Smartphone and App Usage in Orthopedics and Trauma Surgery: Survey Study of Physicians Regarding Acceptance, Risks, and Future Prospects in Germany

Abstract

Background In the course of digitization, smartphones are affecting an increasing number of areas of users’ lives, giving them almost ubiquitous access to the internet and other web applications. Mobile health (mHealth) has become an integral part of some areas of patient care. In contrast to other disciplines, routine integration of mobile devices in orthopedics and trauma surgery in Germany is still in its infancy. Objective This study aimed to investigate physicians’ current state of opinion regarding acceptance, future prospects, and risks of medical apps in the field of orthopedics and trauma surgery in Germany. Methods A web-based survey among orthopedics and trauma surgeons in German university hospitals on the use of medical apps in everyday clinical practice was conducted between September 2018 and February 2019. The survey consisted of 13 open- and closed-ended or multiple-choice questions. A logistic regression analysis was performed to ascertain the effects of interindividual characteristics on the likelihood of participants’ app and smartphone usage behavior. Results A total of 206 physicians participated in the survey. All of the participants (206/206, 100%) owned a smartphone, and 79.1% (159/201) used the device, while 64.7% (130/201) used apps regularly in everyday clinical practice. Medical apps were perceived as beneficial, given their substantial future promise, by 90.1% (181/201) of the participants. However, 62.5% (120/192) of the participants were not satisfied with the current supply of medical apps in app stores. Desired specifications for future apps were “intuitive usability” (167/201, 83.1%), “no advertising” (145/201, 72.1%), and “free apps” (92/201, 45.8%). The attributes “transparent app development and app sponsoring” (75/201, 37.3%) and the existence of an “easy-to-understand privacy statement” (50/201, 24.9%) were of minor relevance. The majority of the participants (162/194, 83.5%) considered that future apps in the field of “medical research” would provide the greatest benefit. The greatest predicted risks were “data misuse” (147/189, 77.8%), “usage of untrustworthy apps” (135/189, 71.4%), and “alienation from patients” (51/189, 27.0%). Increasing age was significantly associated with a reduction in the likelihood of regular smartphone (odds ratio [OR] 0.91, 95% CI 0.86-0.97; P=.002) and app (OR 0.90, 95% CI 0.85-0.96; P=.001) usage, while the medical profession grade had no significant impact on the usage behavior. Conclusions The study demonstrates that young German doctors in orthopedics and trauma surgery already use smartphones and apps in everyday clinical practice. Medical apps are considered to play an important role in the future. However, a significant discrepancy exists between the supply and demand of mHealth applications, which creates a legal and ethical vacuum with regard to data protection.

The Use of Mobile Applications for the Diagnosis and Treatment of Tumors in Orthopaedic Oncology – a Systematic Review

“…The potential for new apps to be developed is great. According to Dittrich et al, 62.5% of users in orthopaedic and trauma surgery were dissatisfied with the current range of medical mobile applications in general [16]. Consistent with our results, Wong et al described that patient education and exercise programs made up the largest share of available applications.…”

“…The potential for new apps to be developed is great. According to Dittrich et al, 62.5% of users in orthopaedic and trauma surgery were dissatisfied with the current range of medical mobile applications in general [ 16 ].…”

“…They highlighted that only 39% had named medical professional involvement in their development or content [ 4 ]. In order to obtain a high-quality product, the involvement of physicians is indispensable in this process [ 16 ].…”

Acceptance, Barriers, and Future Preferences of Mobile Health Among Patients Receiving Trauma and Orthopedic Surgical Care: Paper-Based Survey in a Prospective Multicenter Study

“…Only a minority of the population stated the previous use of medical apps. Although many physicians use apps in their daily clinical routine, seemingly, not many consider medical apps to be important tools for patient care [8,9,18]. Consequently, very few patients reported having received a physician's recommendation for a medical app.…”

“…The use of smartphones and medical apps seems to be very popular among trauma surgeons and orthopedic surgeons as well. In Germany, the majority (79.1%) of trauma and orthopedic surgeons reported the use of smartphones and medical apps (64.4%) in their daily clinical routine [9]. Despite the extensive possibilities arising from the use of this evolving technology, the evidence base is currently still limited and there is a need for further studies [10,11].…”