Provider Adoption of mHealth in Rural Patient Care: Web-Based Survey Study (Preprint)

Abstract

BACKGROUND Physicians and patient-facing caregivers have increasingly utilized mobile health (mHealth) technologies in the past several years, accelerating during the COVID-19 pandemic. However, barriers and feedback surrounding adoption remains relatively understudied and varied across health systems, particularly in rural areas. OBJECTIVE We aimed to identify provider adoption, attitudes, and barriers towards mHealth in a large, multi-site, rural U.S. healthcare system. We investigated 1) m-Health apps that providers use for their own benefit, and 2) m-Health apps that a provider uses in conjunction with a patient. METHODS We surveyed all patient-seeing providers within the Marshfield Clinic Health System with a brief, 16 item, web-based survey assessing attitudes towards mHealth, adoption of these technologies, and perceived barriers faced by providers, their peers, and the institution. Survey results were summarized via descriptive statistics, with log-binomial regression and accompanying pairwise analyses, using Kruskal-Wallis and Jonckheere-Terpstra tests for significance, respectively. Respondents were grouped by reported clinical role and specialty. RESULTS We received a 38% response rate, with 61% of those sufficiently complete for analyses. Roughly 54% of respondents reported mHealth use, primarily around decision making and supplemental information, with use differing based on provider role and years of experience. Self-reported barriers to using mHealth included a lack of knowledge and time to study mHealth technologies. Providers also reported concerns about patients’ internet access and the complexity of mHealth apps to adequately utilize mHealth technologies. Providers believed the health system’s barriers were primarily privacy, confidentiality and legal review concerns. CONCLUSIONS These findings echo similar studies in other health systems, surrounding providers’ lack of time and concerns over privacy and confidentiality of patient data. Providers emphasized concerns over the complexity of these technologies for their patients, and concerns over patients’ internet access to fully utilize mHealth in their delivery of care.