[Effects and driving factors of digital transformation in measures against infectious disease operations at a public health center].

Objective　The study aim was to clarify the effects and driving factors of digital transformation (DX) on COVID-19 countermeasures.Methods　The Obihiro Public Health Center promoted the use of DX to cope with the increased workload caused by the COVID-19 pandemic. Before August 3, 2022 (early phase), the center devised measures using questionnaires; however, we had to print and file an epidemiological investigation form and questionnaire for each patient. From August 4 to November 16, 2022 (middle phase), we created a database that consolidated all the information on a sheet of paper and printed it automatically. After November 17, 2022 (later phase), the workflow was reviewed to completely digitize the operations, and personal records were handed over within an electronic folder. Quantitative indicators included the percentage of groups adopting DX, and paper usage was compared for the three phases. The number of days required from notification acceptance to recuperation began, and the questionnaire response time was analyzed using the Mann-Whitney U-test. Questionnaire response rates were compared using the chi-square (χ²) test. Qualitative data were coded based on the reflections of the staff involved in the DX promotion. Subcategories were created from commonalities among the codes, and categories were generated through increasing levels of abstraction.Results　As the phases progressed, the percentage of groups adopting DX increased and paper usage decreased. The number of days required was shorter in the later phase (0.4 days) than in the middle phase (0.6 days, P < 0.05). The questionnaire response time was shorter in the later phase (72.3 minutes) than in the middle phase (97.5 minutes, P < 0.01). The questionnaire response rate increased from 4.9% in the middle phase to 11.4% in the later phase (P < 0.01). Seven [categories] of DX driving factors were extracted from the qualitative data. The middle phase included [a need to review the support system because of the rapid spread of infection] and [concrete proposals to introduce DX and decisions by management]. During the later phase, the workflow became paperless as it was completed electronically. Furthermore, we promoted our efforts while providing [technical support to enhance the understanding and adaptation to the DX promotion]. We also sought to [understand individual values and encourage improved awareness].Conclusion　DX efforts reduced paper usage and the time spent on administrative tasks. The driving factors for DX were motivation from social situations, actions, decision-making to solve issues, and support for organizations and individuals. The promotion of DX across departments has led to labor-saving improvements and greater efficiency in operations.