I will present findings from my research on fragile cities at the 2019 Annual ICMA Conference. This research was funded by ICMA as part of my research fellowship. Michael Hunter collaborated with me on this research project.
Resiliency, cybersecurity, and creating more sustainable places are all topics being discussed by local government practitioners and scholars. Could it be that as local governments are increasing reliance on technology that they are becoming more fragile in the absence of considering some of the socio-economic consequences? Join this roundtable to offer your thoughts and opinions.
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I am heading to Beijing today to attend 2019 International Symposium on Budget Performance Management: National Governance and Comprehensive Budget Performance Management in the New Era hosted by the China Development Research Foundation. I will present a paper co-authored with M. Zhang, Evolving from Performance Management to Proactive Governance: The Opportunity and Gaps.
New paper published in Journal of Medical Internet Research with Tarricone, Cucciniello, Armeni, Petracca, Hall, and Keefe.
Mobile Health Divide Between Clinicians and Patients in Cancer Care: Results From a Cross-Sectional International Survey
Background: Mobile technologies are increasingly being used to manage chronic diseases, including cancer, with the promise of improving the efficiency and effectiveness of care. Among the myriad of mobile technologies in health care, we have seen an explosion of mobile apps. The rapid increase in digital health apps is not paralleled by a similar trend in usage statistics by clinicians and patients. Little is known about how much and in what ways mobile health (mHealth) apps are used by clinicians and patients for cancer care, what variables affect their use of mHealth, and what patients’ and clinicians’ expectations of mHealth apps are.
Objective: This study aimed to describe the patient and clinician population that uses mHealth in cancer care and to provide recommendations to app developers and regulators to generally increase the use and efficacy of mHealth apps.
Methods: Through a cross-sectional Web-based survey, we explored the current utilization rates of mHealth in cancer care and factors that explain the differences in utilization by patients and clinicians across the United States and 5 different countries in Europe. In addition, we conducted an international workshop with more than 100 stakeholders and a roundtable with key representatives of international organizations of clinicians and patients to solicit feedback on the survey results and develop insights into mHealth app development practices.
Results: A total of 1033 patients and 1116 clinicians participated in the survey. The proportion of cancer patients using mHealth (294/1033, 28.46%) was far lower than that of clinicians (859/1116, 76.97%). Accounting for age and salary level, the marginal probabilities of use at means are still significantly different between the 2 groups and were 69.8% for clinicians and 38.7% for patients using the propensity score–based regression adjustment with weighting technique. Moreover, our analysis identified a gap between basic and advanced users, with a prevalent use for activities related to the automation of processes and the interaction with other individuals and a limited adoption for side-effect management and compliance monitoring in both groups.
Conclusions: mHealth apps can provide access to clinical and economic data that are low cost, easy to access, and personalized. The benefits can go as far as increasing patients’ chances of overall survival. However, despite its potential, evidence on the actual use of mobile technologies in cancer care is not promising. If the promise of mHealth is to be fulfilled, clinician and patient usage rates will need to converge. Ideally, cancer apps should be designed in ways that strengthen the patient-physician relationship, ease physicians’ workload, be tested for validity and effectiveness, and fit the criteria for reimbursement.
Paper available at: https://mhealth.jmir.org/2019/9/e13584/