JMIR Publications

ABSTRACT

Background:

Age-related diseases such as dementia are playing an increasingly important role with regard to 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, the aim of this study is to address the question of what makes the use of an digital health application by physicians more likely.

Methods:

We developed and validated a novel measurement tool - the Digital-Health-Compliance-Questionnaire (DHCQ) - to assess the role of four proposed factors on the likelihood of using a health application. Therefore, a survey was conducted online that evaluated the likelihood of using a digital application for screening of Alzheimers’ 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. The study was completed by 331 physicians from Germany, of whom a total of 301 physicians fulfilled the study criteria (e.g., being in regular contact to dementia patients). This data was analysed 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 (Cronbachs-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 time of use”} and "likelihood of use" ranged from r = 0.29 to r = 0.79 as well as between “effort of collection” and "likelihood of use" at r = -0.80. In addition, we found high levels of skepticism regarding data protection and the age of the subjects was found to be negatively related to their technical experience as well as 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 in order to make the use of digital health applications more attractive for physicians because it can be adjusted to their everyday needs. Further research could explore the connection between areas such as adherence on patient side and its impact on the likelihood of use by the physician.