J. S. Abelson1, E. J. Kaufman1, M. E. Charlson2, H. Yeo1,3 1Weill Cornell Medical College,Surgery,New York, NY, USA 2Weill Cornell Medical College,Integrative Medicine,New York, NY, USA 3Weill Cornell Medical College,Healthcare Policy And Research,New York, NY, USA
Introduction: Using smartphone and mobile health (mHealth) technology to monitor recovery after surgery has the potential to improve postoperative care, prevent complications, and reduce cost. We evaluated individuals’ perception of barriers and advantages to using mHealth after surgery.
Methods: Data were collected by Cornell University’s Survey Research Institute. Interviews were performed across New York State. Respondents were asked the following open-ended questions: 1. What are barriers or issues you might see to using a free mobile health app after surgery to improve your care? 2. What are benefits you might see to using a free mobile health app after surgery to improve your care? Of the 800 responses, 200 responses were coded independently by 3 reviewers to develop a preliminary codebook. The subsequent 600 responses were coded independently by 2 reviewers. The codebook was refined iteratively with all changes independently verified by the 3rd reviewer; all disagreements were resolved by consensus. We used modified grounded theory to allow themes to arise from the data.
Results: The average age of our cohort was 47 yrs (+17yrs) with an equal distribution of male and female participants. Most respondents were White (67%) while 13% identified as having Hispanic ethnicity. The most common barrier identified was protecting privacy and security of personal health data. Although less common, other areas of concern included: uncertainty about accessibility and usefulness of mHealth; preference for face-to-face interaction wtih surgeon; and high effort required by patients. There were several advantages noted by respondents; the most commonly cited advantages were the potential for mHealth to improve recovery and prevent complications as well as to strengthen communication and the relationship with surgeon. Other advantages included: increased patient knowledge and self-engagement in recovery; and saving time and money by reducing doctor visits. Several respondents identified no barriers, and a few identified no advantages.
Conclusion: This is the first large-scale qualitative analysis to evaluate perceptions of barriers and advantages in using mHealth after surgery to monitoring recovery. The majority of participants identified a narrow range of barriers, primarily focusing on confidentiality and data security. Nearly all participants identified a wide variety of potential advantages, ranging from improved communication with surgeons to preventing complications and saving time and money. These results indicate that while participants were in general willing to use mHealth and perceived many benefits, design and promotion of these apps should address patient concerns about data security and technology accessibility.
