The usefulness of a mobile device-based system for patient-reported outcomes in a spine outpatient clinic

Abstract Background Context Patient reported outcomes (PRO) are typically collected using a paper form, but this format is cumbersome to incorporate into outpatient clinic visits as well as in research. Therefore, we developed a mobile device-based system (mobile system) for spinal PRO. We hypothesized that this system may improve the quality of care in an outpatient clinic. Purpose To analyze the patient-reported efficacy of a mobile system through a survey of patients' responses compared to a paper system. Study Design/Setting Prospective observational study Patient Sample Surveys were conducted for 103 patients who had experience using both the paper and electronic systems in the outpatient clinic. Outcome Measures Patient-reported positive response score (PRS) Methods The survey included the characteristics of the patients (sex, age, use of smartphone, familiarity with smartphone applications, proficiency of typing with mobile device, site of pain and education level) and eight questions in four domains: 1) efficacy in the waiting room, 2) efficacy during the clinic visit, 3) overall satisfaction and 4) opinion about the use of this system. The response to each question was scored from 1–5 (1, negative; 5, positive response). The patient-reported PRS was calculated by adding the scores of the 8 questions and converting the total range to 0 to 100 (60, neutral). Results The mean PRS of the 8 questions was 79.8 (95% CI, 76.7–83.9). The mean PRS was 78.9 (75.6-82.2) at the waiting room and was 80.5 (77.1–83.9) during the clinic. The PRS for overall satisfaction and use of this system were 83.3 (79.6–87.0) and 77.1 (71.9–82.3), respectively. The use of smartphones and the proficiency of typing were independently significant predictors of PRS with an R2 value of 0.325. Conclusions The mobile device-based system improved the patient-reported efficacy in spine outpatient clinics. However, various factors such as the use of smartphones need to be considered when developing and applying mobile systems.