Factors affecting physicians using mobile health applications: an empirical study

Background Mobile health applications (mHealth apps) have created innovative service channels for patients with chronic diseases. These innovative service channels require physicians to actively use mHealth apps. However, few studies investigate physicians’ participation in mHealth apps. Objective This study aims to empirically explore factors affecting physicians’ usage behaviors of mHealth apps. Based on the extended Unified Theory of Acceptance and Use of Technology (UTAUT2) and mHealth apps features, we propose a research model including altruism, cognitive trust, and online ratings. Methods We collected data from physicians who have used mHealth apps and conducted a factor analysis to verify the convergence and discriminative effects. We used a hierarchical regression method to test the path coefficients and statistical significance of our research model. In addition, we adopted bootstrapping approach and further analyzed the mediating effects of behavioral intention between all antecedent variables and physicians’ usage behavior. Finally, we conducted three robustness analyses to test the validity of results and tested the constructs to verify the common method bias. Results Our results support the effects of performance expectancy, effort expectancy, social influence, and altruism on the behavioral intentions of physicians using mHealth apps. Moreover, facilitating conditions and habits positively affect physicians using mHealth apps through the mediating effort of behavioral intention. Physicians’ cognitive trust and online rating have significant effects on their usage behaviors through the mediating efforts of behavioral intention. Conclusions This study contributes to the existing literature on UTAUT2 extension of physicians’ acceptance of mHealth apps by adding altruism, cognitive trust, and online ratings. The results of this study provide a novel perspective in understanding the factors affecting physicians’ usage behaviors on mHealth apps in China and provide such apps’ managers with an insight into the promotion of physicians’ active acceptance and usage behaviors.

EXPRESS: Extremity Bias in Online Reviews: The Role of Attrition

In a range of studies across platforms, online ratings have been shown to be characterized by distributions with disproportionately-heavy tails. We focus on understanding the underlying process that yields such “j-shaped” or “extreme” distributions. We propose a novel theoretical mechanism behind the emergence of “j-shaped” distributions: differential attrition, or the idea that potential reviewers with moderate experiences are more likely to leave the pool of active reviewers than potential reviewers with extreme experiences. We present an analytical model that integrates this mechanism with two extant mechanisms: differential utility and base rates. We show that while all three mechanisms can give rise to extreme distributions, only the utility-based and the attrition-based mechanisms can explain our empirical observation from a large-scale field experiment that an unincentivized solicitation email from an online travel platform reduces review extremity. Subsequent analyses provide clear empirical evidence for the existence of both differential attrition and differential utility.

Real and Imagined Smellscapes

The smellscape is the olfactory environment as perceived and understood, consisting of odours and scents from multiple smell sources. To what extent can audiovisual information evoke the smells of a real, complex, and multimodal environment? To investigate smellscape imagination, we compared results from two studies. In the first, onsite participants (N = 15) made a sensory walk through seven locations of an open-air market. In the second, online participants (N = 53) made a virtual walk through the same locations reproduced with audio and video recordings. Responses in the form of free-form verbal annotations, ratings with semantic scales, and a ‘smell wheel’, were analysed for environmental quality, smell source type and strength, and hedonic tone. The degree of association between real and imagined smellscapes was measured through canonical correlation analysis. Hedonic tone, as expressed through frequency counts of keywords in free-form annotations was significantly associated, suggesting that smell sources might generally be correctly inferred from audiovisual information, when such imagination is required. On the other hand, onsite ratings of olfactory quality were not significantly associated with online ratings of audiovisual reproductions, when participants were not specifically asked to imagine smells. We discuss findings in the light of cross-modal association, categorisation, and memory recall of smells.

Physician Rating Websites in the United States: A systematic review (Preprint)

BACKGROUND Physician rating websites are gaining popularity, however, data on their usability and influence on healthcare quality is limited. OBJECTIVE to provide an overview of physician rating websites in the US and find answers for the following questions: 1. What are the most commonly studied/rated physician rating websites in the US? 2. Which specialty of physicians/providers are most commonly studied/rated? 3. How many physicians were rated on the studied PRWs? 4. What is the average number of ratings on these websites and are they positive or negative? 5. How does the profile of providers influence their rating? 6. How are PRWs associated with healthcare quality? 7. How PRWs are associated with patient-physician relationship? METHODS A systematic literature search was conducted through Medline for peer-reviewed articles in the English language on studies conducted in the US. RESULTS 33 articles published in peer-reviewed journals were included in the final review. Most of the studies were conducted on surgeons. A significant number of studies observed no correlation of online ratings with gender, geographic location, and years of experience. Additionally, no significant correlation was found between PRWs and healthcare quality. CONCLUSIONS It has been observed that with the current structure of these websites, the reliability of information available on them is rather questionable, and hence more research is required to assess the credibility of these websites along with their cost-effectiveness, effect on the patient-physician relationship, and quality of healthcare delivery.

Patient satisfaction reviews for 967 spine neurosurgeons on Healthgrades

OBJECTIVE Patients are increasingly relying on independent physician rating websites (PRWs) to obtain information about healthcare providers. Healthgrades.com is a widely used PRW that allows patients to rate physicians on various metrics of performance and quality of care. This study categorically investigated the correlations between demographics of spine neurosurgeons and online ratings on Healthgrades to better understand the factors driving patient satisfaction in spine surgery in the United States. METHODS In August–December 2019, the authors performed a retrospective data analysis using Healthgrades. The American Association of Neurological Surgeons (AANS) membership database was used to identify spine neurosurgeons in the United States and extract biographical and career data. Individuals with an academic practice were further investigated for academic rank, leadership, and fellowship training. Scores from eight patient satisfaction metrics (PSMs) were collected for each surgeon from Healthgrades. RESULTS A total of 967 spine neurosurgeons were included in the study cohort. Patient satisfaction did not correlate with sex, PhD acquisition, academic status, or academic rank. Among those who were academic surgeons, completion of fellowship training was associated with higher ratings. Geographical location of practice did not influence patient satisfaction. Prolonged wait time was an independent predictor of decreased patient satisfaction and was a key confounding variable underlying trends seen with advanced career duration and age. CONCLUSIONS Overall, patients rated spine neurosurgeons highly favorably on the Healthgrades website. Due to the emerging role of PRWs in locating and assessing providers, it is important for both patients and clinicians to understand the factors that impact patient experience.

What Movie Will I Watch Today?

Browsing online ratings and viewers’ comments is an integral part of the experience of choosing and watching a movie. Current theories have broadened the concept of entertainment beyond amusement (hedonic motives) to include experiences of meaning, value, and self-development (eudaimonic motives). With a between-subjects design, we examined the role of reviewers’ ratings (medium rating vs. high rating), comments (hedonic vs. eudaimonic) and participants’ gratification styles on their interest in watching a movie. Results showed that participants (N = 383) reported a higher preference for the high rating movie. Results also revealed a match between comment type and individual gratification style, with participants with hedonic motives reporting more interest for the movie with hedonic comments, and those reporting eudaimonic motives for the movie with eudaimonic comments.

Gender Biases in Online Physician Ratings: Female Doctors Evaluated More Harshly by Patients (Preprint)

BACKGROUND Prior research has highlighted gender differences in online physician reviews, however, to date no research has linked online ratings with quality of care. OBJECTIVE To compare a consumer-generated measure of physician quality (online ratings) with a clinical quality outcome (sanctions for malpractice or improper behavior), to understand how patients’ perception and evaluation of doctors differ based on the physician’s gender and quality. METHODS We use data from a large online doctor reviews website and the Federation of State Medical Boards. We implement paragraph vector methods to identify words that are specific to and indicative of the separate groups of physicians. We then enrich these findings by utilizing the NRC word-emotion association lexicon to assign emotional scores to the various segments: gender, gender and sanction, and gender and rating. RESULTS We find significant differences in the sentiment and emotion of reviews for male and female physicians. We find that numerical ratings are lower and the sentiment in text reviews is more negative for women who will be sanctioned than for men who will be sanctioned; sanctioned male doctors are still associated with positive reviews. CONCLUSIONS Conclusions: Given the growing impact of online reviews on demand for physician services, understanding the different reviews faced by male and female physicians is important for consumers and for platform architects in order to revisit their platform design.

I Will Survive: Predicting Business Failures from Customer Ratings

This paper presents a novel method that uses online ratings to predict business failures.