JMIR Publications

ABSTRACT

Background:

In October 2020, Germany became the first country worldwide to approve certain mHealth applications (German: “Digitale Gesundheitsanwendung” or ”DiGA”) for prescription with costs covered by standard statutory health insurance. Yet, this option has hardly been used so far.

Objective:

The objective of this study was to investigate physicians’ and psychotherapists’ current attitudes toward mHealth applications, barriers to adoption and potential remedies.

Methods:

We conducted a two-stage sequential mixed-methods study. In phase one, semi-structured interviews were conducted with physicians and psychotherapists for questionnaire design until thematic saturation was reached. In phase two, an online survey was conducted among physicians and psychotherapists.

Results:

1308 survey responses by mostly outpatient-care physicians and psychotherapists who could prescribe DiGA from across Germany were recorded, making this the largest study on mHealth prescriptions to date. 62% of respondents support the opportunity to prescribe DiGA. Improved adherence (77%), health literacy (65%) and disease management (61%) were most frequently seen as benefits from DiGA. Yet, only 32% of respondents plan to prescribe DiGA, varying greatly by medical specialty. Professionals are still facing substantial barriers such as insufficient information (87%), reimbursement for DiGA-related medical services and medical evidence (both 55%), as well as legal (52%) and technological uncertainties (51%). To support professionals unsure of prescribing DiGA, extended information campaigns (85%), recommendations from medical associations (80%) and medical colleagues (79%) were seen as the most impactful remedies.

Conclusions:

To realize the benefits from DiGA through increased adoption, additional information sharing about DiGA from trusted bodies, reimbursement for doctoral services related to DiGA and further medical evidence are recommended.