In the last decades, the use of Information and Communication Technologies (ICTs) has progressively spread to society and public administration. Health is one of the areas in which the use of ICTs has more intensively developed through what is now known as eHealth. That area has recently included mHealth. Spanish health system has stood out as one of the benchmarks of this technological revolution. The development of ICTs applied to health, especially since the outbreak of the pandemic caused by SARS Cov-2, has increased the range of health services delivered through smartphones and the development of subsequent specialized apps. Based on the data of a Survey on Use and Attitudes regarding eHealth in Spain, the aim of this research was to conduct a comparative analysis of the different eHealth and mHealth user profiles. The results show that the user profile of eHealth an mHealth services in Spain is not in a majority. Weaknesses are detected both in the knowledge and use of eHealth services among the general population and in the usability or development of their mobile version. Smartphones can be a democratizing vector, as for now, access to eHealth services is only available to wealthy people, widening inequality.

Background: In recent years, the healthcare sector has experienced accelerated progress in terms of the inclusion of Information and Communication Technologies (ICTs) in its procedures and formalities. However, public administrations have been unable to adapt to the peculiarities of the most vulnerable groups. This leads to marginalization of at-risk groups within the healthcare system and contributes to the widening of the so-called digital divide. Methods: Based on the analysis of the literature, three dimensions have been constructed to identify the level of inclusion of web portals: the perception of quality, the perception of usability, and the importance attributed to their content. In order to obtain data on each of these dimensions, a study was designed based on the user test methodology as a central element (identifying and evaluating 11 vulnerable groups) and, in parallel, a survey of the general population and heuristic tests. Results: A high percentage of vulnerable people at risk of social exclusion are not receiving adequate healthcare due to the digitalization of the system and the implementation of scarcely inclusive health web portals, which pose significant barriers in service provision for the 11 selected collectives. Meanwhile, the general population is being introduced to eHealth benefits, although the latter did not have high levels of digitization or a broad portfolio of services. Conclusions: The general population has a relatively positive perspective of eHealth services, but only a minority of them make intensive use of them, and they are not widespread in Spain as a whole. Meanwhile, the population at risk of exclusion lacks the skills and resources to make real use of eHealth, needing “digital intermediaries” from the social sphere to achieve results. eHealth policies are not taking into account people with higher levels of marginalization, aggravating their exclusion and the digital divide.

Introducción: La extensión de herramientas de Inteligencia Artificial (IA), impulsada en gran medida por modelos generativos, está marcando un punto de inflexión social, suscitando diversas actitudes entre la población. Metodología: El objetivo principal es explorar como el conocimiento sobre IA se vincula con las actitudes hacia esta, observando su relación con variables como edad, nivel de estudios o nivel de conocimiento. Se emplea el Estudio 3495 del Centro de Investigaciones Sociológicas sobre IA, analizando descriptivamente la situación actual, continuando con un contraste de medias, concluyendo con un Análisis de Correspondencias Múltiples sobre los perfiles actitudinales. Resultados: Se refleja una división emocional, predominando la incertidumbre, además de identificar sentimientos optimistas con un mayor conocimiento en IA, alta formación y en personas jóvenes. En cambio, el miedo predomina entre mayores de 65 años y con estudios básicos. Discusión: Los factores sociodemográficos enfatizados por la literatura al afrontar la IA, como la edad o el nivel educativo se muestran claves, mientras el conocimiento y familiarización con estas tecnologías, y sobre todo la legitimidad precisan de mayor investigación. Conclusiones: La percepción ante la IA refleja factores de desigualdad social, subrayando la presencia continuada de brechas preexistentes y la necesidad de una alfabetización digital equitativa.

Resumen Ofrecer un análisis pormenorizado de la evolución e implantación de las Tecnologías de la Información y la Comunicación (TIC) en el ámbito sanitario -eSalud- en España, atendiendo a los principales servicios implementados, su situación actual y sus perspectivas de futuro, así como a su posible impacto en el sistema sanitario y particularmente en sus usuarios. Se ha revisado la literatura científica sobre eSalud para identificar los servicios implementados más extendidos y sus características. En función de esa información se ha diseñado y administrado una encuesta a nivel estatal a usuarios del sistema nacional de salud de España (SNS) para conocer su percepción sobre los servicios recibidos y los obstáculos existentes para su pleno desarrollo. Los resultados fueron contrastados con otras fuentes secundarias. Existen servicios plenamente implementados y con un elevado nivel de uso; otros todavía permanecen en una fase más inicial. Se confirma una asimetría en los servicios ofertados por las administraciones de salud de las Comunidades Autónomas. Se confirma que el sistema sanitario español ha experimentado un importante avance tecnológico, orientando la eSalud hacia la oferta de servicios centrados en la equidad, la calidad y la eficiencia, aunque todavía subsisten obstáculos a superar.

To find out the opinions of users and primary care doctors on the progress of e-health in primary care. Focus groups set up between 1st May and 25th September 2018. Primary care level in regional online health services. A total of 29 users and 33 primary care doctors linked to primary care that were contacted, through user associations and regional public health services, respectively. Inductive analysis of transcripts from focus groups about the following issues: accessibility and security; efficiency; information and technical problems; potentialities. Online health services are positively valued in terms of cost savings both by users and doctors of primary care. Nevertheless, face-to-face interaction is still considered a key factor in the quality of service. When it comes to the access and provision of e-health services, there is shared concern for the security of the data and for the training deficiencies of users and doctors. An adequate design of the applications becomes a condition for the acceptance and diffusion of technologies that support online health. Health authorities should intensify the use of new technologies oriented towards easing the work of doctors, simplifying bureaucratic tasks, providing diagnostic and prescription security, and protecting data. As long as systems generate failures and mistrust, new technologies will remain to be perceived as a complement, but not as an alternative to the traditional care model.

Background: The accelerated development of information and communication technologies has made health care one of the pioneering fields in the incorporation of these tools. As new technologies have been applied, existing technologies have been sophisticated and improved and the concept of eHealth has expanded. However, these advances and expansion of eHealth do not seem to have served to adapt the supply of services to users’ demands; rather, supply seems to be governed by other variables. Objective: The main objective of this work was to review the existing differences between user demands and the supply of eHealth services in Spain and their causes. The aim is to provide information on the level of use of the services and the causes of the variation in demand for these services, which can be useful in correcting existing differences and adapting them to the needs of users. Methods: A survey, “Use and Attitudes Toward eHealth in Spain,” was applied by telephone to a sample of 1695 people aged 18 years and over, taking into account sociodemographic profile characteristics (sex, age, habitat, educational level). The confidence level was set at 95% and the margin of error was ±2.45 for the whole sample. Results: The survey results showed that the online doctor’s appointment service is the most frequently used eHealth service by users: 72.48% of respondents used this service at some point and 21.28% stated that they use it regularly. The other services showed significantly lower percentages of use, including “managing health cards” (28.04%), “consulting medical history” (20.37%), “managing test results” (20.22%), “communicating with health professionals” (17.80%), and “requesting a change of doctor” (13.76%). Despite this low usage, a large majority of respondents (80.00%) attach great importance to all the services offered. Overall, 16.52% of the users surveyed were willing to make new service requests to the regional websites, with 9.33% of them highlighting services such as “the availability of a complaints and claims mailbox,” “the possibility of consulting medical records,” and “the availability of more detailed information on medical centers (location, medical directory, waiting lists, etc).” Other outstanding requests (8.00%) were to simplify the procedures for using certain existing services. Conclusions: The data from the survey show that eHealth services are widely known and highly valued by users, but not all services are used with the same frequency or intensity. It appears that users find it difficult to suggest new services that might be useful to them in terms of demand for new services that do not currently exist. It would be useful to use qualitative studies to gain a deeper understanding of currently unmet needs and the possibilities of eHealth. The lack of access to and use of these services and the unmet needs particularly affect more vulnerable populations who have the greatest difficulty in meeting their needs through alternative means to eHealth.