Awareness, Attitude, and Usage of Digital Health among Medical Students – A Malaysian Perspective

INTRODUCTION

Worldwide, digital technology is revolutionising various aspects of daily life, including the healthcare sector. Digital health or telehealth refers to the delivery of healthcare facilities remotely by electronic means to individuals or communities to improve the clinical outcomes of patients in rural areas, as well as the elderly who are unable to make it to the hospital.¹ The primary objective of digital health is to maximise the effectiveness of healthcare delivery to the patients and the general population.² Further, the wide accessibility of the Internet allows for the dissemination of health-related information to the general population and promotes well-being.³ Healthcare data analysis allows for prudent utilisation of drugs, equipment, and doctor mobilisation, facilitating resource allocation and operational efficiency. In addition, e-Health provides patient data for analysis, which is valuable information to plan for precise diagnosis and patient-centred care.⁴

In Malaysia, telemedicine gained prominence during the COVID-19 pandemic, which restricted physical contact and travel. Telemedicine services provided convenient video consultations and e-prescriptions, allowing patients to have control over their health and wellbeing.⁵ Similar reports on the popularity of telemedicine during the pandemic have emerged from different countries.^6-8

Medical students play a prominent role in the future of healthcare, making their awareness, attitudes, and usage of digital health vital indicators of its potential integration into clinical practice. Understanding how medical students perceive and engage with these technologies can provide valuable insights into the readiness of the next generation to harness the benefits of digital health for improved patient outcomes.⁹ Recent studies highlight that many medical graduates leave medical schools without being adequately prepared to utilise digital health effectively.^1,10 Hence, this study was conducted to assess the knowledge, attitude, and possible challenges to the usage of digital health among medical students in a private university in Malaysia.

MATERIAL AND METHODS

RESULTS

The demographic characteristics of the respondents are depicted in Table 1. It reveals that most of them are female (59.4%) from urban areas (60.6%), and the majority, 115 (63.9%), were aged between 22 and 25 years. With regards to ethnicity, 34.4% of the respondents were Indians, 28.9% Malay, 21.1% Chinese, and 15.6% others. The respondents included students pursuing Bachelor of Medical Sciences (36.7%), MBBS (36.1%), Diploma in Medical Sciences (15.6%), and Foundation in Medical Sciences (11.7%). The majority of the study population had a family income between 2500 to 7000RM.

Regarding the responses related to awareness about digital health, it was observed that the majority of the respondents considered themselves to have a medium level of knowledge (47.2 %), and 40% considered themselves to have a high knowledge about digital health, while only 12.8% considered themselves to have a low knowledge about digital health. The most frequently used device to search for health-related information was the laptop (52.2%), followed by the cell phone (26.1%) and the tablet (21.7%). To access health-related information, the majority of the respondents preferred websites (64.4%), followed by applications (21.7%) and social media (13.9). Many respondents relied on the Medline Plus website for health-related information (41.1%), followed by the WHO website (39.5%) and the National Institute of Health website (19.4%). 47.2% of the respondents used digital health weekly, while 40.6% used it daily [Table 2].

The majority of the respondents were affirmative that the healthcare information obtained through the websites or other digital platforms is reliable (80%) and believed that digital health is applicable to today’s healthcare needs (86.7%). They were comfortable in using online or application-based information to make personal decisions (66.7%). About 70.6% of the participants in this research acknowledged that they were using digital health, and 91.1% were prepared to take advantage of the technological developments within the medical field. A notable number of medical students (90%) believed that digital health usage would be able to make a significant impact on the well-being of individuals, and 88.3% of them would recommend the usage of digital health to others. Hence, generally, the results shown in Table 3 signify a positive attitude toward digital health.

On considering the challenges faced when using digital health, the results, as depicted in Table 4, reveal that the study respondents disagree that they are financially stable to afford digital health services, with 75% of the respondents finding it expensive. Only 7.8% agree that they are financially stable. Further, 67.2 % feel that digital health is not easily accessible to them. However, only 25.6% think that digital health access can be limited in rural areas. 69.4% believe that privacy, protection, and ethical consent are not a major concern when dealing with digital health usage. Regarding the skills needed to practice digital health, 70% of the students did not find this an obstacle. Collectively, these findings show that the respondents do not face any significant challenges except for the affordability and accessibility of digital health.

DISCUSSION

Digitalisation has permeated all fields of life, including healthcare, with digital innovations such as electronic health records, telemedicine, AI-driven diagnostics, and mobile health applications.¹⁴ Medical students are increasingly expected to utilise and manage these technologies in clinical practice, highlighting the need to assess their awareness and attitude toward digital health. In addition, this study examines the challenges shaping the medical students’ perception of digital health, with the ultimate objective of providing recommendations for enhancing digital health literacy among future doctors.

Results of the current study showed that the majority of the medical students have a moderate level of acquaintance with digital health, with more than 50% of the respondents being confident with their level of expertise. This indicates that medical students comprehend digital health concepts and their applications. Nevertheless, a sizeable percentage of respondents reported a poor degree of knowledge, indicating a requirement for additional education and training in this field. Websites were chosen by the majority of respondents, ahead of mobile applications or social media platforms, as the preferred digital media for seeking information relevant to health. This preference for websites underscores the significance of reputable and user-friendly health-related websites that are geared towards catering to the unique requirements of medical students. These findings are consistent with previous studies that have demonstrated an increasing level of digital health literacy among healthcare professionals.¹⁵ The favourable attitude of respondents toward digital health reflects an awareness of its potential benefits in enhancing healthcare delivery. Furthermore, the results of this study reveal that medical students are comfortable using information sourced from the Internet or mobile applications to inform personal health-related decisions. It reflects their desire to embrace digital health tools not only in managing their but also supporting the healthcare needs of others.

An overwhelming majority of the respondents (90%) endorsed the view that utilisation of digital health can have a significant impact on individual wellness. This exemplifies the widely shared belief in the potential of digital health technologies to improve overall quality of life. This positive disposition is consistent with previous studies, which highlight the potential of digital health innovation to advance healthcare delivery and improve patient outcomes.¹⁶

A sizeable proportion of medical students reported difficulty in applying the requisite skills to effectively use specific digital health platforms. When viewed from the demographic perspective, the majority of the study population reported a family income between 2500 and 7000 RM, which signifies low-to-middle income groups in Malaysia.¹⁷ This socioeconomic context may partially explain the substantial proportion of respondents (49.4%) who disagreed and (17.8%) strongly disagreed with the statement that digital health is easily accessible. This finding resonates with the findings of previous studies that identified some barriers and challenges associated with digital health adoption, such as cost, interoperability, data security, and insufficient training.^18,19 It draws attention to the need for financial assistance to a segment of medical students to improve their digital health competency.

The survey findings suggest that medical students perceive digital health to be a valuable tool for enhancing healthcare delivery and community well-being. This presents an opportunity for healthcare professionals and policymakers to leverage digital health solutions to improve the quality of patient care and the overall health of populations.²⁰ Furthermore, the study findings reveal the respondents’ affirmative attitudes regarding reliability, applicability, and personal comfort in utilising digital platforms for healthcare information and decision-making. It mirrors the findings from previous studies, emphasising the growing trust in digital health sources, especially among younger and more technologically literate populations.^21,22

In this study, 86.7% of participants agreed that digital health is aligned with modern healthcare needs, echoing the findings from literature that emphasise the increasing integration of digital health solutions into national healthcare frameworks and medical curricula.²³ Consistent with previous studies, respondents in this study demonstrated their willingness to adopt digital health, particularly when aptly supported by institutional infrastructure and targeted training.²⁴ Notably, 66.7% of participants reported feeling comfortable using online information for personal decisions, with a substantial majority already making use of digital health (70.6%). These findings are consistent with global trends of growing engagement with digital health tools among university students.²⁵ Moreover, the respondents also appreciated the role of digital health in improving individual well-being and exhibited willingness to recommend its use, which aligns with previous literature.²⁶ The positive perceptions found in this study may be attributed to recent efforts in Malaysia and across the Asia-Pacific region to prioritise e-health training and awareness programs, as stressed in recent reviews.²⁷

This study has some limitations despite the fact that it gives useful insights into the attitudes, usage patterns, and challenges faced by medical students about digital health. In the first place, the survey was conducted at a single private university, limiting the generalisability of the results. Second, the study relied on self-reported data, which makes it vulnerable to response biases. Further, the small sample size limited the scope of demographic subgroup analysis. Future research should consider a larger, more diverse population of students drawn from different medical schools across Malaysia to enable broader and more reliable conclusions.

CONCLUSION

The results of this study posit a favourable attitude towards digital health among medical students of a private university in Malaysia. They recognise the potential of digital health in improving both the delivery of healthcare and individual well-being. The findings highlight the relevance of integrating digital health education and resources into the medical curriculum, despite the fact that there are hurdles to overcome, such as financial considerations and accessibility. No matter what their demographic makeup may be, medical students should have the same opportunities to receive training and access to digital health technologies. Efforts in this direction should be prioritised to equip the students to use the benefits of digital health in their future practices.