Overview
This study is the first formal survey to investigate mobile phone ownership and usage among GPs in China. The result of our study demonstrates that a substantial proportion (90.4%) of GPs use mobile phones, with no difference based on income level or professional grades (Table 1). Previously, in the UK, a regional survey conducted on mobile phone-based healthcare apps usage by Payne et al [2] in 2011 found 74.8% of junior doctors owned a mobile phone (n=601). In the US, a nation-wide email survey of all the ACGME training programs (N=3,306) revealed that 85% of respondents used a mobile phone [4]. In Ireland, a voluntary novel questionnaire survey revealed that, among interns in two university hospitals, 98.4% owned a mobile phone [5]. Though the income for GPs in China is lower than Western countries, the percent of mobile phone ownership is higher than the UK and the US, and lower than Ireland. It should be pointed out that the surveys in UK and US were conducted before 2012, when mobile phones were not so widespread. An investigation from Google and IPSOS in 2013 revealed that mobile phone penetration is currently at 47% of the population in China [11]. Our research shows that mobile phone ownership among GPs in eastern China is higher than that of the general public. The common feature of previously-mentioned studies is that the selected subjects were young doctors, while in this study GPs at every age level were included. The extreme popularity of mobile phones among all ages demonstrates how well-accepted mobile phones are among Chinese GPs. When examining the differences between ages, our survey suggested that young GPs (under 35 years) are more likely to embrace mobile phones, perhaps due to the fact that they are more “technologically adept” [2].
In our survey, 66.4% of mobile phone users reported downloading medical apps, 86.7% of whom own 1-3 such apps (Table 1). In the UK, 75.5% of mobile phone user used medical apps among junior doctors, and the majority (51%) of them owned 1 to 5 medical apps [2]. In the US, 63.5% of doctors used medical apps [4]. In Ireland, 77% of urology trainees [3] and 91.6% of interns [5] downloaded apps. With these intern mobile phone users, 53.3% reported downloading between 1 and 3 medical apps [5]. Research from all these countries show that the majority of doctors download few medical apps, perhaps due to the cost of apps and Internet connections, limited working time, the capacity of their mobile phones, and high workload [2,12].
In Table 2, we see that 36% of GPs report using medical apps on a daily basis. In Table 3, the majority of doctors report using medical apps daily less than 30 minutes to aid the clinical activities. Compared with other surveys, these results are higher than junior doctors in the UK, but lower than interns in Ireland. In the UK, 29.6% of junior doctors reported using apps on a daily basis and most of them using apps less than 30 minutes per day [2]. In Ireland, 43.6 % interns report using them on a daily basis [5]. This suggests that doctors are using apps as a source of quick references [2], and the conclusion could be drawn that convenience and speed are the main reasons for doctors choosing apps.
When we try to investigate which kinds of apps for GPs were used frequently, interestingly, we found that non-medical apps were used much more frequently to aid their medical activity than medical apps during working hours, as shown in Figure 1 and 2. 67% of GPs use social media apps every day to support clinical activities. Most of the clinical activities included reading case-related essays, as reported by the respondents. Web browsers were the second most popular type of app (34% report daily use) which GPs use to search medical knowledge. By contrast, the most frequently used type of medical app–drug reference apps–only have 5% daily users. This remarkable contrast can be attributed to 2 reasons. First of all, the apps’ function cannot meet their needs [4]. Some respondents in our survey told the investigator that using apps to aid clinical activities is waste of time and they did not have time to use them. Secondly, while medical apps have very specialized applications, non-medical apps provide more diverse functions. For instance, social media can provide an online community where doctors can read articles, listen to experts, find new medical research results, and communicate with colleagues and patients [13]. On the other hand, most medical apps have limited function, and as a result, their acceptance is not as high as non-medical apps.
With medical apps, the most frequently used in China are for drug reference, while social media is the most popular type of non-medical app. In contrast, junior doctors in the UK used clinical scoring apps more often [2]. There are two possible explanations for this. First of all, in Chinese hospitals, there are many traditional Chinese medicines, and different hospitals own different medicines from various companies, resulting in a complex pharmaceutical system. Moreover, patients may approach GPs with prescriptions received from other hospitals. As such, GPs have to constantly update their knowledge about different kinds of medicines. Secondly, in China, most GPs take care of their patients based on their own experiences rather than evidence-based medicine, and they rarely use clinical scoring apps to aid their work.