Investigation of physicians' awareness and use of mHealth apps: A mixed method study
Introduction
The healthcare information technology market is expanding globally. Reports reveal trajectories support the proliferation of mobile technology use in delivering healthcare services is becoming the norm [1]. McKinsey's report presented that the tablet PC and smartphones market will expand by up to 30% by 2018 [2]. On the software side, the number of mobile apps has reached more than one hundred thousand in approximately three years [3].
In parallel to this, studies investigating the effects of mobile technology usage and apps in healthcare services are also increasing. The studies underlined the significant global impact of mHealth and in particular, the importance of mHealth technologies in developing countries for accessing healthcare and for patient monitoring [4], [5]. However, common concerns for the technology remain with regard to sustainability, scalability, security, and privacy, which may subsequently lead to problems in service quality [6]. On the other hand, Healthcare Providers (HCP) report that locational constraints, needs for interoperability, professional control and effective management for chronic conditions are their particular concerns with regard to using mHealth in healthcare delivery [7].
The actual use of mHealth requires in-depth investigation in order to understand the true impact on its end users. Significant escalation in smartphone usage might have increased app usage in healthcare services, yet, its utilization has not reached an acceptable level in practice [8]. Studies have demonstrated that acceptance issues for mobile healthcare services need to be resolved to assure better healthcare delivery [9], [10]. In that regard, the use of mHealth apps and the attitudes of healthcare providers remain questionable and therefore in need of investigation [11].
In Turkey, the Ministry of Health reports over 135 thousand physicians actively practice medicine [12]. The number of patients per physician is around 600, and each hospital physician sees more than 4600 patients per year. Thus, there is an excessive workload for physicians. To maintain quality in healthcare delivery, assistive technologies were predicted to help physicians, such as mHealth apps [13]. However, there is a gap in practical knowledge. The current state of mHealth app use in most developing countries is barely known, with few studies providing insight about mHealth use in developing, low and mid-income countries [14].
This current study investigates physicians’ mHealth app usage in Turkey. A Mobile Health Acceptance Model (M-TAM) was proposed and tested as a means to understanding the influencing factors in mHealth app usage. Furthermore, the study presents a social validation retrieving a collective meaning among individuals through focus group interviews in order to understand expectations and characteristics of mHealth app use.
Section snippets
mHealth overview
Clinical use of mobile apps and devices is increasing. Clinicians report that mHealth apps will become an important tool for health management in the near future [15]. A Wolters Kluwer Health report stated that eight out of ten healthcare professionals use smartphones in daily practice, and that six out of ten are using tablet PCs [16]. The literature demonstrated that mHealth is located in a position that provides a promising technology integration opportunity among healthcare services. It
Research model
In order to assess physicians’ perceptions and attitudes toward mHealth apps, a technology acceptance model was proposed, named as the Mobile Health Technology Acceptance Model, or M-TAM. The model was developed based on the findings of an in-depth literature review on technology acceptance, and the consensus of experts. A group of scholars (Ph.D. level of knowledge in behavioral science or healthcare) were informed about the purpose of the study and the literature findings. A consensus was
Results
After the data collection process, 151 physicians completed the questionnaire, which represented a 15% response rate. Incomplete responses were then removed, and 137 complete responses were used in the testing of the hypotheses.
Discussion
The literature argued that healthcare providers are aware of mHealth technologies, and they acknowledge the benefits of mHealth in clinical communication and healthcare delivery [20], [72]. This study supports this argument, outlining a variety of evidence regarding physicians’ intentions toward using mHealth apps.
Conclusion
This study contributed to the literature in terms of providing a new model to explain the acceptance of mHealth apps by healthcare providers. In addition to that, providing a dataset from a developing country depicted an alternative outlook to influencing factors in using mHealth apps. Furthermore, this study extended prior research about the perceptions and preferences on mobile healthcare apps [36], [76], [88]. The authors would suggest further studying of mHealth apps in order to increase
Author contribution
This research study is out of a PhD thesis work of the first author Mr. Emre Sezgin, who has completed his thesis work. Emre Sezgin will defend his thesis in the next couple of months. The second and third authors Associate professor Dr. Sevgi Ozkan-Yildirim and professor Soner Yildirim are supervisors of him and they have initiated, directed and critically contributed to the research and the paper.
Funding
There is no direct funding for his research. However the authors have been receiving grants from TUBITAK (The Turkish Scientific and Research Council) for doing this research.
Conflict of interest
Up to the authors' knowledge, there is no conflict of interest. The survey conducted has been accomplished voluntarily by the participating physicians' willing and consent. The survey participants were informed about the research they are involved and they accepted the terms and conditions on the interpretation of the
Acknowledgements
This study was supported by The Scientific and Technological Research Council of Turkey (TUBITAK) with 2211C doctoral research scholarship program.
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