An Assessment of Technology Usage and Barriers to Adoption Among Patients in a Radiation Oncology Clinic

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Mobile and digital technology may provide platforms for consistent and real-time symptom tracking for cancer patients, allowing for improvements in symptom reporting and timely interventions. There has been limited research about barriers to adoption within the oncology setting. Understanding patients’ perceptions, concerns, and willingness to adopt these tools is key for development and successful implementation. To determine technology usage and willingness among patients to utilize mobile technologies to report symptoms in an outpatient radiation oncology setting. Adult patients completed an anonymized survey consisting of 21 questions. Demographics, technology usage, barriers to utilization, and willingness to report data were studied using descriptive statistics. These were compared using chi-square tests for categorical variables, with a statistical significance of p<0.05. Predictors of willingness to use mobile applications to report symptoms were analyzed using univariate and multivariate logistic regression. 144 patients completed the survey, with mean age 64 years, 70% Caucasian, and 50% male. Of the cohort, 66.7% used a smartphone, 87.5% reported access to home internet, and 79.2% used a computer. Only 17% of patients reported using a wearable fitness tracker. Concern for privacy (26.0%) and limited technological literacy (18.8%) were identified as significant barriers to reporting health-related data via mobile applications. 69% would be willing to use a mobile application to record/report cancer symptoms. Age >65 (OR 0.27), owning a smartphone (OR 3.60, p=0.001), not owning a computer (OR 0.35), concern for privacy (OR 0.35), and limited technological literacy (OR 0.38) were identified on univariate analysis as significant variables (P<0.05) affecting participants’ willingness to report health-related data via a mobile application. On multivariate analysis, only age >65 (OR 0.29) and owning a smartphone (OR 4.27) were significantly associated with willingness to report symptoms via a mobile application. By age distribution, the percentage of patients reporting willingness at <50yrs, 50-59yrs, 60-69 yrs, ≥ 70yrs were 93%, 77%, 71%, and 55% respectively (p=0.035). Compared to those age <50yrs, those age ≥70yrs were 10 times less likely to be willing to use a device to report symptoms (OR 0.10, P=0.029). The majority of radiation oncology patients are willing to use mobile technology to report symptoms, with willingness increasing with younger age and smartphone ownership. While care should be taken to address patient privacy and technological literacy concerns, future efforts in developing and testing mobile applications for reporting cancer symptoms in this population is warranted while addressing barriers to adoption.