Potential for Mobile Health Technology to Reduce Health Disparities in Underserved Communities
Binz S, Van Veen T, Muminovic M, Rose K, Rammal JA, France J, and Miller J. Potential for mobile health technology to reduce health disparities in underserved communities. Acad Emerg Med 2018; 25:S39-S40.
Acad Emerg Med
Background: Mobile health (mHealth) technology has potential to change how patients make healthcare decisions. However, in underserved communities, the readiness to use mHealth technology is unclear. We sought to determine the readiness for these patients to use mHealth technology to guide their medical decision making. Methods: This is a prospective, observational study of patients presenting to the urgent care section of an urban emergency department with a large, underserved population. Patients over the age of 2 that presented with low acuity complaints were included. We excluded patients with any suspicion for acute illness that would require admission. A structured interview was conducted with each patient or parent (for minors) about willingness to use mHealth tools for guidance. Analysis included descriptive statistics and univariate analysis based on age and gender. Results: 560 patients were included with 80% adults, 64% female, and 90% Black. The mean age was 28 ± 9 years for adults and 9 ± 5 years for children. One-third of patients reported no primary care physician while 55% were without phone access to any nurse or clinician for medical advice. Adults were less likely to have access to phone consultation than parents of children (42% vs. 59%, p<0.001), as were males compared to females (35% vs. 51%, p<0.001). Most patients (96%) reported cellular access for mobile apps, and 76% of patients reported that they frequently using mobile apps. While 67% of patients described seeking medical advice from friends or relatives, an equal number also reported using online references. The most commonly used online references were Google (66%) and WebMD (14%). When asked how they would behave if an mHealth tool advised them that their current health problem is low risk, 69% of patients responded that they would seek care in an outpatient clinic (30%), stay home and not seek urgent medical care (28%), or utilize telehealth (11%). Conclusion: In an urban community of young adults and parents, there is a high degree of capacity and willingness to implement mHealth technology to guide medical decision making. While traditional models of care may be strained, these results highlight the potential for mHealth to reduce disparities in healthcare in these communities.