# Presentation

DH7 - Patient’s perceived technology use workload on doctor in new cancer patient visits

DescriptionIntroduction

Computer use has drastically changed the setting of a healthcare visit and the interaction between doctors and patients. Doctors increasingly make use of electronic health record systems and other computerized systems to register and monitor patient information. The use of health information technologies during these visits has shown many positive effects on healthcare, but the impact of technology on patients’ workload has been mostly undiscovered.

This study focusses on the workload perceived by patients of various demographics, as healthcare providers make use of computers during their first visit. Additionally, we test whether the perceived technology use related workload of patients has significant relationship to the satisfaction level of patients during the visit.

Methods

Data was gathered from a survey covering questions related to perceived workload due to computer interaction, overall satisfaction level, and patient demographics during the cancer patients’ first visit. The research includes 72 participants, defined as newly diagnosed cancer patients aged eighteen or older. The perceived workload of patients is captured by a selection of four questions including computer interaction of the NASA-TLX index. These questions are: “To what extend did provider’s interaction with computer affect your mental effort in the visit?”, “How much physical activity was required to perform activities in the visit related to interaction with the computer (e.g., looking at the computer, understand displayed information, etc.)?”, “How much things did you need to remember from computer used by the provider?”, and “How much time pressure did you feel when providers use computer during the visit?”. The questions consider workload perceived by doctor-computer interaction as well as patient-computer interaction during the visit. The participants are asked to provide a score to each question between 1 (no perceived workload) and 10 (high perceived workload). The scores the questions are averaged to a score between 0-100. Additionally, the survey assesses the patients’ overall satisfaction level during the visit based on a 5-point Likert scale (from Strongly Agree, Agree, Neither, Disagree, and Strongly Disagree). Patient demographics are collected on age, gender, race, and educational level. We analyze the outcomes using descriptive statistics, t-test and regression.

Results

Among the 72 respondents, 29 are Male (40%), and 43 are Female (60%). 22 are White (21%), and 50 are from other minorities (69%). They were categorized by age: 2 young adults ranging 18-34 (3%), 19 middle-aged adults ranging 35-49 (26%), 50 elderly-aged adults ranging 50 - 64 69%, 1 senior over 64 (1%). Considering educational level, six categories were reported: 9 with a graduate degree (13%), 23 with a bachelor’s degree (32%), 23 with a high school degree (32%), 6 with some school, but no degree (8%), 1 with no diploma (1%), and 8 technical associates (11%). 2 respondents (3%) did not report their educational level and is therefore unknown.

Based on the NASA-TLX score of the four questions, patients perceive a relatively low workload (N = 72, mean = 17.29, SD = 16.20) out of 100. Considering the different demographics, there is a difference in mean between females (N = 43, mean = 18.20, SD = 18.74) and males (N = 29, mean = 15.95, SD = 11.62), but from statistical analysis using an unpaired t-test on the two samples we do not see a significant difference (p = 0.57). From a race demographic perspective, we observe the same results. White respondents (N = 50, mean = 16.20, SD = 13.07) have a different mean from non-white respondents (N = 22, mean = 19.77, SD = 21.89), however, the mean is not significantly different (p = 0.39).

When observing the mean for the different educational levels, we notice that the mean NASA-TLX tech score for a graduate degree (N = 9, mean = 25.28, SD = 24.09) is higher than the mean for the other levels. We perform an unpaired t-test to determine whether there is significant difference between graduate level (N = 9, mean = 25.28, SD = 24.09) and other educational levels. For all statistical tests there is no significant difference between the means of bachelor’s degree (N = 23, mean = 16.96, SD = 17.79, p = 0.29), high school diploma (N = 23, mean = 16.30, SD = 14.42, p = 0.20) , some school, but no degree (N = 6, mean = 13.75 , SD = 7.03, p = 0.28), and technical associate (N = 8, mean = 10.31, SD = 0.88, p = 0.10) compared to graduate level. Because of the sample size of respondents with no diploma (N = 1, mean = 10) we did not compare the mean to graduate level. For the age demographic we also observe the means of the age groups. We report the highest mean for the elderly-adult group (N = 50, mean = 18.20, SD = 18.23). We compare this group to the other age ranges to determine whether the mean is significantly different. After a paired t-test, we observe no significant differences compared to young adults (N = 2, mean = 10, SD = 0, p = 0.53), and middle-aged adults (N = 19, mean = 16.05, SD = 10.81, p = 0.63).

Next to the NASA-TLX tech score, all respondents have rated the satisfaction with the overall visit. To determine whether there is a relationship between the perceived tech workload and the overall satisfaction, we used regression for the two variables. From our analysis we report that the overall workload negatively impacts the overall satisfaction level with the visit (coefficient: -0.03, CI: [-0.05; -0.01], p = 0.009). This means that as the perceived tech workload gets smaller the overall satisfaction level goes up.

Conclusion

From our results we conclude that overall, the perceived tech workload related to computer use during the first cancer visit is relatively low. It is understandable since doctors are the active users of the computers, not patients. When we look at the demographics of the respondents, we do not see any significant difference between the means of the different demographic levels.

For the relationship between the perceived workload during the visit and the overall satisfaction level we conclude that the perceived workload negatively impacts the overall satisfaction level. The individual questions leading up to the NASA-TLX tech score, do individually not show any significant impact. This implies that a combination of factors that influence the total perceived workload only impacts the overall satisfaction level with significance. This also implies that, although patients have low tech related workload, still they prefer technology not being used that much in the first cancer visits.

Computer use has drastically changed the setting of a healthcare visit and the interaction between doctors and patients. Doctors increasingly make use of electronic health record systems and other computerized systems to register and monitor patient information. The use of health information technologies during these visits has shown many positive effects on healthcare, but the impact of technology on patients’ workload has been mostly undiscovered.

This study focusses on the workload perceived by patients of various demographics, as healthcare providers make use of computers during their first visit. Additionally, we test whether the perceived technology use related workload of patients has significant relationship to the satisfaction level of patients during the visit.

Methods

Data was gathered from a survey covering questions related to perceived workload due to computer interaction, overall satisfaction level, and patient demographics during the cancer patients’ first visit. The research includes 72 participants, defined as newly diagnosed cancer patients aged eighteen or older. The perceived workload of patients is captured by a selection of four questions including computer interaction of the NASA-TLX index. These questions are: “To what extend did provider’s interaction with computer affect your mental effort in the visit?”, “How much physical activity was required to perform activities in the visit related to interaction with the computer (e.g., looking at the computer, understand displayed information, etc.)?”, “How much things did you need to remember from computer used by the provider?”, and “How much time pressure did you feel when providers use computer during the visit?”. The questions consider workload perceived by doctor-computer interaction as well as patient-computer interaction during the visit. The participants are asked to provide a score to each question between 1 (no perceived workload) and 10 (high perceived workload). The scores the questions are averaged to a score between 0-100. Additionally, the survey assesses the patients’ overall satisfaction level during the visit based on a 5-point Likert scale (from Strongly Agree, Agree, Neither, Disagree, and Strongly Disagree). Patient demographics are collected on age, gender, race, and educational level. We analyze the outcomes using descriptive statistics, t-test and regression.

Results

Among the 72 respondents, 29 are Male (40%), and 43 are Female (60%). 22 are White (21%), and 50 are from other minorities (69%). They were categorized by age: 2 young adults ranging 18-34 (3%), 19 middle-aged adults ranging 35-49 (26%), 50 elderly-aged adults ranging 50 - 64 69%, 1 senior over 64 (1%). Considering educational level, six categories were reported: 9 with a graduate degree (13%), 23 with a bachelor’s degree (32%), 23 with a high school degree (32%), 6 with some school, but no degree (8%), 1 with no diploma (1%), and 8 technical associates (11%). 2 respondents (3%) did not report their educational level and is therefore unknown.

Based on the NASA-TLX score of the four questions, patients perceive a relatively low workload (N = 72, mean = 17.29, SD = 16.20) out of 100. Considering the different demographics, there is a difference in mean between females (N = 43, mean = 18.20, SD = 18.74) and males (N = 29, mean = 15.95, SD = 11.62), but from statistical analysis using an unpaired t-test on the two samples we do not see a significant difference (p = 0.57). From a race demographic perspective, we observe the same results. White respondents (N = 50, mean = 16.20, SD = 13.07) have a different mean from non-white respondents (N = 22, mean = 19.77, SD = 21.89), however, the mean is not significantly different (p = 0.39).

When observing the mean for the different educational levels, we notice that the mean NASA-TLX tech score for a graduate degree (N = 9, mean = 25.28, SD = 24.09) is higher than the mean for the other levels. We perform an unpaired t-test to determine whether there is significant difference between graduate level (N = 9, mean = 25.28, SD = 24.09) and other educational levels. For all statistical tests there is no significant difference between the means of bachelor’s degree (N = 23, mean = 16.96, SD = 17.79, p = 0.29), high school diploma (N = 23, mean = 16.30, SD = 14.42, p = 0.20) , some school, but no degree (N = 6, mean = 13.75 , SD = 7.03, p = 0.28), and technical associate (N = 8, mean = 10.31, SD = 0.88, p = 0.10) compared to graduate level. Because of the sample size of respondents with no diploma (N = 1, mean = 10) we did not compare the mean to graduate level. For the age demographic we also observe the means of the age groups. We report the highest mean for the elderly-adult group (N = 50, mean = 18.20, SD = 18.23). We compare this group to the other age ranges to determine whether the mean is significantly different. After a paired t-test, we observe no significant differences compared to young adults (N = 2, mean = 10, SD = 0, p = 0.53), and middle-aged adults (N = 19, mean = 16.05, SD = 10.81, p = 0.63).

Next to the NASA-TLX tech score, all respondents have rated the satisfaction with the overall visit. To determine whether there is a relationship between the perceived tech workload and the overall satisfaction, we used regression for the two variables. From our analysis we report that the overall workload negatively impacts the overall satisfaction level with the visit (coefficient: -0.03, CI: [-0.05; -0.01], p = 0.009). This means that as the perceived tech workload gets smaller the overall satisfaction level goes up.

Conclusion

From our results we conclude that overall, the perceived tech workload related to computer use during the first cancer visit is relatively low. It is understandable since doctors are the active users of the computers, not patients. When we look at the demographics of the respondents, we do not see any significant difference between the means of the different demographic levels.

For the relationship between the perceived workload during the visit and the overall satisfaction level we conclude that the perceived workload negatively impacts the overall satisfaction level. The individual questions leading up to the NASA-TLX tech score, do individually not show any significant impact. This implies that a combination of factors that influence the total perceived workload only impacts the overall satisfaction level with significance. This also implies that, although patients have low tech related workload, still they prefer technology not being used that much in the first cancer visits.

Event Type

Poster Presentation

TimeMonday, March 254:45pm - 6:15pm CDT

LocationSalon C

Digital Health

Simulation and Education

Hospital Environments

Medical and Drug Delivery Devices

Patient Safety Research and Initiatives