Does an app make patients happy? Impact of a novel medical history app on patient satisfaction in urgent care consultations in Germany: cluster-randomized interventional trial 'DASI'.

Clinical Snapshot

Key Findings

• P Value: Statistically significant differences reported (specific p-values not provided)

• Effect Size: Significant improvements in 12 of 17 individual EUROPEP items and all three domain scores

• Primary Outcome: Patient satisfaction measured by EUROPEP instrument across 17 items and 3 domains

• Nnt Or Sensitivity: 78-96% of patients rated care as excellent or very good, with intervention group showing higher top-level ratings in 9 of 17 items

• Confidence Interval: Not reported in abstract

Clinical Application

High feasibility given smartphone ubiquity and user-friendly interface, though requires initial setup and staff training Relevant to Australian after-hours GP services and emergency departments. Could integrate with existing digital health initiatives and MyHealth Record system. May require TGA software classification assessment. Patients attending urgent care and after-hours services, particularly younger demographics (median age 31 years)

Abstract

BACKGROUND: Patient satisfaction is an important indicator of healthcare quality. However, time constraints in primary care limit effective communication and history-taking. Digital medical history systems have the potential to improve the quality of medical consultations by enabling patient preparation and providing physicians with comprehensive pre-consultation information. This study aimed to evaluate the impact of a novel medical history-taking app (DASI app) on patient satisfaction in out-of-hours practices (OOHP) in Germany. METHODS: We conducted a two-center, cluster-randomized trial over 12 months. Within each practice, weeks were randomized to either an intervention or control group, resulting in a cluster-randomized trial (CRT) with clustering in weeks within the same practice. Patients either used the DASI app before consultations (intervention group) or received standard care (control group). The DASI app is a patient-facing tool that guides patients through a dynamic questionnaire adapted to the selected complaints and previous answers. Patient satisfaction was measured using 17 items from the EUROPEP instrument covering relation and communication, medical care, and information and support. Additionally, we collected sociodemographic data. Statistical analyses included Mann-Whitney U tests for individual items and t-tests for domain scores. Analyses were performed with R, version 4.5.2. RESULTS: Among 1,460 approached patients, 1,040 (71%) were enrolled and 1,034 included in analyses. Patient median age was 31 years, with 60% female participants. Patients in the intervention group (n = 496) showed significantly better ratings in 12 of 17 EUROPEP items compared to controls (n = 538) and demonstrated significantly higher satisfaction across all three EUROPEP domains. Between 78 and 96% of patients rated care as excellent or very good, with intervention group patients more likely to select top-level evaluations in 9 of 17 items. CONCLUSIONS: Digital medical history taking significantly enhanced patient satisfaction in urgent care settings. The app likely improved satisfaction through multiple pathways including increased patient empowerment, better consultation preparation, and more efficient physician-patient interactions. These findings demonstrate that user-friendly digital tools can meaningfully enhance patient experience without disrupting existing workflows, supporting healthcare digitalization efforts while maintaining high-quality patient-centered care. TRAIL REGISTRATION: German register for clinical trials (DRKS00026659; date of registration: 2021-11-03).

References

1. 1.Noack, E. M., Antweiler, K., Müller, F., Schröder, D., Friede, T., Hummers, E., & Roddewig, L. (2026). Does an app make patients happy? Impact of a novel medical history app on patient satisfaction in urgent care consultations in Germany: cluster-randomized interventional trial 'DASI'. BMC Health Services Research. https://doi.org/10.1186/s12913-021-06748-y