title: Mobile health apps in Sweden: what do physicians recommend?
abstract: BACKGROUND
  Currently over 50,000 mobile health apps are available worldwide. In general, they are considered as innovations potentially delivering benefits to patients. Physicians are considered as potential channels to disseminate these innovations to patients. However, physicians' behavior in this regard has not been studied.
  
  
  OBJECTIVE
  To capture physicians' attitudes towards recommending health apps to patients and to describe factors influencing physicians' behavior, taking the specifics of an early adopter country, Sweden, into account.
  
  
  METHODS
  Diffusion of Innovation theory, the Health App Maturity Model and the Six Hurdles Model were used to construct a web-based survey that was answered by 44 Swedish physicians. Survey results were followed up with 2 individual interviews. Descriptive statistics were used for quantitative data analysis and recursive abstraction for qualitative data analysis.
  
  
  RESULTS
  Only a small group of physicians currently recommend mobile health apps to their patients. However, most physicians have a positive attitude and perceive improvement of patients' self-management ability as main benefit of health apps. Main perceived weaknesses include the lack of evidence-based content and lack of multi-language support. Regulation of health apps under the Medical Device Directive is asked for to assure quality and patient safety.
  
  
  CONCLUSIONS
  Innovators and early adopters play an important role in the diffusion of mobile health apps. Interpersonal communication is seen as the most effective way for physicians gaining information and also motivates them to recommend mobile health apps to their patients. Physicians' knowledge about certified websites to ensure quality is however low.
authors.affiliation: Health Informatics Centre, LIME, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Yiping
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Health Informatics Centre, LIME, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Sabine
authors.initials: S
authors.lastname: Koch
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications / Q000145:classification* / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D012648:Self Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013548:Sweden; D017216:Telemedicine / Q000706:statistics & numerical data*