Digital Patient Navigation Systems and Treatment Acceptance: A Mixed-Methods Study of Patient Coordination in Modern Healthcare Clinics

Abstract

Abstract: Background and Objectives: Digital patient navigation systems have transformed healthcare delivery through electronic coordination of patient care pathways. These systems facilitate appointment scheduling, treatment reminders, and communication between patients and healthcare providers. This study sought to examine the relationship between digital navigation system usage and treatment acceptance rates among patients attending outpatient clinics in London. Given the cross-sectional design, causality cannot be inferred.

Material and Methods: A convergent mixed-methods design was employed across four National Health Service outpatient clinics between March and November 2024. The platform under investigation was CarePath Navigator (NHS Digital/Cerner), a cloud-based system integrated with electronic health records. The quantitative component involved 412 patients who completed structured questionnaires measuring system usage patterns, perceived ease of use, and treatment acceptance intentions. Treatment acceptance was operationalised using the nine-item Treatment Acceptance Scale (TAS-9), a validated instrument measuring behavioural intention, confidence, and self-reported adherence (Cronbach's α = .912). The qualitative component comprised 28 semi-structured interviews with patients and 12 interviews with healthcare staff, analysed in NVivo 14 using thematic analysis with independent dual coding (Cohen's κ = .893). Data were analysed using SPSS version 27 for quantitative analysis and Braun and Clarke's six-phase approach for qualitative data. Mixed-methods integration was achieved through a joint display table.

Results: Quantitative findings demonstrated a positive correlation between digital navigation system usage and treatment acceptance (r = 0.64, p < 0.001). However, this association is observational and may reflect self-selection by motivated patients. Patients who used the system regularly showed higher acceptance rates (78.3%) compared to infrequent users (52.1%; F(3, 408) = 48.72, p < .001, ηÇ = .264). Multiple regression indicated that system usage frequency (β = 0.312, p < .001), perceived usefulness (β = 0.298, p < .001), and digital literacy (β = 0.198, p < .001) collectively explained 47.2% of variance in treatment acceptance, with no multicollinearity (all VIF < 2.0). Qualitative analysis identified three primary themes with nine sub-themes: enhanced patient autonomy (control over scheduling, access to information, informed decision-making), reduced administrative burden (efficient booking, automated reminders, staff workload reduction), and improved care continuity (secure messaging, perceived support, reduced unnecessary visits). Staff interviews highlighted the importance of system integration with existing electronic health records. Joint display analysis revealed convergence across all major themes, with divergence identified regarding staff training deficits.

Conclusions: Digital patient navigation systems are positively associated with treatment acceptance through improved care coordination and patient empowerment. However, the cross-sectional design precludes causal conclusions. Healthcare organisations should invest in user-friendly navigation platforms that integrate with clinical workflows, whilst acknowledging that selection bias may inflate observed associations. Training programmes for both patients and staff remain essential for optimal system utilisation.