Digital readiness and smartphone-related skills of cardiovascular inpatients in germany: implications for adoption of digital health applications
R Freund, D Grosse MeininghausAbstract
Background
Digital health applications frequently rely on patient-operated smartphones. However, age-related differences in digital competence and skills might limit access and thus, reduce effectiveness in specific cohorts. A thorough understanding of digital readiness in patients, particularly dealing with arrhythmia-related problems, is a prerequisite to improve implementation, usability, and clinical benefit.
Purpose
To assess age-dependent digital readiness and smartphone-related skills of cardiovascular inpatients in Germany, and to identify barriers for future utilization of digital health applications.
Methods
Consecutive patients of a cardiology-ward were asked to undergo a short questionnaire-based survey prospectively. Smartphone ownership and general commitment to participate in clinical studies using digital devices were inquired [Fig. 1]. In addition, age-related skills to operate enhanced options of smartphones were analyzed (in detail, utilization restricted to perform telephone calls, additional text-messaging, internet browsing, and file upload/transmission) [Fig. 2], each visualized by split violin plots (inserted boxplots show mean and interquartile-range [IQR]). Differences were analyzed using Mann–Whitney U test.
Results
A total of 345 patients answered the survey. Two-thirds of all participants reported to own a smartphone, but only half of those committed themselves to participate in clinical studies with digital assessment [Fig. 1]. With regard to specific smartphone-applications, patients with positive answers (yes) were significantly younger (p<.001), particularly addressing internet browsing and file transfer [Fig. 2]. In general, patients with advanced age reported a need for assistance to perform complex tasks.
Conclusion
Cardiovascular inpatients in Germany show an age-dependent digital divide, both for digital skills and commitment to participate in digital-based health research. The latter may be a barrier for clinical utilization of smartphones. With that, scalable implementation of digital health solutions might be hampered. The need for assistance to solve more complex tasks on a smartphone (e.g., text messaging) contribute to the limitation of digital applications, at least in advanced age. Cardiac digital health applications have to focus on user-friendly design, eased workflow, and assisted support to enhance benefit and real-world effectiveness.Smartphone ownership and utilizationAge-related use of smartphone functions