Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 24, 2019
Open Peer Review Period: Jul 26, 2019 - Aug 21, 2019
Date Accepted: Oct 20, 2019
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Understanding user experience with SecondEars: a mixed-methods implementation study of a consultation audio-recording app
ABSTRACT
Background:
Healthcare systems are increasingly looking to mobile device technologies (mHealth) to improve patient experience and health outcomes. SecondEars is a smartphone app designed to allow patients to audio-record medical consultations to improve recall, understanding, and healthcare self-management. Novel health interventions such as SecondEars often fail to be implemented post pilot-testing due to inadequate user experience (UX) assessment as one key component of a comprehensive implementation strategy
Objective:
The purpose of this study was to pilot the SecondEars app within an active clinical setting to identify factors necessary for optimal implementation. Objectives were to: a) investigate patient UX and acceptability, utility, and satisfaction with the SecondEars app, and b) understand health professional perspectives on issues, solutions and strategies for effective implementation of SecondEars.
Methods:
A mixed-methods implementation study was employed. Patients were invited to test the app to record consultations with participating oncology health professionals. Follow-up interviews were conducted with all participating patients (or carers), and health professionals, regarding uptake and extent of app use. Responses to the Mobile App Rating Scale were also collected. Interviews were analysed using interpretive descriptive methodology; all quantitative data were analysed descriptively.
Results:
A total of 24 patients used SecondEars to record consultations with 10 multidisciplinary health professionals. Twenty-two of these patients used SecondEars to listen to all or part of the recording, either alone or with family. One hundred percent of patient participants reported in the MARS that they would use SecondEars again, and recommend it to others. Three themes were identified from the patient interviews relating to the UX of SecondEars: empowerment; facilitating support in cancer care; and usability. Five themes were identified from the health professional interviews relating to implementation of SecondEars: changing hospital culture; mitigating medico-legal concerns; improving patient care; communication; and practical implementation solutions.
Conclusions:
Data collected during pilot testing regarding recording use, UX and health professional and patient perspectives will be useful to design an effective implementation strategy for SecondEars. Those testing the app found it useful, and felt that it could facilitate the benefits of consultation recordings, along with providing patient empowerment and support. Potential issues regarding implementation were discussed, and solutions generated. Clinical Trial: Australia and New Zealand Clinical Trials Registry [ACTRN12618000730202].
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