Digital Readiness for Smartphone-Dependent Diagnostic Pathways in Urogynecology: A Quality Improvement Survey from a U.K. District General Hospital
Background: Digital solutions are increasingly integrated into gynecological services to improve efficiency and reduce avoidable cancellations. A smartphone-dependent home urine dipstick pathway was proposed as part of a quality improvement initiative to reduce same-day cancellations of urodynamic investigations. Understanding patient access to and confidence with digital technology is essential for successful implementation. Objective: To evaluate smartphone ownership, digital confidence, and familiarity with QR code technology among patients attending a urogynecology service and to assess readiness for a smartphone-based diagnostic pathway. Methods: A cross-sectional survey was conducted among adult patients attending urogynecology outpatient clinics at a UK district general hospital between May and July 2025. The survey assessed smartphone ownership, self-reported confidence using smartphones (5-point Likert scale), quick response code (QR code) familiarity, and acceptability of digital components of care. Age-stratified analyses were performed. Results: Of 156 patients invited, 108 participated (69.2%). Overall, 92 participants (85.2%) owned a smartphone. Ownership declined significantly with age ( p < 0.001), from 100% in patients aged <50 years and 97.4% in those aged 50–69 years to 67.4% in those aged ≥70 years. Mean smartphone confidence scores and QR code familiarity also decreased significantly with increasing age ( p < 0.001). Overall, 39.8% of participants met predefined criteria, indicating a potential need for additional support or alternative pathways. Conclusion: While smartphone access is high in urogynecology patients, significant age-related disparities in digital confidence and QR familiarity may limit equitable implementation. Quality improvement initiatives introducing smartphone-dependent pathways should incorporate flexible, inclusive strategies to prevent digital exclusion.
Authors
- Nimmi Varghese
- Aditi Siddharth (ORCID: https://orcid.org/0000-0003-0529-8240)
- Avanti Patil
- Ian Currie
- Harini Devabaktuni
- Melissa Alvares
Institutions
- Worcestershire Acute Hospitals NHS Trust (GB)
- Buckinghamshire Healthcare NHS Trust (GB)
- Nuffield Orthopaedic Centre (GB)
- University of Oxford (GB)
- Wye Valley NHS Trust (GB)
Publication Details
- Journal
- Journal of Gynecologic Surgery
- Published
- 2026-05-22
- DOI
- https://doi.org/10.1177/10424067261453183
- Primary Topic
- Mobile Health and mHealth Applications
- Type
- article
- Field-Weighted Citation Impact
- 0.00