Mobile health apps and recovery after surgery: What are patients willing to do?

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Abstract

Background

Mobile health technologies (mHealth) may improve post-operative care but it is unknown if patients are willing to use this technology.

Methods

We surveyed 800 NY State residents to determine their willingness to engage in mHealth after surgery and compared socioeconomic factors that may affect willingness to engage.

Results

A majority of respondents reported willingness to wear a tracker on their wrist (80.6%), fill out a survey (74.3%), send pictures of their wound to their surgeon (66.3%), and share updates with friends/family (59.1%). Older age was associated with lower likelihood of having a smartphone, but not associated with willingness to engage with other features. Hispanic ethnicity was associated with lower likelihood of wearing a tracker while Black race was associated with lower willingness to send pictures.

Conclusions

Overall, potential users of mHealth are interested and willing to use mHealth. Older respondents are as willing as younger respondents to engage with mHealth. Individuals with Hispanic ethnicity and Black race may be less willing to engage and therefore may require education regarding benefits of this technology.

Introduction

Smartphone access and use has increased dramatically over the past five years.1 In parallel, development of mobile health apps has also increased, predominantly for the management of chronic diseases.2, 3 Recently, a few small pilot studies have demonstrated the opportunity for mobile health technology4, 5, 6, 7 and telehealth8, 9, 10 to monitor post-operative recovery to improve outcomes and potentially reduce patient costs.

As part of the growing body of literature evaluating the utility of mobile health technology, several studies have evaluated the public's interest11 and willingness to engage with mobile health applications12, 13, 14, 15 and health information exchange16 to manage chronic medical disease. Only one other small, single center study evaluated patients' perceptions regarding mobile health app use in the acute post-operative setting.17 As a result, there is a paucity of data regarding which patients would be willing to participate and what they would be willing to do in the perioperative period.

Our study objective was to ascertain the public's willingness to engage in mobile health technology in the post-operative setting, using a representative survey, and to identify patient-specific variables associated with a willingness to do so.

Section snippets

Survey development and administration

The Cornell University Survey Research Institute is a member of the Association of Academic Survey Research Organization and is a well-established organization that has been conducting survey research since 1996.18 They have been conducting the Empire State Poll, a telephone survey of adult residents ≥18 years of age in New York State, every year since 2003. Each year there is a core set of questions addressing themes of community, government, and the economy. In addition to the core questions,

Description of cohort

A total of 739 NY state residents had complete survey data. The average age of respondents was 47 years old (±17) with an equal distribution of men and women. Most respondents were White (67%), followed by Black (18%) and Other (15%). 13% of respondents identified as having Hispanic ethnicity. The median income was $70,000 (IQR = $42,000-$100,000) and 31% of the cohort did not complete any education beyond high school.

Primary outcome: willingness to engage with mHealth

Overall, the majority of respondents reported a willingness to engage with

Discussion

Use of mobile health apps and trackers after surgery offer the potential to shorten length of stay, and improve care by potentially identifying complications earlier thus decreasing 30-day readmission, improving recovery, and reducing healthcare costs.4, 5, 6, 7 Despite its possible benefits, previous studies have indicated that not all patients are amenable to using these innovative technologies.12, 13, 23 This is the first large-scale survey to address this important issue of patient

Conclusions

The majority of respondents in our large statewide survey indicated a willingness to engage with a variety of mobile health technology functions including wearing a tracker, filling out a daily survey, sending pictures of their wound to their surgeon, and sharing updates with select family and friends. Older respondents are just as willing as younger respondents to engage with mobile health technology. Individuals with Hispanic ethnicity and Black race may be less willing to engage and

Funding/support

Funding for this study came from two sources supporting Dr. Yeo: Career Development Award from the Society for Surgery of the Alimentary Tract and Center for Advanced Digestive Care at New York Presbyterian Hospital-Weill Cornell Medicine.

Acknowledgements

Acknowledgements to Myung Hee Lee for statistical support.

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