The role of health-care providers in mHealth adoption

Leigh, Simon; Ashall-Payne, Liz

doi:10.1016/s2589-7500(19)30025-1

Cited by 64 publications

(55 citation statements)

References 6 publications

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“…13 However, while advancements have been made in the development, validation, and regulation of apps, it is less clear how to disseminate appropriate interventions to patients and providers. 14 The sheer number of apps available, each with varying functionality, complexity, impact, and cost, creates substantial barriers to the diffusion of these apps into clinical care. Furthermore, the evidence base supporting the use of even the best apps is scant, and most apps do not deliver value, especially for patients who are sick or have chronic conditions.…”

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confidence: 99%

Beyond validation: getting health apps into clinical practice

et al. 2020

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Beyond validation: getting health apps into clinical practice

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“…Each of these study types is now considered acceptable forms of evidence for the right type of health app under NICE’s evidence standards framework. However, it is unclear whether this notion of not all apps being equal [ 19 ] is accepted by HCPs who have the ultimate responsibility for patient well-being. This is a question that future research should aim to address before developers of health apps to invest too heavily in evidence generation, particularly considering the WTP estimates suggested by this analysis (£29.20 extra for each additional study and £124.61 for an NHS stamp of approval).…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the face-to-face discussions, we also invited HCPs to provide responses on the web, of which 57 HCPs from the United Kingdom contributed. Further details of this exercise are provided elsewhere [ 19 ]. Following the conclusion of the ranking exercise, the 6 highest ranked attributes were selected for inclusion in the discrete choice experiment (DCE).…”

Section: Methodsmentioning

confidence: 99%

“…A DCE, designed to elicit the preferences of HCPs for digital health prescribing, and including the attributes identified during the literature review, face-to-face discussions, and ranking exercise [ 19 ], was provided to HCPs between March and June 2019 (sample survey instrument is provided in Multimedia Appendix 3 ). The DCE survey was provided digitally, using Google Forms (Google, Alphabet Inc) and disseminated using social media (LinkedIn, Twitter, and Facebook).…”

Section: Methodsmentioning

confidence: 99%

“…On the basis of the combined results of a qualitative pilot study [ 19 ] and a targeted literature review [ 8 - 18 , 20 , 21 ], we conducted a discrete choice experiment (DCE) among 222 HCPs in the United Kingdom to determine priorities, trade-offs, and willingness-to-pay (WTP) for several common characteristics of digital health technologies.…”

Section: Introductionmentioning

confidence: 99%

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Barriers and Facilitators to the Adoption of Mobile Health Among Health Care Professionals From the United Kingdom: Discrete Choice Experiment

Leigh¹,

Ashall-Payne²,

Andrews³

2020

JMIR Mhealth Uhealth

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Background Despite the increasing availability of mobile health services, clinical engagement remains minimal. Objective This study aims to identify and weight barriers to and drivers of health app use among health care professionals (HCPs) from the United Kingdom. Methods A discrete choice experiment was conducted with 222 HCPs using a web-based survey between March 2019 and June 2019. Participants were recruited to take part via social media and asked to choose their preferred option of 2 hypothetical health apps to prescribe to a hypothetical patient or to prescribe neither. Choices were characterized by differing levels of patient age, cost, published evidence bases, whether they had a National Health Service (NHS) stamp of approval, personal familiarity with the technology, and whether they were recommended by a fellow HCP. The results were analyzed using a mixed logit model, with subgroup analyses to account for heterogeneity. Results We received 230 responses, a total of 96.5% (n=222/230) of respondents understood the survey task and passed the test of rationality. The median age was between 36 and 45 years, and 62.6% (n=139/222) of the health care providers responding to the survey had previously recommended the use of health apps to patients. Health apps were most likely to be prescribed to patients if they had an NHS stamp of approval or if they were recommended by another HCP (both P<.001). Published studies detailing clinical effectiveness were important (P<.001), but it would take five published studies to have the same impact on prescribing behavior as an NHS stamp of approval and two studies to be as convincing as having used the technology personally. Increasing patient age and costs resulted in significant reductions in digital health prescribing (P<.001), none more so than among allied health professionals. Willingness-to-pay for health apps increased by £124.61 (US $151.14) if an NHS stamp of approval was present and by £29.20 (US $35.42) for each published study. Overall, 8.1% (n=18/222) of respondents were reluctant to use health apps, always choosing the I would prescribe neither option, particularly among older HCPs, nurses, and those who do not use health apps personally. Subgroup analyses revealed significant differences in preferences among HCPs of differing ages and clinical backgrounds. Conclusions An NHS stamp of approval, published studies, and recommendations from fellow HCPs are significant facilitators of digital prescribing, whereas increasing costs and patient age are significant barriers to engagement. These findings suggest that demonstrating assurances of health apps and supporting both the dissemination and peer-to-peer recommendation of evidence-based technologies are critical if the NHS is to achieve its long-term digital transformation ambitions.

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Focusing on Digital Health Equity

Lyles

Wachter

Sarkar

2021

JAMA

138

101

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The disproportionate toll of the COVID-19 pandemic on Black, Hispanic/Latinx, and lower-income communities highlighted long-standing disparities in health and health care. Addressing these disparities requires fundamental changes to health care delivery; more equitable outcomes will not be achieved without changing the underlying system.The renewed focus on health equity comes at a time of rapid digital transformation of the health care system. This transformation offers an opportunity to address many core health equity challenges. Digital health involves digitally enabled tools and environments to augment in-person health care with digital communication, education, and remote care management. These approaches have the potential to address some of the structural challenges for marginalized populations, including lowering access barriers of time and distance and providing tailored communication by language and literacy. Yet the digitization of health care can also harm health equity if this digitally enabled ecosystem moves forward without proactive engagement, planning, and implementation.Digital access and skills are foundational social determinants of health, 1 as effective use of both social services (including educational, housing, and other resources) and health care information (such as patient medical records) are increasingly moving online. The

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The role of health-care providers in mHealth adoption

Cited by 64 publications

References 6 publications

Beyond validation: getting health apps into clinical practice

Beyond validation: getting health apps into clinical practice

Barriers and Facilitators to the Adoption of Mobile Health Among Health Care Professionals From the United Kingdom: Discrete Choice Experiment

Focusing on Digital Health Equity

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