O'Reilly-Shah Vikas, Easton George, Gillespie Scott
Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Department of Pediatric Anesthesiology, Children's Healthcare of Atlanta, Atlanta, GA, USA.
BMJ Glob Health. 2017 Aug 6;2(3):e000299. doi: 10.1136/bmjgh-2017-000299. eCollection 2017.
The rapid global adoption of mobile health (mHealth) smartphone apps by healthcare providers presents challenges and opportunities in medicine. Challenges include ensuring the delivery of high-quality, up-to-date and optimised information. Opportunities include the ability to study global practice patterns, access to medical and surgical care and continuing medical education needs.
We studied users of a free anaesthesia calculator app used worldwide. We combined traditional app analytics with in-app surveys to collect user demographics and feedback.
31 173 subjects participated. Users were from 206 countries and represented a spectrum of healthcare provider roles. Low-income country users had greater rates of app use (p<0.001) and ascribed greater importance of the app to their practice (p<0.001). Physicians from low-income countries were more likely to adopt the app (p<0.001). The app was used primarily for paediatric patients. The app was used around the clock, peaking during times typical for first start cases.
This mHealth app is a valuable decision support tool for global healthcare providers, particularly those in more resource-limited settings and with less training. App adoption and use may provide a mechanism for measuring longitudinal changes in access to surgical care and engaging providers in resource-limited settings. In-app surveys and app analytics provide a window into healthcare provider behaviour at a breadth and level of detail previously impossible to achieve. Given the potentially immense value of crowdsourced information, healthcare providers should be encouraged to participate in these types of studies.
医疗保健提供者在全球范围内迅速采用移动健康（mHealth）智能手机应用程序，这给医学带来了挑战和机遇。挑战包括确保提供高质量、最新且经过优化的信息。机遇包括研究全球实践模式、获得医疗和外科护理以及满足继续医学教育需求的能力。
我们研究了一款全球使用的免费麻醉计算器应用程序的用户。我们将传统的应用程序分析与应用内调查相结合，以收集用户的人口统计学信息和反馈。
31173名受试者参与了研究。用户来自206个国家，代表了一系列医疗保健提供者角色。低收入国家的用户应用程序使用率更高（p<0.001），并且认为该应用程序对他们的实践更为重要（p<0.001）。低收入国家的医生更有可能采用该应用程序（p<0.001）。该应用程序主要用于儿科患者。该应用程序全天候使用，在首次开始手术的典型时间段达到使用高峰。
这款移动健康应用程序是全球医疗保健提供者的宝贵决策支持工具，尤其是那些资源有限且培训较少的提供者。应用程序的采用和使用可能提供一种机制，用于衡量获得外科护理的纵向变化，并使资源有限环境中的提供者参与其中。应用内调查和应用程序分析为医疗保健提供者的行为提供了一个窗口，其广度和详细程度是以前无法实现的。鉴于众包信息可能具有巨大价值，应鼓励医疗保健提供者参与这类研究。
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