An Explorative Analysis of the Use of Mobile Device App for Communication between Physician and Patient in the Context of a Private Sector Hospital in Riyadh, Saudi Arabia
Introduction:
Mobile technology has produced many opportunities to increase the quality of health care services. The opportunity to mobile communication could create bountiful improvements in patient care but there are many questions left unanswered. Before a mobile communication app can be implemented the risks and limitations of the software need to be carefully analyzed. A hasty implementation could cause a great opportunity for patient care to fail. The proposed research program will examine the attitudes and beliefs of the key stakeholders, doctors and patients, to determine key recommendations towards the implementation of the mobile communication tool.
Statement of problem:
Mobile technology yields endless opportunities to increase patient care but implementing the drastic technological changes into a clinical setting poses many obstacles.
Purpose of study:
Private hospitals pride themselves in the exemplary care they provide to their patients, an app that mobilizes patient-doctor communication can minimize the time patients wait to communicate with their physician. The purpose of this study is to gain insight into the attitudes and beliefs of doctors and patients about the use of a mobile app to facilitate communication between the two parties. The results of the research can be used to improve the communication between doctors and patients by identifying barriers affecting their communication.
Theoretical perspective:
Two theories that set out to describe how physicians response to the use of mobile technology in a clinical setting are Davis’ theory in 1989 -Technology Acceptance Model [TAM] and the Actor-Network Theory. The Technology Acceptance Model sets out to describe the process that technology users to come accept and use technology. The TAM theory assumes that users will base their acceptance of new technology based on the perceived usefulness and how they perceive the ease of use of the proposed technology (Lala, 2014). Meanwhile, the Actor-Network Theory sets out to examine the functional network created by the regular shared activities of humans and objects (McBride, 2003). The two theories combined will illustrate the cognitive reaction physicians may have when mobile patient communication technology is introduced to a clinical setting.
Research questions:
R1) What are the barriers that affect the implementation of a mobile app that facilitates communication between doctors and patients?
R2)What risks does a mobile app pose when used to facilitate doctor-patient communication?
R3)What are the attitudes of doctors and patients about the use of a mobile app to communicate with the other party?
Delimitations:
The Technology Acceptance Model [TAM] and the Actor-Network Theory provides guidance to the anticipants responses users have with new technology but offers very little feedback into the individual factors applied in the specific context of a private hospital in Riyadh, Saudi Arabia. The theories best describe the reactions users have when technology is introduced into their daily lives the context of the situation will be best served by an in-depth analysis of the individual scenario.
Limitations:
Limitations of this study include a small geographical scope along with the limitations of the mixed method research structure. The interview structure will yield intimate details from the participating physicians but the small sample size will pose further limitations. The results of interview-based research can rarely be reproduced causing limitations to the validity and reliability of the results of the proposed research study. The proposed study will be conducted at a private hospital in Riyadh, Saudi Arabia. The study’s results will not provide data that can be accurately transferred to another geographical location. The study will focus upon a specific situation faced by one private hospital and may not be accurately representative of a larger population. The interview based research structure along with the narrow sample group is the two anticipated limitations; however, further limitations may arise during the course of the research.
Review of Literature
Physician -Patient Mobile Communication
Alsos, O., Das, A., & Svanæs, D. (2012). Mobile health IT: The effect of user interface and form factor on doctor–patient communication. International Journal of Medical Informatics, 81(1), 12-28. http://dx.doi.org/10.1016/j.ijmedinf.2011.09.004
Dwivedi, Y. K., Shareef, M. A., Simintiras, A. C., Lal, B., & Weerakkody, V. (2015). A generalised adoption model for services: A cross-country comparison of mobile health (m-health). Government Information Quarterly, doi:10.1016/j.giq.2015.06.003
Freiwat, H. (2015, August 10). Why physicians must develop a mobile technology strategy. Medical Economics, 92(15), 52+. Retrieved from http://ra.ocls.ca/ra/login.aspx?inst=conestoga&url=http://go.galegroup.com.eztest.ocls.ca/ps/i.do?&id=GALE%7CA426999472&v=2.1&u=conestoga&it=r&p=AONE&sw=w&asid=2b8c88ee0c47dd9134be67701fea60cc
Gordon, C. R., Rezzadeh, K. S., Li, A., Vardanian, A., Zelken, J., Shores, J. T., & Jarrahy, R. (2015). Digital mobile technology facilitates HIPAA-sensitive perioperative messaging, improves physician-patient communication, and streamlines patient care. Patient Safety in Surgery, 9(1), 1-7. doi:10.1186/s13037-015-0070-9
Hampshire, K., Porter, G., Owusu, S., Mariwah, S., Abane, A., & Robson, E. et al. (2015). Informal m-health: How are young people using mobile phones to bridge healthcare gaps in Sub-Saharan Africa?. Social Science & Medicine, 142, 90-99. http://dx.doi.org/10.1016/j.socscimed.2015.07.033
Lala (Fădor), G. (2014). The Emergence and Development of the Technology Acceptance Model (TAM). Proceedings of the International Conference Marketing - From Information to Decision, 7149-160.
Leventhal, R. (2015). The Mobile Patient: How mHealth Tools are Paving the Way for Better Care Management. Healthcare Informatics, 32(3), 16-20 5p.
McBride, N.. (2003). Actor-Network Theory and the Adoption of Mobile Communications. Geography, 88(4), 266–276. Retrieved from http://www.jstor.org/stable/40573881
Morrissey, J. (2014, July 10). Remote patient monitoring: mobile devices move in to curb chronic conditions. Medical Economics, 91(13), 18+. Retrieved from http://ra.ocls.ca/ra/login.aspx?inst=conestoga&url=http://go.galegroup.com.eztest.ocls.ca/ps/i.do?&id=GALE%7CA376205948&v=2.1&u=conestoga&it=r&p=AONE&sw=w&asid=cc64c127322281122d929284014e7cfe
Pourfakhran, M., Mostafapour, E., Hosseini, E., Mostafapour, A., Arash Javad Mousavi, S., & Hasan Pourfakhran, M. (2013). Case Report: Sending blood glucose level of a diabetic patient to physician by Global system for Mobile Communications in diabetic patients. Razi Journal of Medical Sciences, 20(107), 73-77 5p.
Schuman, A. J. (2013). Improving patient care: Smartphones and mobile medical devices. Contemporary Pediatrics, 30(6), 33-37 5p.
Standards Activities Respond to Consumer Mobile Health IT Trends. (2016). Journal of AHIMA, 87(1), 40-43 4p.
Terry, K. (2015, June 25). Prescribing mobile apps: what to consider: lessons that other physicians have learned about using mobile apps to help treat patients. Medical Economics, 92(12), 35+. Retrieved from http://ra.ocls.ca/ra/login.aspx?inst=conestoga&url=http://go.galegroup.com.eztest.ocls.ca/ps/i.do?&id=GALE%7CA421082709&v=2.1&u=conestoga&it=r&p=AONE&sw=w&asid=7859321581bdd05eb8b1297d6b43e255
Varshney, U. (2014). Mobile health: Four emerging themes of research. Decision Support Systems, 66, 20-35. http://dx.doi.org/10.1016/j.dss.2014.06.001
Wnats new in "connected" medical devices? Physicians and parents are adopting a host of health-related tools that communicate with smartphones and tablets. Here are the latest worth checking out. (2015). Contemporary Pediatrics, 32(11), 43-46 4p.
Riyadh, Saudi Arabia Specific Literature
Alasmary, M., Metwally, A., & Househ, M. (2014). The Association between Computer Literacy and Training on Clinical Productivity and User Satisfaction in Using the Electronic Medical Record in Saudi Arabia. Journal Of Medical Systems, 38(8), 1-13 13p. doi:10.1007/s10916-014-0069-2
Melly, P. (2014). Hospitals Trial Smart Technology. Meed: Middle East Economic Digest, 8-9.
Rich, A. K. (2015). Riyadh, Saudi Arabia. Salem Press Encyclopedia,
Saudi Arabia. (2015). Funk & Wagnalls New World Encyclopedia, 1p. 1.
Saudi Arabia: A future regional hub for advanced education, research, science and technology. (2015, October 31). Journal of Pakistan Medical Association, 65(10). Retrieved from http://ra.ocls.ca/ra/login.aspx?inst=conestoga&url=http://go.galegroup.com.eztest.ocls.ca/ps/i.do?&id=GALE%7CA431353136&v=2.1&u=conestoga&it=r&p=AONE&sw=w&asid=c49f69474dcf63517589ec85558f280a
Saudi Arabia has made huge investment in science and technology infrastructure. (2015). Pulse International, 16(14), 7-9.
Saudi Arabia : MoH enters strategic partnership to enhance e-health services. (2016, January 12). Mena Report. Retrieved from http://ra.ocls.ca/ra/login.aspx?inst=conestoga&url=http://go.galegroup.com.eztest.ocls.ca/ps/i.do?&id=GALE%7CA439697510&v=2.1&u=conestoga&it=r&p=AONE&sw=w&asid=07931870d8ab42c5b638a8d01688a126
Methods
Type of research design:
The proposed research program is two sided. A mix method design will allow for two separate assessments to be conducted and later compared. Interviews with physicians will allow for more in-depth analysis of the factors perceived by the physicians affecting the use of a mobile app to facilitate physician – patient communication. Meanwhile a questionnaire is best suited for the purpose of obtaining feedback from patients about their opinions on the use of an app to facilitate communication with a physician.
Sample and participants:
The two research tools used with each have a separate group of targeted participants. In order to gain insight from the physicians ten participants will be interviewed. The physicians will be chosen on an availability basis. Meanwhile, the survey will aim for a minimum of 100 participants. A convenience sample of participants will be used. Patients will be targeted in the waiting room both in person and through promotion of the online survey.
Role of researcher:
The role of the researcher is to ensure that the research produces highest quality of results using ethical research principals. The researcher will obtain the required authorization from the hospital along with full disclosure authorization in writing from all participants. The researcher will ensure that the data collected will remain anonymous and all findings will remain confidential until the study’s results are disclosed. The researcher will conduct ten interviews that will run the duration of 20 – 40 minutes each and collect the results of 100 questionnaires which will require 15-20 minutes of participation from the respondents. The researcher will perform the research during a three month stay in Riyadh.
Data collection:
The researcher will disseminate the research findings and create digital files of the research. All data collected will be stored on the designated laptop for a period of up to five years.
Instruments and materials:
The study will use two different research tools and implements for the two targeted groups of the study. The qualitative analysis will be recorded using the NVivo Software while, the quantitative analysis will be recorded using SPSS software.
Data analysis procedures:
Once sufficient data has been collected the findings will be analyzed in an attempt to discover the trends and patterns within the information. The exact questions asked and the answers provided by participants will determine the best procedure for disseminating the data. The results of the questionnaires will the tallied and plotted into a table before being analyzed for correlations. Meanwhile the interviews will be transcribed and examined using narratology and ethnographic analysis tools. The responses to the interviews will be analyzed to determine if there are any strong patterns in the participant’s responses.
Ensuring trustworthiness.
The research proposed is that of a sensitive nature and will requires the highest level of professionalism. The study will require the authorization of the hospital and at any point in time the study can be annulled should there be any indiscretions by the researcher. The goal of this study is to provide the hospital with results that can improve communication between doctors and patients.
Significance of the Study
It is expected that this study will contribute towards improving patient doctor communication. The findings will provide comprehensive results to determine the attitudes and beliefs of patients and doctors of a specific private hospital in Riyadh, Saudi Arabia. The results of the study will be specific to the individual context of the situation. The narrow focus of the study will yield results that can be used to counteract barriers in communication between the hospitals doctors and patients. Upon completion of the proposed study recommendations can be made that will guide the successful implementation of a mobile app to facilitate doctor/patient communication improving the overall quality of care.
