Mobile technology: Usage and perspective of patients and caregivers presenting to a tertiary care emergency department

doi:10.5847/wjem.j.1920-8642.2020.01.001

Abstract

Abstract:

BACKGROUND: Developments in information technology (IT) have driven a push in healthcare innovation in the emergency department (ED). Many of these applications rely on mobile technology (MT) such as smartphones but not everyone is comfortable with MT usage. Our study aims to characterize the technology usage behavior of users in the ED so as to guide the implementation of IT interventions in the ED.

METHODS: A cross-sectional survey was conducted in the emergency department of a tertiary hospital. Patients and their caregivers aged 21 and above were recruited. The survey collected demographic information, technology usage patterns, and participant reported comfort level in the usage of MT. We performed descriptive statistics and multivariate logistic regression to identify factors differentially associated with comfort in usage of MT.

RESULTS: A total of 498 participants were recruited, and 299 (60%) were patients. English was the most commonly written and read language (66.9%) and 64.2% reported a comfort level of 3/5 or more in using MT. Factors that were associated with being comfortable in using MT include having a tertiary education, being able to read and write English, as well as being a frequent user of IT. Caregivers were more likely to display these characteristics.

CONCLUSION: A large proportion of ED patients are not comfortable in the usage of MT. Factors that predicted comfort level in the usage of MT were common amongst caregivers. Future interventions should take this into consideration in the design of MT interventions.

Key words: Mobile health technology, Information technology, Emergency department

Zhenghong Liu, Mingwei Ng, Dinesh V. Gunasekeran, Huihua Li, Kishanti Ponampalam, R Ponampalam. Mobile technology: Usage and perspective of patients and caregivers presenting to a tertiary care emergency department[J]. World Journal of Emergency Medicine, 2020, 11(1): 5-11.

Figures/Tables 3

Table 1

Characteristics and language usage of survey participants, n (%)

Variables	Overall (n=498)	Age (years)			Role
Variables	Overall (n=498)	21-40 (n=203)	40-60 (n=149)	>60 (n=146)	Patient (n=299)	Caregiver (n=199)
Mean age (years)	48.7 (SD 18.04; min 21 to max 90)	30.3 (SD 5.99)	51.4 (SD 5.72)	71.3 (SD 6.32)	50.8 (SD 15.41)	45.6 (SD 19.34)
Male	256 (51.5)	111 (54.7)	76 (51.0)	69 (47.6)	166 (55.5)	90 (45.5)
Role
Caregiver	199 (40.0)	88 (43.3)	75 (50.3)	36 (24.7)	-	-
Patient	299 (60.0)	115 (56.7)	74 (49.7)	110 (75.3)	-	-
Race
Chinese	317 (63.9)	105(52.2)	96 (64.4)	116 (79.5)	187 (62.5)	130 (66.0)
Malay	72 (14.5)	43 (21.4)	16 (10.7)	13 (8.9)	42 (14.0)	30 (15.2)
Indian	79 (15.9)	41 (20.4)	25 (16.8)	13 (8.9)	51 (17.1)	28 (14.2)
Others	28 (5.6)	12 (6.0)	12 (8.1)	4 (2.7)	19 (6.4)	9 (4.6)
Education
Primary	88 (18.9)	18 (9.1)	22 (!5.3)	48 (38.7)	73 (26.4)	15 (7.9)
Secondary	132 (28.3)	39 (19.7)	49 (34.0)	44 (35.5)	84 (30.4)	48 (25.3)
Tertiary	246 (52.8)	141 (71.2)	73 (50.7)	32 (25.8)	119 (43.1)	127 (66.8)
Employment
Unemployed/student	74 (15.2)	21 (10.5)	37 (25.2)	16 (11.2)	42 (14.3)	32 (16.5)
Employed	313 (62.9)	177 (88.9)	102 (69.4)	34 (23.8)	177 (60.2)	136 (69.7)
Retired	102 (20.5)	1 (0.5)	8 (5.4)	93 (65.0)	75 (25.5)	27 (13.8)
Read/write
English	333 (66.9)	174 (85.7)	109 (73.2)	50 (34.2)	171 (57.2)	162 (81.4)
Mandarin	267 (53.6)	98 (48.3)	81 (54.4)	88 (60.3)	155 (51.8)	112 (56.3)
Malay	111 (22.3)	57 (28.1)	35 (23.5)	19 (13.0)	67 (22.4)	44 (22.1)
Tamil	54 (10.8)	33 (16.3)	12 (8.1)	9 (6.2)	37 (12.4)	17 (8.5)
Others	17 (3.4)	9 (4.4)	5 (3.4)	3 (2.1)	10 (3.3)	7 (3.5)
Speak
English	359 (72.1)	186 (91.6)	118 (79.2)	55 (37.7)	196 (65.6)	163 (81.9)
Mandarin	291 (58.4)	101 (49.8)	87 (58.4)	103 (70.5)	174 (58.2)	117 (58.8)
Malay	135 (27.1)	64 (31.5)	41 (27.5)	30 (20.5)	82 (27.4)	53 (26.6)
Tamil	64 (12.9)	35 (17.2)	17 (11.4)	12 (8.2)	42 (14.0)	22 (11.1)
Others	38 (7.6)	9 (4.4)	17 (11.4)	12 (8.2)	22 (7.4)	16 (8.0)

Table 1

Table 2

Baseline technology use and comfort level in technology use, n (%)

Variables	Overall (n=498)	Age (years)			Role
Variables	Overall (n=498)	21-40 (n=203)	40-60 (n=149)	>60 (n=146)	Patient (n=299)	Caregiver (n=199)
Baseline technology usage
Mobile phone owner	470 (94.4)	202 (99.5)	143 (96.0)	125 (85.6)	276 (92.3)	194 (97.5)
Smartphone owner	378 (76.1)	196 (96.6)	119 (79.9)	63 (43.4)	199 (66.8)	179 (89.9)
Regular computer usage	288 (57.9)	167 (82.7)	93 (62.4)	28 (19.2)	138 (46.3)	150 (75.4)
Able to access internet at home	376 (75.8)	195 (96.1)	120 (80.5)	61 (42.4)	197 (66.1)	179 (90.4)
Able to access internet at work	322 (66.0)	182 (91.0)	102 (70.3)	38 (26.6)	167 (56.6)	155 (80.3)
Has mobile internet data	361 (72.6)	192 (94.6)	118 (79.2)	51 (35.2)	186 (62.4)	175 (87.9)
Has restrictions on internet use	134 (28.1)	77 (38.3)	36 (25.0)	21 (15.9)	76 (26.5)	58 (30.5)
IT usage patterns
Frequency of internet use
< Once a week	139 (28.1)	11 (5.4)	37 (25.2)	91 (63.2)	115 (38.7)	24 (12.2)
Once a week	10 (2.0)	3 (1.5)	1 (0.7)	6 (4.2)	9 (3.0)	1 (0.5)
2-6 times a week	51 (10.3)	19 (9.4)	16 (10.9)	16 (11.1)	34 (11.4)	17 (8.6)
Daily	32 (6.5)	8 (3.9)	15 (10.2)	9 (6.3)	16 (5.4)	16 (8.1)
Many times a day	262 (53.0)	162 (79.8)	78 (53.1)	22 (15.3)	123 (41.4)	139 (70.6)
Frequency of email use
< Once a week	159 (32.1)	13 (6.4)	43 (29.1)	103 (71.5)	126 (42.4)	33 (16.7)
Once a week	27 (5.5)	14 (6.9)	9 (6.1)	4 (2.8)	17 (5.7)	10 (5.1)
2-6 times a week	68 (13.7)	34 (16.7)	24 (16.2)	10 (6.9)	38 (12.8)	30 (15.2)
Daily	62 (12.5)	46 (17.7)	14 (9.5)	12 (8.3)	33 (11.1)	29 (14.6)
Many times a day	179 (36.2)	106 (52.2)	58 (39.2)	15 (10.4)	83 (27.9)	96 (48.5)
Frequency of social media use
< Once a week	171 (34.6)	15 (7.4)	48 (32.4)	108 (75.5)	131 (44.3)	40 (20.2)
Once a week	21 (4.3)	7 (3.4)	9 (6.1)	5 (3.5)	16 (5.4)	5 (2.5)
2-6 times a week	50 (10.1)	22 (10.8)	19 (12.8)	9 (6.3)	29 (9.8)	21 (10.6)
Daily	57 (11.5)	31 (15.3)	18 (12.2)	8 (5.6)	29 (9.8)	28 (14.1)
Many times a day	195 (39.5)	128 (63.1)	54 (36.5)	13 (9.1)	91 (30.7)	104 (52.5)
Comfort level with MHT
Comfortable sending messages on mobile device (≥3)	352 (71.1)	192 (94.6)	111 (75.1)	49 (34.0)	181 (60.9)	177 (86.3)
Comfortable receiving messages on mobile device (≥3)	354 (71.3)	190 (93.5)	110 (74.3)	54 (37.2)	184 (61.8)	170 (85.9)
Comfortable using English on mobile device (≥3)	317 (64.2)	172 (84.7)	103 (70.0)	42 (29.1)	154 (52.1)	163 (82.3)

Table 2

Table 3

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Variables	Comfortable in using MT
Variables	Yes	No	P
Age (n=494)
≤60	275 (78.6)	75 (21.4)	0.001
>61	42 (29.1)	102 (70.8)
Sex (n=493)
Male	156 (61.4)	98 (38.6)	0.168
Female	161 (67.4)	78 (32.6)
Caregiver status (n=494)
Patient	154 (52.0)	142 (48.0)	0.001
Caregiver	163 (82.3)	35 (17.7)
Education (n=462)
Secondary and below	86 (39.4)	132 (60.6)	0.001
Tertiary	225 (92.2)	19 (7.8)
Employment (n=485)
Employed	247 (79.4)	64 (20.6)	0.001
Unemployed	66 (37.9)	108 (62.1)
Reads/writes English (n=494)
Yes	299 (90.9)	30 (9.1)	0.001
No	18 (10.9)	147 (89.1)
Owns a smartphone (n=493)
Yes	297 (79.0)	79 (21.0)	0.001
No	19 (16.2)	98 (83.8)
Has mobile internet data (n=493)
Yes	299 (83.3)	60 (16.7)	0.001
No	18 (13.4)	116 (86.6)
Frequent IT user (n=492)
Yes	274 (94.5)	16 (5.5)	0.001
No	42 (20.8)	160 (79.2)

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