro Lopes Ferreira, Fátima Roque, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5772983/v2 This work is licensed under a CC BY 4.0 License Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Abstract Purpose Digital health (DH) has undergone rapid expansion in recent years, driven by new innovations aimed at improving healthcare quality, service efficiency, and patient empowerment. However, DH adoption and usage remains inconsistent, shaped by disparities in individual and contextual factors. This study explores key perceptions, barriers, and experiences with DH in Portugal to identify systemic challenges and opportunities for equitable integration. Methods A qualitative research design was employed, utilizing focus groups discussions. Participants were recruited via institutional e-mail campaigns and social media outreach. Five focus group sessions were conducted, with six to eight participants each, via Zoom videoconference. Sessions were recorded, transcribed verbatim, and inductive thematic analysis to identify emergent patterns. Results Thirty-four participants engaged across five focus groups, with data saturation achieved by the fifth session. Thematic analysis revealed seven core themes: 1) DH concepts; 2) experiences with DH; 3) health information; 4) advantages of DH; 5) concerns towards DH; 6) barriers to DH access and use; 7) solutions to improve the DH framework. Conclusion Despite the digital health framework improvement throughout the years, a lot needs to be done to make digital health truly accessible to everyone in Portugal, as significant gaps persist in accessibility, equity, and user-centric design. Concerns regarding equitable access, digital health literacy, infrastructure, patient-healthcare professional relationship and AI are some of the many dimensions that must be considered when working towards digital transformation in healthcare. Future policies must balance technological innovation with equitable access to ensure all population segments take advantage of digital health. Digital health Perceptions Experiences Barriers Solutions Portugal Focus Groups Full Text Additional Declarations The authors declare no competing interests. Supplementary Files SupplementaryMaterial.docx Cite Share Download PDF Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5772983","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":400617630,"identity":"e2090b8d-af59-46a2-95f7-cefe0b9c5481","order_by":0,"name":"Marta Estrela","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAsklEQVRIiWNgGAWjYPACCwZ+UpQzNjAwSDBINoDYCaRoMThArBbd9vbnjysqJOSNbyQ/YC78QYQWszNnDBvPnJEw3HYjzYB5BjG2mN3IYWxsbJNg3HYjwYCZhygt958/bGz8J2G/eUb6ByK13GAwbGxskEjcIJFDrC1ncgxnNhyTSJ5x5k3B4RlpxGg5fvzBx4YaG9v+9vSNjwtsiNCCAg6TqoGBgZl0LaNgFIyCUTASAADxVTgrrDCW9gAAAABJRU5ErkJggg==","orcid":"","institution":"University of Aveiro","correspondingAuthor":true,"prefix":"","firstName":"Marta","middleName":"","lastName":"Estrela","suffix":""},{"id":400617631,"identity":"f46363c6-f3ee-42cb-a45e-c113cc2bfae0","order_by":1,"name":"Catarina Leitão","email":"","orcid":"","institution":"University of Aveiro","correspondingAuthor":false,"prefix":"","firstName":"Catarina","middleName":"","lastName":"Leitão","suffix":""},{"id":400617632,"identity":"6ab29522-97ee-4c8a-a336-564264183ea3","order_by":2,"name":"Pedro Lopes Ferreira","email":"","orcid":"","institution":"University of Coimbra","correspondingAuthor":false,"prefix":"","firstName":"Pedro","middleName":"Lopes","lastName":"Ferreira","suffix":""},{"id":400617633,"identity":"140dbea6-9194-4c8d-ae63-e0eaacf915aa","order_by":3,"name":"Fátima Roque","email":"","orcid":"","institution":"University of Beira Interior (CICS-UBI)","correspondingAuthor":false,"prefix":"","firstName":"Fátima","middleName":"","lastName":"Roque","suffix":""},{"id":400617634,"identity":"3ff97601-681d-4e78-852d-775ce39f58b6","order_by":4,"name":"Maria Teresa Herdeiro","email":"","orcid":"","institution":"University of Aveiro","correspondingAuthor":false,"prefix":"","firstName":"Maria","middleName":"Teresa","lastName":"Herdeiro","suffix":""}],"badges":[],"createdAt":"2025-01-06 10:40:28","currentVersionCode":2,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-5772983/v2","doiUrl":"https://doi.org/10.21203/rs.3.rs-5772983/v2","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":84096596,"identity":"5112fa5c-8f42-4989-a9e5-5102924da33a","added_by":"auto","created_at":"2025-06-06 17:44:19","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":16897,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryMaterial.docx","url":"https://assets-eu.researchsquare.com/files/rs-5772983/v2/6a5b4a13aebfbd58f8f9a48a.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"Digital health in Portugal: Exploring perceptions, barriers, and experiences through a focus group study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Digital health, Perceptions, Experiences, Barriers, Solutions, Portugal, Focus Groups","lastPublishedDoi":"10.21203/rs.3.rs-5772983/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5772983/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDigital health (DH) has undergone rapid expansion in recent years, driven by new innovations aimed at improving healthcare quality, service efficiency, and patient empowerment. However, DH adoption and usage remains inconsistent, shaped by disparities in individual and contextual factors. This study explores key perceptions, barriers, and experiences with DH in Portugal to identify systemic challenges and opportunities for equitable integration.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA qualitative research design was employed, utilizing focus groups discussions. Participants were recruited via institutional e-mail campaigns and social media outreach. Five focus group sessions were conducted, with six to eight participants each, via Zoom videoconference. Sessions were recorded, transcribed verbatim, and inductive thematic analysis to identify emergent patterns.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThirty-four participants engaged across five focus groups, with data saturation achieved by the fifth session. Thematic analysis revealed seven core themes: 1) DH concepts; 2) experiences with DH; 3) health information; 4) advantages of DH; 5) concerns towards DH; 6) barriers to DH access and use; 7) solutions to improve the DH framework.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDespite the digital health framework improvement throughout the years, a lot needs to be done to make digital health truly accessible to everyone in Portugal, as significant gaps persist in accessibility, equity, and user-centric design. Concerns regarding equitable access, digital health literacy, infrastructure, patient-healthcare professional relationship and AI are some of the many dimensions that must be considered when working towards digital transformation in healthcare. Future policies must balance technological innovation with equitable access to ensure all population segments take advantage of digital health.\u003c/p\u003e","manuscriptTitle":"Digital health in Portugal: Exploring perceptions, barriers, and experiences through a focus group study","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2025-06-06 17:36:14","doi":"10.21203/rs.3.rs-5772983/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2025-01-10 17:58:23","doi":"10.21203/rs.3.rs-5772983/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"02a86ca6-dc32-46f4-a0f6-ae0d469dba02","owner":[],"postedDate":"June 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-01-13T04:38:08+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-06 17:36:14","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v2","identity":"rs-5772983","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5772983","identity":"rs-5772983","version":["v2"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}