Effect of a mobile medical app on outpatient experience: a cross-sectional study. (December 2017)

• Record Type: Journal Article
• Authors: Xie, Jinzhu; Hu, Yinhuan; Wang, Guanping; Lu, Chuntao
• Is Part Of: Lancet. Volume 390(2017)Supplement 4
• Page Start: S65
• Publication Date: 2017-12
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(17)33203-8
• Languages: English
• ISSNs: 0140-6736

Abstract

Abstract: Background: In January 2015, the National Health and Family Planning Commission recommended that information technology should be taken advantage of to improve patient experience. We aimed to learn the use of mobile medical app and its effect on outpatient experience to improve the outpatient experience. A mobile medical app is an application that meets the definition of a medical device, is an accessory to a regulated medical device, or transforms a mobile platform into a regulated medical device. The major functions of health applications included registration, online consulting, self-diagnosis, medical charge paying, and health information acquisition. Methods: In this cross-sectional study, we assessed the outpatient experience at three public hospitals in Wuhan, China. Participants filled out a two-part questionnaire based on a five point Likert scale. The first part of the questionnaire was the Outpatient Experience Questionnaire, with good reliability and validity, including six dimensions and 28 items. The dimensions included physical environment and convenience, doctor–patient communication, health information, medical expenses, short-term outcome, and general satisfaction. The second part surveyed the characteristics, included sex, age, education, income, living place, marital status, payment, self-rated health status, and whether using application. A score of 5 means best experience, and a score of 1 means worst experience. The rank sum test was done to assess the difference of each item score between outpatients who used the mobile medical app and those who never used it. Multiple linear regression analysis was done to examine the effects of mobile medical app use and other sociodemographic factors on outpatient experience. This study was approved by the Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology (IORG No: IORG0003571), and informed consent was obtained from all participants. Findings: 300 outpatients were recruited, 150 of whom had used the mobile medical app, and 150 of whom had never used it. Multiple linear regression model showed that the use of mobile medical app had an effect on outpatient experience (β=0·139; 95% CI 0·022–0·266; p<0·0001. We found no collinearity between the medical app and other independent variables (0<VIF<10). The mean experience score of those who used mobile medical app was 3·72 (SD 0·50), whereas the mean experience score for those who never used the mobile medical app was 3·49 (0·56). Among the outpatients who used mobile medical app, 145 outpatients (97%) used it to register. 97 outpatients (65%) said the app was able to provide the most desired function. 130 outpatients (87%) believed that the use of mobile medical app was more convenient than traditional visit mode. Outpatients who used the mobile medical app gave highest experience score for the convenience of registration (3·97 [0·89]; p=0·005). We found a significant difference between users and non-users of the app in communication experience (3·73 [0·59] with app vs 3·52 [0·64] without app, p=0·004), medical information experience (3·91 [0·67] vs 3·61 [0·80]; p<0·0001), and medical cost experience (3·52 [0·67] vs 3·19 [0·77]; p<0·0001). Interpretation: The effects of mobile health apps on the outpatient experience in China has not been investigated in much detail. We explored whether the use of an app could affect the patient experience, and the difference in patient experience between health application users and non-users. The use of a mobile medical app was associated with the outpatient experience. We can improve the outpatient experience by optimising the accessibility, reliability, perceived ease of use, and perceived usefulness of the mobile medical app. Two limitations should be considered. First, because of the fluidity of the outpatients and lack of complete visiting record, the survey did not follow rigorous random sampling. Second, our research was a cross-sectional survey, so changes could not be examined. Funding: Fundamental Research Funds for the Central Universities (2017WKYXQY004).