A Clinical Journey Mobile Health App for Perioperative Patients: Cross-sectional Study

Abstract

Background Mobile eHealth apps are important tools in personal health care management. The Patient Journey app was developed to inform patients with musculoskeletal disorders during their perioperative period. The app contains timely information, video exercises, and functional tasks. Although the Patient Journey app and other health apps are widely used, little research is available on how patients appreciate these apps. Objective The primary aim of this study was to evaluate the user-friendliness of the Patient Journey app in terms of its usability and the attitudes of users toward the app. The secondary aim was to evaluate positive and negative user experiences. Methods A web-based questionnaire was sent to 2114 patients scheduled for surgery for a musculoskeletal disorder. Primary outcomes were usability (measured with the System Usability Scale) and user attitudes regarding the Patient Journey app (assessed with the second part of the eHealth Impact Questionnaire). The secondary outcomes were evaluated with multiple choice questions and open-ended questions, which were analyzed via inductive thematic content analyses. Results Of the 940 patients who responded, 526 used the Patient Journey app. The usability of the app was high (System Usability Scale: median 85.0, IQR 72.5-92.5), and users had a positive attitude toward the Information and Presentation provided via the app (eHealth Impact Questionnaire: median 78.0, IQR 68.8-84.4). The app did not adequately improve the users’ confidence in discussing health with others (eHealth Impact Questionnaire: median 63.9, IQR 50.0-75.0) or motivation to manage health (eHealth Impact Questionnaire: median 61.1, IQR 55.6-72.2). Three core themes emerged regarding positive and negative user experiences: (1) content and information, (2) expectations and experiences, and (3) technical performance. Users experienced timely information and instructions positively and found that the app prepared and guided them optimally through the perioperative period. Negative user experiences were overly optimistic information, scarcely presented information about pain (medication), lack of reference data, insufficient information regarding clinical course deviations and complications, and lack of interaction with clinicians. Conclusions The Patient Journey app is a usable, informative, and presentable tool to inform patients with musculoskeletal disorders during their perioperative period. The qualitative analyses identified aspects that can further improve the user experiences of the app.

Peer Review of “Continuous User Experience Monitoring of a Patient-Completed Preoperative Assessment System in the United Kingdom: Cross-sectional Study”

“…The methods of the study warrant improvement to make it robust and up to standard. 6. Some sections need to be moved and others reorganized for a better flow.…”

“…It is possible to merge some of the tables. 6. Kindly report all P values following the guidelines (eg, P<.001 and not P<0.001).…”

“…The authors concluded that the user experience and usability of the app were high. Other studies have reported the testing of apps using other scales, with the most prominent being the SUS deployed in the testing of the “Be Prepared” app among subjects undergoing surgery [ 5 ], the “Patient Journey” app among subjects booked for surgery [ 6 ], and the “Pregnancy and Work” app among pregnant women [ 7 ] in the Netherlands, as well as the “mCare” app among subjects undergoing elective surgery in the United States [ 8 ] and a non-motor symptoms app among subjects with Parkinson disease in the United Kingdom [ 9 ].…”

Sinn und Unsinn von Patienten-Apps in der Endoprothetik

“…526 Patienten (89 mit einer Hüft- und 164 mit einer Knieendoprothese) bewerteten die App insgesamt als sehr nützlich. Allerdings waren die Patienten durch die App zu keinem erhöhten Austausch mit anderen bereit, verstanden weder die Umstände besser noch war deren Motivation zur Verbesserung der Situation gesteigert [ 18 ].…”