Health Maintenance Organization–mHealth Versus Face-to-Face Interaction for Health Care in Israel: Cross-Sectional Web-Based Survey Study (Preprint)

Abstract

BACKGROUND Health Maintenance Organization-Mobile Health (HMO-mHealth) services have a direct impact on patients' daily lives, and HMOs are regularly expanding their range of mHealth services. HMO-mHealth are saving HMOs time and money, and the services are becoming more accessible to patients. However, the willingness to use mHealth apps depends on user perception. Although mHealth apps can change the relationship dynamic between HMOs and patients, patients prefer to use them to facilitate face-to-face interactions rather than replace them. OBJECTIVE This study aims to examine the extent to which adults in Israel prefer adopting healthcare services using HMO-mHealth as a replacement for face-to-face interaction. METHODS Israeli adults aged ≥18 years completed the questionnaire. The data collection period was from December 2020 to February 2021. 6,321 respondents (68% female and 32% male) could only complete the questionnaire once electronically. All services available in the main HMO-mHealth apps of the four Israeli HMOs were mapped. The 29 healthcare services used in this study were identical in all four HMO-mHealth apps in Israel. The association between sociodemographic characteristics and health condition with preference for HMO-mHealth or face-to-face interaction was analyzed separately for each healthcare service using a logistic model. RESULTS Seven main variables were found to influence HMO-mHealth adoption, including: gender, age, education, marital status, religious affiliation, and subjective health condition. Females were more likely to prefer HMO-mHealth apps for administrative matters and face-to-face interaction for personal medical diagnosis or treatment (OR:0.74, p<.001 and 0.82 p<.001, respectively). Married individuals preferred using HMO-mHealth app more than a face-to-face meeting to obtain a new medical diagnosis (OR:1.31, p<.001) or treatment (OR:1.34, p<.001). A better subjective perception of health condition was found to be associated with an increased preference for the use of HMO-mHealth apps. No significant association was found between the presence of a chronic disease and the preferred mode of interaction for most services. CONCLUSIONS HMO-mHealth is proving to be a robust and efficient tool for the delivery of healthcare services when compared to face-to-face healthcare interactions. However, there are still barriers that affect vulnerable populations when adopting HMO-mHealth. To address existing disparities, it is important to tailor HMO-mHealth apps to older adults, the chronically ill, and minorities in society, as these groups have an even greater need for these services. Such customizations are essential to mitigating healthcare disparities in Western societies. To provide an optimal response to these populations, future studies should focus on identifying the barriers that affect the utilization of HMO-mHealth in these groups.