1 Acceptance of mobile phone eHealth a study of health consumer perceptions

2 “I love the convenience, but the roaming charges are killing me.”

3 Research topic and question Methodology Pilot study results

4 += mobile phone eHealth Uses Interaction Helping with health actions Medical information Managing services

5 ICT may facilitate health behaviors ubiquitous ICT channel speed and potential savings

6 Research problem Problem Will people want to use technology? Understanding human behavior Purpose Understand perceptions Understand health consumer acceptance Deficiencies in research base Research has focused on feasibility, outcome, pilot studies Understudied areas: attitudes, experiences, information science issues

7 How do individual perceptions of mobile phone eHealth contribute to the acceptance of this technology?

8 Significance Promote usability Facilitate design Justify development Facilitate health education Develop evaluation metrics

9 Qualitative interviews Background questionnaire Watch introductory video Semi-standardized interviews via in-person, phone and communication

10 Why qualitative methods? technology is emerging few hypotheses complex and nuanced acceptance responses

11 Collecting data on … PERCEPTIONS          ACCEPTANCE first impressions advantages disadvantages reception by other health consumers health information behavior impact health behavior change impact acceptance of the technology rationale for acceptance impact of perceptions on acceptance decision experience with technology

12 Participants Undergraduate students Information professionals Health professionals Patients of chronic health conditions People with mobile phone eHealth experience

13 Recruitment of participants Purposeful sampling International perspectives Online recruitment Poster recruitment Convenience sampling

14 Financial compensation

15 Transcribe audio recordings Code in MAXQDA Identify themes from codes Data analysis

16 Timeline Summer Pilot study Fall Data collection Winter Data collection Spring Data analysis Writing Summer Writing Defense

17 Preliminary results

18 What have I done so far? Number of participants interviewed As of Dec 8: 11 By Dec 31: 14 Number of participants interviewed (by group) By Dec 31 4 Undergraduates 7 Information professionals 4 Health professionals 3 Patients of chronic health conditions 0 Other health consumers 0 Mobile phone eHealth users Length of audio recordings analyzed for the preliminary results reported today 7 hours 16 minutes 47 seconds

19 For themes, refer to code system

20 Acceptance decision Rejection Positive feelings Negative feelings Health behavior Information behavior Technology development Proposed services Safety Discussion: themes and implications

21 Acceptance decision Implications Target specific groups Explaining the context of use is helpful Highlight how technology is not a revolution but a transfer or evolution of existing practices User control/customization may address issues with emotional tolerance Conditional acceptance of this technology: they will adopt this technology on certain conditions. Decision-making factors –Costs –Emotional tolerance –Health context –Helps me –Inevitability –Matches my personality –Need proof –Other adoption factors

22 Rejection Alternatives exit Does not suit my lifestyle Feel uncomfortable Hard to trust Hard to use Reject for now Selective rejection What is the value? Implications Study people’s personal health management systems and understand how cell phone technology may or may not help. There are idiosyncratic reasons for rejection that can not be addressed.

23 Positive feelings Best platform Freeing Give it a chance Improves life Life organizer Takes care of me Implications In promoting this technology emphasize these positive feelings of: best platform, freeing, life improvement, life organizer, and “takes care of me”. Focus on developing these elements of the technology.

24 Negative feelings Distracting Emotionally inappropriate Hard to use Information overload Lacking technology Losing the human touch Loss of privacy Threat to health Will it make a difference? Implications Show people the type of messages shown. Have them control the tone of the message and frequency. –Specific: Remember to take your aspirin: 2 tablets with fruit juice. –Generic: Medication time. –Obscure: Health is wealth. –Absence: [no messages sent] The type of message sent depends on the stage of learning the medical regiment. Asynchronous communication is good for positive news. Bad news requires human interaction. Need for complementary systems that enhance interaction with health care professionals. Emphasize systems that complement existing human interactions, and use automated procedures where before there was no human interaction.

25 Health behavior Health actions Health behavior change Health needs Health needs of patients of chronic illness Preventive health actions Implications People like to be informed and educated about health status and health conditions. People like tiny reminders to take care of their health. People need help prioritizing health. People desire a social-personal medium with health professionals. People with chronic health conditions need special organizational tools because they are managing multiple medication regiments and multiple sets of healthcare professionals. Concerns about bothering doctors may hinder preventive actions. Would automated procedures help? Proactive, preventive healthcare is valued over reactive services.

26 Information behavior Data collection Information need Information organization Information seeking Information sharing Information use Implications People are recognizing that the power dynamic in health information is shifting. Doctors will have less authority and ownership of the right answer Asynchronous information sharing helps people manage information at their convenience. People belong to different stages of readiness and tolerance for acquiring and using health information. There is a need for graduated information systems that cater to the right level of readiness: (1) definitions, (2) pathophysiology, (3) care, (4) prognosis. There is a need for visual and audio recording and transmission of health symptoms (e.g. changing appearance of symptoms, abnormal sounds). People have concerns about accuracy of information and comprehension. What if I misdiagnose or mistreat myself? There is a need for complementary human services to provide oversight for automated procedures.

27 Technology development Automation Integrated system Marketing Personalization Proper communication Regulations Technical factors Implications Hybrid systems are needed. Linking this technology for printing capabilities and web technologies for more intensive applications. Cell phone eHealth needs to be integrated among the pateints’ healthcare stakeholders: insurance companies, healthcare professionals, health organizations, family. People should be able to choose how cell phone eHealth should work for them. People don’t wish to bother health professionals, but wish there was a triage system for them to quickly check if they need to see someone. There should be communication from the health professional to provide closure for medical tests and procedures. (Sometimes health professionals say they will only contact you if the test results indicate bad news.) People feel eHealth should not substitute for direct medical care, but complement it. Cell phone eHealth may be a convenient portal to electronic healthcare records.

28 Proposed services Notification of delays at doctor’s office. (A pager system like those at restaurants.) Viewing electronic medical records for discussing medical history with health professional. Triage system. Entering symptoms, and determining whether it is worthwhile seeing the doctor. Contact management / advanced directory services. Record reminders and notes for your next interaction with a health professional. Facilitate sharing of medical records. Requesting files to be transferred from one office to another. Medical calculators. For example, blood alcohol content, calories expended in exercise.

29 Safety Flexible definitions of safety Health threat Help me feel safe by doing this No safety problem Other people can see/hurt me Safety behavior Implications User should have control of what information is revealed or shown, since definitions of innocuous and vulnerable health information vary from individual to individual. For concerns regarding cell phones and radiation, provide Bluetooth and other options so that you’re not holding the phone by the head. People are interested in a record of who has accessed their electronic records and what changes were made. People are interested in statistics that show hackers have been stopped. A security status report is valued. Inform people of unfounded safety concerns and misinformation. Encourage people to practice safe health information behavior, learn about existing precautions, and demand more safety precautions from healthcare organizations.

30 “At the conclusion of this evening’s concert, ladies and gentlemen, I’ll thank you for not forgetting the tip jar.”