Patients perspective of m-health adoption factors in the developing world. Development of a Proposed framework

Abstract

Patient perceptions and experiences of mobile health (m-health) systems have been recognised as an important element to consider in the adoption of m-health based technologies. Though much research supports this, published studies that focus on m-health use by patients appear to highlight these issues in an isolated rather than holistic manner. Consequently, there is no encompassing framework that serves as a guide for effective implementation and maximum adoption of m-health from the perspective of patients in the developing world. This review documents patient adoption issues, and uses these to develop a framework of patient adoption issues for m-health in the developing world. A structured literature search was conducted using PubMed and Scopus. For PubMed a consolidated search string combined ‘MESH’ terms and ‘All Fields’ terms for selected keywords. For Scopus an equally consolidated search string was used. The searches were restricted to articles in English during the period January 2000 - December2019 and relevant to the developing world. Duplicate articles were removed. Titles and abstracts were screened by all authors for inclusion, and those studies that met the inclusion criteria were selected for full-text review. Review and data abstraction was performed by two authors. Fifty-four (54) articles reported factors that impact patient adoption. Review and data abstraction identified specific factors, initially classified under 22 categories, that promote or impede m-health adoption in the developing world. Continued iterative review and discussion reduced these to 7 primary categories, with 21 sub-categories. The review showed: great inconsistency in the approach and tools used in published studies; multiple factors impact patient adoption of m-health in the developing world; the specific factors vary from setting to setting and by recency of findings. Successful adoption of m-health by patients in the developing world critically depends on addressing the factors identified in the proposed framework, and assessing them prior to implementation of m-health initiatives in any specific setting. The framework will serve to: increase the consistency of patient adoption studies, form the basis for informed policy decisions by stakeholders, and provide the foundation for greater success of future m-health implementations for patients in the developing world.