Digital health in palliative care: use is largely limited to conventional technologies – a cross-sectional survey of healthcare professionals

Background Digital health technologies (DHTs) can help address challenges in palliative care, particularly in rural and underserved areas. However, evidence on their routine use and acceptance among healthcare professionals (HCPs) remains limited.

Aim To assess HCPs reported use of DHTs, digital health literacy, attitudes, and perceived benefits and barriers regarding DHT implementation in routine palliative care.

Design Cross-sectional survey using a self-administered questionnaire informed by prior qualitative research. Data were collected online and on paper (Sept–Nov 2023).

Setting/participants 152 HCPs in palliative care across Brandenburg, Germany: 68 physicians, 36 nurses, and 48 others (e.g. psycho-oncologists, social workers).

Results Physicians showed the highest digital health literacy (mean eHEALS: 33/40). Nurses expressed the highest general agreement with DHTs, though acceptance in palliative care was lower—especially among physicians. Email (72–78%) and documentation tools (60–67%) were widely used. Innovative tools such as video consultations (6%), mobile apps (10–22%), and wearables (10–22%) were used infrequently. Perceived benefits included location flexibility (up to 81%) and time independence (up to 78%). Barriers included inadequate infrastructure (up to 78%) and limited digital skills among patients and families (up to 80%). DHT use was more frequent in inpatient settings (ρ = 0.183, p = 0.014), urban areas (p = 0.04), and among physicians and nurses (p = 0.049). Non-users had a higher median age than users (p = 0.023). Those using conventional tools were more likely to adopt innovative ones (p < 0.001).

Conclusions DHT use in palliative care remains centered on conventional tools. While professionals recognize potential benefits, structural deficits and limited perceived relevance hinder adoption. Strengthening infrastructure and digital literacy is key to sustainable digital transformation.