V. N. O’Reilly-Shah1,2, G. Easton3, S. Gillespie4 1Emory University School Of Medicine,Anesthesiology,Atlanta, GA, USA 2Children’s Healthcare Of Atlanta,Pediatric Anesthesiology,Atlanta, GA, USA 3Emory University Goizueta Business School,Information Systems & Operations Management,Atlanta, GA, USA 4Emory University School Of Medicine,Pediatrics,Atlanta, GA, USA
Introduction: According to the Lancet Commission on Global Surgery, over 5 billion people have deficient access to basic surgical and anesthetic care. The rapid global adoption of mobile health (mHealth) smartphone apps by healthcare providers provides opportunities to study global medical practice patterns, track access to care, and disseminate best practice information. App analytics, combined with in-app demographic surveys, can provide powerful tools for the collection of data in these areas.
Methods: We studied users of a free anesthesia calculator app used in nearly every country in the world. We combined traditional app analytics, with in-app surveys, to collect user demographics and feedback.
Results: Mining data on ~389k patient entries from 42,389 subjects in 206 countries, we found that most app uses were associated with the care of pediatric patients: ~79k (20%) of patient records were less than one month old, and ~281k (72%) were less than twelve years old. We observed significant differences in age of the patients (for which the app was consulted) as a function of country income level. Specifically, the proportion of neonates, infants, and toddlers was higher in lower income countries. We also observed significant differences in the hour of the day when the app was used; for neonates, infants, and toddlers, app uses were observed at a significantly higher rate in the evenings and at night in lower income countries.
Conclusions: Country income level appears to be an important predictor of the use of mHealth clinical decision support, which may suggest higher need for decision support in the care of this vulnerable population. Due to lack of available assistance, the increased rate of evening and nighttime procedures in lower income countries is potentially a very easy target for intervention in improving outcomes.