Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: May 3, 2020
Date Accepted: Jun 9, 2020
Date Submitted to PubMed: Jun 9, 2020
Warning: This is an author submission that is not peer-reviewed or edited.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.
Using eHealth to support COVID-19 education, self-assessment and symptom monitoring: An observational study in The Netherlands.
ABSTRACT
Background:
The COVID-19 situation demands a lot from citizens, healthcare providers and governmental institutions. Citizens, for instance, need to cope with guidelines on social interaction, work, home-isolation and symptom recognition. Additionally, healthcare providers and policy makers have to cope with unprecedented and unpredictable pressure on the healthcare system they need to manage. By providing citizens with an app, they always have access to the latest information and can assess their own health. This data could be used to support policy makers and healthcare providers to get valuable insights in the regional distribution of infection load and healthcare consumption.
Objective:
The aim of this observational study was to assess people’s usage of an app to supports them with COVID-19 education, self-assessment and monitoring of their own health for a 7-day period. In addition, we aimed to assess the usability of this data for healthcare providers and policy makers by applying it to an interactive map and combining it with hospital data. The secondary outcomes of the study were user’s satisfaction with the information provided in the app, perceived usefulness of the app, health care providers they contacted and the follow-up actions from this contact.
Methods:
This observational cohort study was carried out at the non-academic teaching hospital “Elisabeth Twee Steden” (ETZ) in Tilburg, The Netherlands. From April 1st, 2020, onwards ETZ offered the COVID-19 education, self-assessment and symptom tracking diary to their already existing app for patient education and monitoring.
Results:
Between April 1st and April 20th, 2020, a total of 6194 people downloaded the app. The self-assessment functionality was used abundantly to check one’s health status. In total, 5104 people responded to the question about severe symptoms from which 242 indicated to suffer from severe symptoms. A total of 4929 people responded to the question about mild symptoms from which 3248 indicated to suffer from these (65.9%). The data was successfully applied to an interactive map, displaying user demographics and health status. Furthermore, the data was linked to clinical data and indicated an association between the number of app users with severe symptoms and the number of people tested positively for COVID-19 per postal code area. App users were satisfied with the information in the app (mean 8, 0-10 scale) and appreciated the symptom diary functionality (mean 8, 0-10 scale). In total, 102 users reached out to a healthcare provider, leading to 91 contacts.
Conclusions:
Our study demonstrated the successful implementation and use of an app with COVID-19 education, self-assessment and 7-day symptom diary. Overall, app users were satisfied with the information supplied through the app and appreciated its functionality. Data collected with the app were successfully applied to an interactive map, displaying postal code specific demographics, health status and healthcare consumption. In addition, we were able to link the data to COVID-19 screening results from the hospital’s microbiology laboratory, indicating an association between app users reporting severe symptoms and the number of patients that we tested positively for COVID-19 in the lab. This data could be used to support policy makers and healthcare providers to get valuable insights in the regional distribution of infection load and healthcare consumption. Clinical Trial: Netherlands Trial Register (NTR): 8501; https://www.trialregister.nl/trial/8501
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