gms | German Medical Science

Background: Self-service technologies, e.g. health terminals [1] enable secure, authenticated access for patients to reach healthcare providers and insurers for example via personal health records or health portals. Health terminals can also provide additional services related to general health topics, such as finding the right healthcare provider. While these technologies are common in other countries health terminals are only used on a project base in Germany [2], [3], [4]. The aim of this study is to gain insight into the usage and its duration in order to better understand their preferences trying to answer the research questions:

• Q1: Which functions of health terminals are used and how often?
• Q2: How does the frequency of use and the duration of using these functions develop over time?

Methods: This study was performed within a larger project on health terminals together with DeGIV. The terminals were set up stepwise from August 2015 onwards in pharmacies (Jul19: 69; Jan20: 92), health insurance service centres (Jul19: 17; Jan20: 21), hospitals (Jul19: 2; Jan20: 19) and medical care centres (MVZ) (Jul19: 0; Jan20: 7). The use of these terminals was logged monthly in the period from July 2019 to January 2020 drawing on methodology and experience from the literature [5], [6].

The following “usage tracking” variables were recorded: site, function used, start and end time of usage and whether the process was aborted. For usage analysis, frequency of use and usage duration (seconds) were captured on a monthly base and expressed per device.

Results: In absolute numbers, the use of terminals increased from 1,097 uses, in July 2019, to 2,716 uses, in January 2020. Thus, the relative usage per device rose from 11.5 uses per month to 21.6 uses. With respect to site and during the entire period, the devices were most frequently used in hospitals (286 uses/device [u/d]) and MVZs (131 u/d), followed by service centres (82.7 u/d) and pharmacies (68.8 u/d). The five most frequently used functions over the entire period were the body mass index (BMI) calculator (n=5,998), physician search (n=3,310), ICD information (n=2,236), transmission of incapacity certificates (AU) (n=934) and readout of data from the electronic health cards (n=426) with a mean duration of 84 s for AU transmission, 33 s for physician search, 31 s for ICD information, and 29 s for data readout. While the usage of physician search (1 to 7 u/d), BMI (5.9 to 8 u/d) and AU transmission (1 to 1.8 u/d) increased over time relative to the number of terminals available, the usage of the other functions stayed the same.

Conclusion: In summary, log file analyses give a hint about which functions were used, and how long it took to complete a process thus governing further developments [7]. During the study period, which captured only roughly six months, the various terminal functions were not used very often and least often in pharmacies. These findings need to be discussed in the context of health apps as competitors for terminals [8]. Further analysis should investigate regional patterns over a longer time period.

The authors declare that they have no competing interests.

The authors declare that an ethics committee vote is not required.