The Use of Mobile Health Applications to Improve Patient Experience: Cross-Sectional Study in Chinese Public Hospitals

Chuntao Lu, Yinhuan Hu, Jinzhu Xie, Qiang Fu, Isabella Leigh, Samuel Governor, Guanping Wang, Chuntao Lu, Yinhuan Hu, Jinzhu Xie, Qiang Fu, Isabella Leigh, Samuel Governor, Guanping Wang

Abstract

Background: The proliferation of mobile health apps has greatly changed the way society accesses the health care industry. However, despite the widespread use of mobile health apps by patients in China, there has been little research that evaluates the effect of mobile health apps on patient experience during hospital visits.

Objective: The purpose of our study was to examine whether the use of mobile health apps improves patient experience and to find out the difference in patient experience between users and nonusers and the characteristics associated with the users of these apps.

Methods: We used the Chinese Outpatient Experience Questionnaire to survey patient experience. A sample of 300 outpatients was randomly selected from 3 comprehensive public hospitals (3 tertiary hospitals) in Hubei province, China. Each hospital randomly selected 50 respondents from mobile health app users and 50 from nonusers. A chi-square test was employed to compare the different categorical characteristics between mobile health app users and nonusers. A t test was used to test the significance in continuous variables between user scores and nonuser scores. Multiple linear regression was conducted to determine whether the use of mobile health apps during hospital visits was associated with patient experience.

Results: The users and nonusers differed in age (χ22=12.2, P=.002), education (χ23=9.3, P=.03), living place (χ21=7.7, P=.006), and the need for specialists (χ24=11.0, P=.03). Compared with nonusers, mobile health app users in China were younger, better educated, living in urban areas, and had higher demands for specialists. In addition, mobile health app users gave significantly higher scores than nonusers in total patient experience scores (t298=3.919, P<.001), the 18 items and the 5 dimensions of physician-patient communication (t298=2.93, P=.004), health information (t298=3.556, P<.001), medical service fees (t298=3.991, P<.001), short-term outcome (t298=4.533, P<.001), and general satisfaction (t298=4.304, P<.001). Multiple linear regression results showed that the use of mobile health apps during hospital visits influenced patient experience (t289=3.143, P=.002). After controlling for other factors, it was shown that the use of mobile health apps increased the outpatient experience scores by 17.7%. Additional results from the study found that the self-rated health status (t289=3.746, P<.001) and monthly income of patients (t289=2.416, P=.02) influenced the patient experience as well.

Conclusions: The use of mobile health apps could improve patient experience, especially with regard to accessing health information, making physician-patient communication more convenient, ensuring transparency in medical charge, and ameliorating short-term outcomes. All of these may contribute to positive health outcomes. Therefore, we should encourage the adoption of mobile health apps in health care settings so as to improve patient experience.

Keywords: mobile applications; outpatients; patient satisfaction; surveys and questionnaire; technology.

Conflict of interest statement

Conflicts of Interest: None declared.

©Chuntao Lu, Yinhuan Hu, Jinzhu Xie, Qiang Fu, Isabella Leigh, Samuel Governor, Guanping Wang. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 23.05.2018.

References

    1. The Beryl Institute. [2018-01-02]. Defining patient experience .
    1. Dr Foster. 2010. Intelligent board: patient experience
    1. Department of Health. 2013. The NHS outcomes framework 2013/14 .
    1. Ahmed F, Burt J, Roland M. Measuring patient experience: concepts and methods. Patient. 2014;7(3):235–41. doi: 10.1007/s40271-014-0060-5.
    1. Jenkinson C, Coulter A, Bruster S. The picker patient experience questionnaire: development and validation using data from in-patient surveys in five countries. Int J Qual Health Care. 2002 Oct;14(5):353–8.
    1. Garratt AM, Bjaertnes OA, Krogstad U, Gulbrandsen P. The outpatient experiences questionnaire (OPEQ): data quality, reliability, and validity in patients attending 52 Norwegian hospitals. Qual Saf Health Care. 2005 Dec;14(6):433–7. doi: 10.1136/qshc.2005.014423. 14/6/433
    1. Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013;3(1):57–60. doi: 10.1136/bmjopen-2012-001570. bmjopen-2012-001570
    1. Anderson R, Barbara A, Feldman S. What patients want: a content analysis of key qualities that influence patient satisfaction. J Med Pract Manage. 2007;22(5):255–61.
    1. Silva BMC, Rodrigues JJPC, de la Torre Diez I, López-Coronado M, Saleem K. Mobile-health: a review of current state in 2015. J Biomed Inform. 2015 Aug;56:265–72. doi: 10.1016/j.jbi.2015.06.003.S1532-0464(15)00113-6
    1. Fox S, Duggan M. Pew Research Center. 2012. [2018-01-02]. Mobile health 2012 .
    1. Agency for Healthcare Research and Quality. 2017. CAHPS health information technology item set .
    1. Yu X, Han H, Du J, Wei L, Li C, Zhang X, Li H, Huang Y, Sun K, Li N, West DM, Bleiberg J. Brookings. [2018-01-02]. mHealth in China and the United States: how mobile technology is transforming healthcare in the world's two largest economies .
    1. Mira JJ, Navarro I, Botella F, Borrás F, Nuño-Solinís R, Orozco D, Iglesias-Alonso F, Pérez-Pérez P, Lorenzo S, Toro N. A Spanish pillbox app for elderly patients taking multiple medications: randomized controlled trial. J Med Internet Res. 2014;16(4):e99. doi: 10.2196/jmir.3269. v16i4e99
    1. Rollo ME, Ash S, Lyons-Wall P, Russell A. Trial of a mobile phone method for recording dietary intake in adults with type 2 diabetes: evaluation and implications for future applications. J Telemed Telecare. 2011;17(6):318–23. doi: 10.1258/jtt.2011.100906.jtt.2011.100906
    1. López MM, López MM, de la Torre Diez I, Jimeno JCP, López-Coronado M. mHealth app for iOS to help in diagnostic decision in ophthalmology to primary care physicians. J Med Syst. 2017 May;41(5):81. doi: 10.1007/s10916-017-0731-6.10.1007/s10916-017-0731-6
    1. Hsu J, Liu D, Yu YM, Zhao HT, Chen ZR, Li J, Chen W. The top Chinese mobile health apps: a systematic investigation. J Med Internet Res. 2016 Aug 29;18(8):e222. doi: 10.2196/jmir.5955. v18i8e222
    1. [x]cube LABS. mobility in healthcare prescription for success
    1. Hu Y, Zhang Z, Xie J, Wang G. The outpatient experience questionnaire of comprehensive public hospital in China: development, validity and reliability. Int J Qual Health Care. 2017 Feb 01;29(1):40–6. doi: 10.1093/intqhc/mzw133.mzw133
    1. Agency for Healthcare Research and Quality. Determining where to focus efforts to improve patient experience .
    1. National Bereau of Statistics of the People's Republic of China. National economic and social development bulletin .
    1. Pellegrini CA, Pfammatter AF, Conroy DE, Spring B. Smartphone applications to support weight loss: current perspectives. Adv Health Care Technol. 2015 Jul;1:13–22. doi: 10.2147/AHCT.S57844.
    1. Chinese doctors are under threat. Lancet. 2010 Aug 28;376(9742):657. doi: 10.1016/S0140-6736(10)61315-3.S0140-6736(10)61315-3
    1. Brusco JM. Mobile health application regulations and compliance review. AORN J. 2012 Mar;95(3):391–4. doi: 10.1016/j.aorn.2011.12.010.S0001-2092(11)01391-3
    1. National Health Service. Commissioning for improved patient experience .
    1. Bjertnaes OA, Sjetne IS, Iversen HH. Overall patient satisfaction with hospitals: effects of patient-reported experiences and fulfilment of expectations. BMJ Qual Saf. 2012 Jan;21(1):39–46. doi: 10.1136/bmjqs-2011-000137.bmjqs-2011-000137
    1. Esan TA, Olusile AO, Akeredolu PA, Esan AO. Socio-demographic factors and edentulism: the Nigerian experience. BMC Oral Health. 2004 Nov 22;4(1):3. doi: 10.1186/1472-6831-4-3. 1472-6831-4-3
    1. Sofaer S, Firminger K. Patient perceptions of the quality of health services. Annu Rev Public Health. 2005;26:513–59. doi: 10.1146/annurev.publhealth.25.050503.153958.
    1. Carroll JK, Moorhead A, Bond R, LeBlanc WG, Petrella RJ, Fiscella K. Who uses mobile phone health apps and does use matter? a secondary data analytics approach. J Med Internet Res. 2017 Apr 19;19(4):e125. doi: 10.2196/jmir.5604. v19i4e125
    1. Ernsting C, Dombrowski SU, Oedekoven M, Kanzler M, Kuhlmey A, Gellert P. Using smartphones and health apps to change and manage health behaviors: a population-based survey. J Med Internet Res. 2017 Apr 05;19(4):e101. doi: 10.2196/jmir.6838. v19i4e101
    1. China Internet Network Information Center. The 41th Chinese statistical report on internet development .
    1. Liu T, Sun L. An apocalyptic vision of ageing in China: Old age care for the largest elderly population in the world. Z Gerontol Geriatr. 2015 Jun;48(4):354–64. doi: 10.1007/s00391-014-0816-5.
    1. Riley WT, Rivera DE, Atienza AA, Nilsen W, Allison SM, Mermelstein R. Health behavior models in the age of mobile interventions: are our theories up to the task? Transl Behav Med. 2011 Mar;1(1):53–71. doi: 10.1007/s13142-011-0021-7. 21

Source: PubMed

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