JMIR Publications

ABSTRACT

Background:

Age-related diseases such as dementia are playing an increasingly important role in global population development. Thus, prevention, diagnostics, and interventions require more accessibility, which can be realized through digital health applications. With the "app on prescription" Germany made history by being the first country worldwide to offer physicians the possibility to prescribe and reimburse digital health applications starting by the end of the year 2020.

Objective:

Considering the lack of knowledge about correlations with the likelihood of use among physicians, this study aims to address the question of what makes the use of a digital health application by physicians more likely.

Methods:

We developed and validated a novel measurement tool - the Digital-Health-Compliance-Questionnaire (DHCQ) – in an interdisciplinary collaboration of experts to assess the role of proposed factors on the likelihood of using a health application. Therefore, an online survey was conducted to evaluate the likelihood of using a digital application to screen for Alzheimer’s dementia called DemPredict. Within this survey, five latent dimensions (acceptance, attitude towards technology, technology experience, payment for time of use, and effort of collection), the dependent variable "likelihood of use" and answers to exploratory questions were recorded and tested within directed correlations. Following a non-probability-sampling strategy, the study was completed by 331 physicians from Germany in the German language, of whom a total of 301 physicians fulfilled the study criteria (e.g. being in regular contact with dementia patients). This data was analyzed using a range of statistical methods to validate the DHCQs’ dimensions.

Results:

The DHCQ revealed good test theoretical measures: it showed excellent fit indices (TLI = .98, CFI = .982, SRMR = .073, RMSEA = .037), good internal consistency (Cronbach’s alpha = .83) and showed signs of moderate to large correlations between the DHCQ-dimensions and the dependent variable. The correlations between {“acceptance”|“attitude towards technology”|“technology experience”|“payment for the time of use”} and "likelihood of use" ranged from r = 0.29 to r = 0.79 as well as between “effort of the collection” and "likelihood of use" at r = -0.80. In addition, we found high levels of skepticism regarding data protection as well as the age of the subjects was found to be negatively related to their technical experience and their attitude towards technology.

Conclusions:

In the context of the results, increased communication between the medical and technology sectors and significantly more awareness rising are recommended to make the use of digital health applications more attractive for physicians because they can be adjusted to their everyday needs. Further research could explore the connection between areas such as adherence on the patient side and its impact on the likelihood of use by the physician.