Anglia Ruskin University, Cambridge, United Kingdom.
University of Applied Sciences Northwestern Switzerland, Brugg, Switzerland.
JMIR Mhealth Uhealth. 2020 Sep 23;8(9):e20203. doi: 10.2196/20203.
Mobile health (mHealth) tools have shown promise in clinical photo and wound documentation for their potential to improve workflows, expand access to care, and improve the quality of patient care. However, some barriers to adoption persist.
This study aims to understand the social, organizational, and technical factors affecting clinicians' adoption of a clinical photo documentation mHealth app and its implications for clinical workflows and quality of care.
A qualitative case study of a clinical photo and wound documentation app called imitoCam was conducted. The data were collected through 20 in-depth interviews with mHealth providers, clinicians, and medical informatics experts from 8 clinics and hospitals in Switzerland and Germany.
According to the study participants, the use of mHealth in clinical photo and wound documentation provides numerous benefits such as time-saving and efficacy, better patient safety and quality of care, enhanced data security and validation, and better accessibility. The clinical workflow may also improve when the app is a good fit, resulting in better collaboration and transparency, streamlined daily work, clinician empowerment, and improved quality of care. The findings included important factors that may contribute to or hinder adoption. Factors may be related to the material nature of the tool, such as the perceived usefulness, ease of use, interoperability, cost, or security of the app, or social aspects such as personal experience, attitudes, awareness, or culture. Organizational and policy barriers include the available clinical practice infrastructure, workload and resources, the complexity of decision making, training, and ambiguity or lack of regulations. User engagement in the development and implementation process is a vital contributor to the successful adoption of mHealth apps.
The promising potential of mHealth in clinical photo and wound documentation is clear and may enhance clinical workflow and quality of care; however, the factors affecting adoption go beyond the technical features of the tool itself to embrace significant social and organizational elements. Technology providers, clinicians, and decision makers should work together to carefully address any barriers to improve adoption and harness the potential of these tools.
移动医疗 (mHealth) 工具在临床照片和伤口记录方面显示出了潜力，有望改善工作流程、扩大医疗服务的可及性并提高患者护理质量。然而，一些采用障碍仍然存在。
本研究旨在了解影响临床医生采用临床照片记录 mHealth 应用程序的社会、组织和技术因素，以及其对临床工作流程和护理质量的影响。
对一款名为 imitoCam 的临床照片和伤口记录应用程序进行了定性案例研究。数据通过对来自瑞士和德国 8 家诊所和医院的 20 名 mHealth 提供者、临床医生和医学信息学专家的 20 次深入访谈收集。
根据研究参与者的说法，在临床照片和伤口记录中使用 mHealth 具有许多好处，例如节省时间和提高效率、更好的患者安全性和护理质量、增强数据安全性和验证性、以及更好的可及性。当应用程序适配临床工作流程时，临床工作流程也可能得到改善，从而提高协作和透明度、简化日常工作、增强临床医生的能力并提高护理质量。研究结果包括可能促进或阻碍采用的重要因素。这些因素可能与工具的物质性质有关，例如应用程序的感知有用性、易用性、互操作性、成本或安全性，也可能与个人经验、态度、意识或文化等社会方面有关。组织和政策障碍包括现有的临床实践基础设施、工作量和资源、决策的复杂性、培训以及法规的模糊性或缺乏。用户在开发和实施过程中的参与是 mHealth 应用程序成功采用的重要因素。
mHealth 在临床照片和伤口记录方面的有前景的潜力是明确的，可能会增强临床工作流程和护理质量；然而，影响采用的因素不仅限于工具本身的技术特点，还包括重要的社会和组织因素。技术提供商、临床医生和决策者应共同努力，认真解决任何采用障碍，以提高采用率并充分发挥这些工具的潜力。
