Patient Experiences with an mHealth App for Complex Chronic Disease Care: Connections Despite Lack of Traditional Clinical Interactions

Chronic diseases are costly to treat and burdensome for patients. Mobile health (mHealth) technologies might reduce costs of care and increase patient self-efficacy in chronic disease management, but the patient experience of mHealth is poorly understood. Our objective, therefore, was to evaluate patient experiences with using an mHealth app for complex chronic disease management, within a U.S. population of low-income patients. We used nurse/patient text messages from an mHealth complex chronic disease management tool, and exit interviews from patients, to assess qualitatively Medicaid patients' experiences with a remote monitoring mHealth app. Salient themes about the patient experience included: (1) Visibility and Invisibility in the Medical System (patients felt both seen and heard when using the app), (2) Deconstructing the Clinical Encounter (patients were reassured by being able to access care from any place at any time), (3) Familiarity in the Nurse/Patient Relationship (patients felt connected to the nurses running the app), and (4) Technology as a Conduit of Caring (the technology enhanced nursing care, rather than detracting from it). M-Health apps might be a way to improve provision of care for high-utilizing patients, particularly those from historically marginalized groups.