Mobile Health Divide Between Clinicians and Patients in Cancer Care – Journal of Medical Internet Research
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/
Emerging technologies are fundamentally impacting and transforming all aspects of our society. I am particularly concerned with how technological innovations impact 1) the design of our public institutions, 2) the apparatuses through which we shape, implement, and evaluate public policies, and 3) our governance frameworks for public goods. All indications suggest that we are moving toward a world where autonomous systems will dictate how we interface and interact with other agents and objects in our society. We can take advantage of emerging technologies to make our societies more livable, just, resilient, and sustainable. To realize this future, we need active and sustained engagement by scholars across a myriad of disciplines, especially public policy and management.
Public policy and governance scholars have largely been absent when it comes to engineering efforts related to the design and deployment of autonomous systems and policy debates that will shape their impact on our society. In this talk, I will outline why we need active engagement by public policy and management scholars during phases of autonomous systems development and implementation. Examples will be drawn from over a dozen research engagements that have studied emerging technologies in the public sector, from predictive analytic systems to blockchain, social media platforms, and machine learning algorithms. I will outline key governance dilemmas and policy challenges confronting public agencies as they try to keep up with the rapid pace of technological innovations.
My co-authored article with Xiaofeng Wang was chosen as the cover story for the current issue of 
Along with colleagues Wenting Yang and 
