Assistant Professor Esther Metting was recently selected as member of De Jonge Akademie (DJA) of the Royal Netherlands Academy of Arts and Sciences (Koninklijke Nederlandse Akademie van Wetenschappen, KNAW). Every year, the DJA selects talented young academics who have demonstrated academic excellence. As part of her DJA membership, Metting will contribute to interdisciplinary research projects that aim to strengthen the relationship between academia, science and society.

Could you tell us a little bit about your academic career so far?
“I am a psychologist and epidemiologist. I obtained my PhD from the University Medical Center Groningen (UMCG) and then started working as a postdoctoral researcher at the UMCG. Later, I worked as an e-health project leader at a large healthcare organization. Today, I work as an assistant professor in e-health at the UMCG and FEB. My expertise is in the implementation of digital healthcare. I combine behavioral, medical and organizational sciences. Apart from my work at the university, I am member of the Young Academy Groningen and I was active as board member and advisor in several patient organizations.” 

What kind of research do you do?
“My research focuses on implementing e-health in a way that meets users' needs. I aim to improve health equity by making digital care more accessible, thereby increasing the impact of digital healthcare innovations. In my Veni project, I  look at e-health accessibility for patients with chronic obstructive pulmonary disease. The aim of this project is to discover which factors influence e-health literacy, find out how these factors interact and develop solutions in co-creation with healthcare professionals and patients. This is unique because digital illiterate patients are mostly not included in studies. The final aim of the project is to develop a decision support method for healthcare professionals that will enable them to make e-health more accessible for patients who can’t currently profit from e-health.”

What led you to focus on the topic of accessible e-health?

"Healthcare is becoming increasingly digitalized. In hospitals, you can schedule appointments online, chat with your doctor online or get digital access to your medical data. These developments can lead to better health outcomes, save travel time for patients and might reduce the workload of healthcare professionals. Yet, unfortunately, not everyone can currently benefit from the advantages of e-health due to poor health and digital literacy. This creates health disparities between people who are digitally literate and those who are not. I use knowledge from clinical, behavioral and organizational sciences to improve the uptake of e-health schemes. This is essential considering the current digitalization of healthcare, to ensure healthcare remains accessible, also for those who have difficulties with digital technology.”

What surprising details did you discover in your research?

“I recently carried out focus groups in various European countries to talk with patients about digital health. Remarkable was that the reasons for not using digital health were very different per country. For example, for patients in Belgium the reliability of digital tools is extremely important. Scottish patients considered digital health as something for young people, whereas Dutch patients considered digital health as unavoidable considering the current workload in healthcare. In Germany, patients hardly used digital healthcare since it was not widely available as in the other countries. Moreover, problems for not using digital healthcare are not always related to digital skills. In our international questionnaire study, we saw that about 25% of the patients experience physical barriers for using digital health. For example poor vision, a tremor or poor eye hand coordination.”

Can you describe the societal impact of your research?

“My unique experience in clinical, behavioral and implementation science have led to a solid, multidisciplinary basis for health research. Because of my expertise on epidemiology and e-health, I have been involved in several COVID-19 projects, including the evaluation of the CoronaMelder for the Ministry of Health, Welfare and Sports, the evaluation of the COVID-19 rapid-testing center and research into the CoronaCheck app. The knowledge and experience of my research group is also used in activities for patients or healthcare professionals. It is important for us to build bridges between science and other professionals and citizens. With all my research, I aim to inform healthcare professionals and patients about the importance of digital literacy and about organizations who can help to improve this. We are currently planning an interactive symposium for citizens in Groningen about digital healthcare.”

To what kind of research projects do you plan to contribute to as DJA member?

“As member of the UG’s Young Academy Groningen, a network of talented, enthusiastic and ambitious young researchers from diverse disciplines at the UG and UMCG, I was working on an awareness project regarding gender differences in Academia. We found that female professors were less likely to have children and that female academics with children spend more time caring for their children compared to academic fathers. As a member of DJA, I would like to start with a national project on this topic. It is important to learn about underlying reasons for these gender differences, so that policies for more equal opportunities in academia can address them. Our background plays a role in how we perform research. In medical science, females were often excluded from clinical studies and the assumption was that disease symptoms and treatment results are the same for men and women. We now know that this is false. This exclusion and assumption led to a lack of knowledge about the female body. If female researchers had equal opportunities in medical sciences, this would probably contribute to more attention for- and ultimately knowledge about- women’s health and the female body. That's why I think it's important for academia to better reflect society.”

What role do you think interdisciplinary research can play in strengthening the relationship between academia, science and society?

“Many societal challenges such as climate change, the housing problem and fake news, don’t have simple solutions and we need to look at them from a broad angle. A good example was the COVID-19 pandemic. From an epidemiological point of view, the best solution would be to have strict quarantine regulations and to vaccinate everyone as quickly as possible. But mental well-being, a healthy economic society, and the development of children is also important. In interdisciplinary research you need to take all perspectives into account, which requires input from different types of experts and non-experts. This can help to find solutions that match the needs of society, give people the feeling that their voice is heard and will eventually lead to better outcomes.”