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Implementation of a mobile app for trauma education: results from a multicenter study
  1. Benjamin R Childs1,
  2. Mary A. Breslin2,
  3. Mai P. Nguyen3,
  4. Natasha M. Simske2,
  5. Paul S. Whiting4,
  6. Aswinkumar Vasireddy5,
  7. Heather A Vallier6
  1. 1El Paso, Texas, USA
  2. 2Cleveland, Ohio, USA
  3. 3Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
  4. 4Department of Orthopaedic Surgery, University of Wisconsin System, Madison, Wisconsin, USA
  5. 5Department of Orthopaedic Surgery, King's College London, London, UK
  6. 6Department of Orthopaedic Surgery, MetroHealth System, Cleveland, Ohio, USA
  1. Correspondence to Dr Heather A Vallier; hvallier{at}


Background In an era of shared decision making, patient expectations for education have increased. Ideal resources would offer accurate information, digital delivery and interaction. Mobile applications have potential to fulfill these requirements. The purpose of this study was to demonstrate adoption of a patient education application (app: at multiple sites with disparate locations and varied populations.

Methods A trauma patient education application was developed at one trauma center and subsequently released at three new trauma centers. The app contains information regarding treatment and recovery and was customized with provider information for each institution. Each center was provided with promotional materials, and each had strategies to inform providers and patients about the app. Data regarding utilization was collected. Patients were surveyed about usage and recommendations.

Results Over the 16-month study period, the app was downloaded 844 times (70%) in the metropolitan regions of the study centers. The three new centers had 380, 89 and 31 downloads, while the original center had 93 downloads. 36% of sessions were greater than 2 min, while 41% were less than a few seconds. The percentage of those surveyed who used the app ranged from 14.3% to 44.0% for a weighted average of 36.8% of those having used the app. The mean patient willingness to recommend the app was 3.3 on a 5-point Likert scale. However, the distribution was bimodal: 60% of patients rated the app 4 or 5, while 32% rated it 1 or 2.

Discussion The adoption of a trauma patient education app was successful at four centers with disparate patient populations. The majority of patients were likely to recommend the app. Variations in implementation strategies resulted in different rates of download. Integration of the app into patient education by providers is associated with more downloads.

Level of evidence Level III care management.

  • multiple trauma
  • education, medical
  • outcome assessment, health care

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  • Presented at This paper was presented at the Annual Meeting of the Society of Military Orthopaedic Surgeons, Palm Beach Gardens, Florida,18 December 2019.

  • Contributors BRC: study development, implementation, enrollment, data collection, data analysis, manuscript writing and literature review. MB: study development, implementation and manuscript critical revision. MN: implementation, enrollment, data analysis and manuscript critical revision. NS: implementation, enrollment, data collection and manuscript critical revision. PW: implementation, data analysis and manuscript critical revision. AV: implementation, data collection and manuscript critical revision. HAV: study design, implementation, enrollment, data analysis, literature review, manuscript drafting and critical revision.

  • Funding This study was IRB approved. Funding to develop the app was provided through the MetroHealth Foundation Nash Endowment for Orthopaedic Education. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. All of the devices in this manuscript are FDA approved.

  • Map disclaimer The depiction of boundaries on this map does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. This map is provided without any warranty of any kind, either express or implied.

  • Competing interests Funding to develop the app was provided through the MetroHealth Foundation Nash Endowment for Orthopaedic Education.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. Data may be available on reasonable request.

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