JMIR Publications

ABSTRACT

Background:

In the course of digitalization, smartphones are affecting more and more areas of life giving the user mobile and almost ubiquitous access to the internet and other web applications. The advantages of Mobile Health (mHealth) are an integral part in some areas of patient care. In contrast to other disciplines, routine integration of mobile devices in orthopaedics and trauma surgery in Germany is still in its very infancy.

Objective:

Knowledge of the actual physicians´ state of opinion regarding acceptance, future prospects and risks is essential in order to develop a stringent but dynamic-adaptive mHealth strategy in the fields of German orthopaedics and trauma surgery in the future.

Methods:

Between September 2018 and February 2019, an online survey among orthopaedics and trauma surgeons in German-speaking countries 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 inter-individual characteristics on the likelihood of participants´ app and smartphone usage behaviour.

Results:

A total of 206 physicians participated in the survey. All participants owned a mobile device 206/206 (100%) and used smartphones 159/201 (79.1%) or apps 130/201 (64.4%) regularly in everyday clinical practice. Benefits of medical apps were seen as highly promising for the future 181/201 (90.1%). However, 120/192 (62.5%) were not satisfied with the current supply of medical apps in the appstores. Desired specifications for future apps were “intuitive usability” 167/201 (83.1%), “no advertising” 145/201 (72.1%) and “free of app-charge” 92/201 (45.8%). The attributes "transparent app-development and -sponsoring" 75/201 (37.3%) and the existence of an "easy-to understand privacy statement" 50/201 (24.9%) were of minor relevance. In the field of “medical research” 162/194 (83.5%), future apps were considered to provide the greatest benefit. Greatest risks were predicted for “data-misuse” 147/189 (77.8%), the “usage of unserious Apps” 135/189 (71.4%) and the “alienation from patients” 51/189 (27.0%). Increasing age was significantly associated with a reduction in the likelihood of regular smartphone (odds ratio: 0.91, P= .002) and app (odds ratio: 0.90, P= .001) usage, while the grade of medical profession had no significant impact on the usage behaviour.

Conclusions:

The study demonstrates that German orthopedic and trauma surgeons already use smartphones and apps on a regular basis in everyday clinical practice. Medical apps are considered to play an important role in the future. But there is still a significant discrepancy between the supply of mHealth applications and the demand, which creates a (data protection) legal and ethical vacuum. Therefore, it is up to German clinicians to remain open to digital innovations, to question them critically and to define and actively shape the role of smartphones in the context of medicine.