Patient perspectives on digital technology and experiences of computerized history taking for chest pain management in the emergency department: The CLEOS-CPDS prospective cohort study (Preprint)
Authors: Fritzell Kaisa , Brandberg Helge , Spaak Jonas , Koch Sabine , Sundberg Carl Johan , Zakim David , Kahan Thomas , Sundberg Kay 
Published: August 2024

BACKGROUND

Automated, self-reported medical history taking has the potential for improving the physician - patient dialogue and for delivering patient - reported information across a wide range of clinical issues. Medical history data was entered by patients on a tablet in an emergency department in the CLEOS‐Chest Pain Danderyd Study (CLEOS-CPDS). Since successful implementation of this technology depends on understanding patients’ views and willingness to use such technology, we have studied this after their entry into the CLEOS study.

OBJECTIVE

To develop a questionnaire to investigate patients’ attitudes, perceptions and skills when using digital technology in health care in general and their experience of using the CLEOS program at an emergency department, which they visited for care of chest pain.

METHODS

The study design included the development of a questionnaire, followed by a cross-sectional study. Questionnaire design and the Technology Acceptance Model underpinned the development of the questionnaire. The think-aloud method was used to test the questionnaire. Adults who participated in the CLEOS-CPDS were invited consecutively to respond to the questionnaire. Descriptive and correlational analyses were performed.

RESULTS

The refinement of the questionnaire included language revision, removal of similar items and replacement of some response formats. The final questionnaire consisted of 16 items and one free text comment that assessed attitudes, perceptions, and skills related to the use of digital technology in health care in general and the specific experience of using the self-reported history taking by CLEOS. The mean age of the participants was 56 years. A clear majority of the 129 patients who answered the questionnaire found it easy to use digital technology in general. Most believed that digital technology has a role when seeking health care; and two thirds believed that patient-reported symptoms are helpful in making a diagnosis. Most felt confident in answering the CLEOS-CPDS questions on a tablet. However, one third were concerned that the interaction between patient and physician would be disrupted when using digital technology in health care. Correlation analyses showed that older age was associated with less ease (p≤0.001), confidence (p≤0.001), and trust (p=0.002) when using digital technology. Moreover, older age was associated with worry that the patient-doctor personal contact would be disrupted when using digital technology in health care (p=0.001)

CONCLUSIONS

This study indicates strong approval of usefulness and trust of digital technology in health care but the concern for lack of personal contact should be acknowledged. The CLEOS program performed well for end users but would benefit from some adjustments for future studies. The questionnaire obtained new insights on perceived usability of digital technology for health care delivery and appears relevant for future evaluations in other contexts.

CLINICALTRIAL

ClinicalTrials.gov NCT03439449