背景:在过去的几年中,医生和面向患者的护理人员越来越多地使用移动健康(mHealth)技术,在COVID-19大流行期间加速。然而,围绕收养的障碍和反馈仍然相对缺乏研究,并且在整个卫生系统中各不相同,特别是在农村地区。
目的:本研究旨在确定供应商的采用,态度,以及大型移动健康的障碍,多站点,美国农村医疗系统。我们调查了(1)提供商为自己的利益使用的mHealth应用程序和(2)提供商与患者一起使用的mHealth应用程序。
方法:我们调查了马什菲尔德诊所健康系统内的所有看病者,16项,基于网络的调查评估对mHealth的态度,采用这些技术,以及提供者面临的感知障碍,他们的同龄人,和机构。调查结果通过描述性统计进行总结,使用对数二项回归和伴随的成对分析,使用Kruskal-Wallis和Jonckheere-Terpstra检验进行显著性检验,分别。受访者按报告的临床角色和专业进行分组。
结果:我们收到了38%(n/N=916/2410)的响应率,60.7%(n=556)的那些足够完整的分析。大约54.1%(n=301)的受访者表示使用mHealth,主要围绕决策和补充信息,根据提供者角色和多年的经验,使用不同。自我报告使用mHealth的障碍包括缺乏知识和时间来研究mHealth技术。提供商还报告了对患者互联网访问以及mHealth应用程序充分使用mHealth技术的复杂性的担忧。供应商认为卫生系统的障碍主要是隐私,保密性,和法律审查问题。
结论:这些发现与其他卫生系统的类似研究相呼应,周围的提供者缺乏时间和对患者数据隐私和机密性的担忧。供应商强调了对这些技术对患者的复杂性的担忧,以及对患者在提供护理时充分利用mHealth的互联网访问的担忧。
BACKGROUND: Physicians and patient-facing caregivers have increasingly used mobile health (mHealth) technologies in the past several years, accelerating during the COVID-19 pandemic. However, barriers and feedback surrounding adoption remain relatively understudied and varied across health systems, particularly in rural areas.
OBJECTIVE: This study aims to identify provider adoption, attitudes, and barriers toward mHealth in a large, multisite, rural US health care system. We investigated (1) mHealth apps that
providers use for their own benefit and (2) mHealth apps that a provider uses in conjunction with a patient.
METHODS: We surveyed all patient-seeing
providers within the Marshfield Clinic Health System with a brief, 16-item, web-based survey assessing attitudes toward mHealth, adoption of these technologies, and perceived barriers faced by providers, their peers, and the institution. Survey results were summarized via descriptive statistics, with log-binomial regression and accompanying pairwise analyses, using Kruskal-Wallis and Jonckheere-Terpstra tests for significance, respectively. Respondents were grouped by reported clinical role and specialty.
RESULTS: We received a 38% (n/N=916/2410) response rate, with 60.7% (n=556) of those sufficiently complete for analyses. Roughly 54.1% (n=301) of respondents reported mHealth use, primarily around decision-making and supplemental information, with use differing based on provider role and years of experience. Self-reported barriers to using mHealth included a lack of knowledge and time to study mHealth technologies.
Providers also reported concerns about patients\' internet access and the complexity of mHealth apps to adequately use mHealth technologies.
Providers believed the health system\'s barriers were largely privacy, confidentiality, and legal review concerns.
CONCLUSIONS: These findings echo similar studies in other health systems, surrounding providers\' lack of time and concerns over privacy and confidentiality of patient data.
Providers emphasized concerns over the complexity of these technologies for their patients and concerns over patients\' internet access to fully use mHealth in their delivery of care.