Baseline characteristics of the patients surveyed

Of 100 patients surveyed, 24.0% were female, median age was 62.5 years (Table 1). Leading causes for hospitalization were coronary artery disease (40.0%) and heart failure (22.0%). The most frequent pre-existing conditions were arterial hypertension (55.0%), atrial fibrillation or atrial flutter (31.0%) as well as again coronary artery disease (31.0%).

Table 1 Baseline characteristics of the patients surveyed

Based on the median age of 62.5 years, patients were divided into two age groups of < 63 and ≥ 63 years, respectively, to allow comparison between younger and older patients.

Previous habits and dealing with the disease

39.0% did sports less than one hour a week and 24.0% more than seven hours a week. 23.0% currently smoke, another 43.0% have smoked in the past (average among active or former smokers: 29.9 pack years).

Typical disease associated feelings were fear for life (43.0%), uncertainty (43.0%), general concern (39.0%), and repression (27.0%). 89.0% stated that they have received support so far particularly from their family, friends, and general practitioner.

The study participants perceived their previous doctor contacts in 76.5% (of n = 98) as very or rather pleasant (mean 2.02 on a scale of 1–5, with 1 representing the most positive value), in 74.5% (of n = 98) as very or rather well organized (mean 2.05), and in 72.7% (of n = 99) as very or rather informative (mean 2.05).

With regard to the management of medical documents, 91.0% (of n = 100) managed them in hard copy in a file folder, 21.0% scanned, and 5.0% used an app. When transferring to the doctor, 83.0% used hard copy, 30.0% sent the documents by e-mail, and 1.0% used an app. 71.4% (of n = 98) found the administration or transfer of documents highly or rather unproblematic (mean 2.06), 71.4% (of n = 98) highly or rather effortless (mean 2.08), and 86.3% (of n = 95) highly or rather errorless (mean 1.61).

52.0% (of n = 100) already used a digital health product, e.g. 32.0% a wearable, 27.0% a pedometer, and 18.0% each a fitness app or an app for managing health data. There was no difference between the age groups in the overall use of any digital health products (30 of 50 respondents of < 63-year-olds vs 22 of 50 respondents of ≥ 63-year-olds, p = 0.109). However, when looking at those answers that referred to using digital health products in the context of an app, a smartphone or a wearable, younger study participants used them significantly more often (29 of 50 respondents of < 63-year-olds vs 18 of 50 respondents of ≥ 63-year-olds, p = 0.028).

Inpatient stay and expectations for the future

Overall, the perception of the current inpatient stay was in a very good to good range. The medical staff was perceived most positively. 76.8% (of n = 99) found this very pleasant, another 19.2% rather pleasant (mean 1.27). The therapy during the current inpatient stay was rated by 86.3% (of n = 95) as very well or rather well organized (mean 1.61). 85.4% (of n = 89) perceived it to be very or rather informative (mean 1.76). Furthermore, 87.8% (of n = 98) found the inpatient stay in general to be very well or rather well organized (mean 1.73). 70.0% (of n = 100) perceived the inpatient stay in general to be very or rather pleasant (mean 2.05). After the inpatient stay, 88.8% (of n = 98) felt very well or rather well informed about their illness (mean 1.64).

When considering the feelings at the end of the inpatient stay and the future management of the disease, 75.0% (of n = 100) felt motivated, 70.0% felt confident, 68.0% felt hopeful, and 63.0% felt reassured. In contrast, 32.0% reported fear of the disease, 25.0% concern about the future, 21.0% felt uncertain, and 20.0% worried (Fig. 1).

Fig. 1

Feelings at the end of the inpatient stay and future management of the disease

Continuous aftercare was very or rather important for 84.8% (of n = 99; mean 1.69). The most common wishes for aftercare were security with 80.0% (of n = 100) and reliability with 76.0%. 81.0% of the study participants stated that they had a general practitioner or specialist and that they could contact them at any time, 15.0% reported having doctors, but without being able to reach them instantly. 93.0% would be important to be able to reach them promptly.

Results concerning the development of the app

88 participants considered an app use and answered the app-related questions. 12 participants rejected the use from the beginning (two < 63-year-olds, ten ≥ 63-year-olds). In the following, therefore, 100% refers to n = 88, respectively n = 48 in < 63-year-olds and n = 40 in ≥ 63-year-olds.

Document management

Among the documents to be deposited, the study participants named doctor’s letters (90.9%), laboratory findings (89.8%) as well as the vaccination record (88.6%) most frequently, followed by further findings (76.1%) and findings from medical imaging (73.9%).

Monitoring

In terms of monitoring, the monitoring of blood pressure (86.4%), heart rate (83.0%), and heart rhythm (80.7%) was particularly desired. Measurements of weight (52.3%) and blood sugar (51.1%) as well as a pedometer (51.1%) followed at a similar lower level. In the case of functions linked to the monitoring parameters, the respondents primarily wished a signal function when individually defined limit values were exceeded (84.1%). 63.6% wished an automatic measurement and transfer of the parameters. In contrast, the possibility of keeping a food diary was perceived as unimportant by 51.1%.

Administration, telemedicine

In the area of administration and telemedicine, the most important functions for patients were the ability to diarize preventive and follow-up examinations with examination cycles (90.9%), in addition, a signal from the app when the next appointment is due or needs to be booked (87.5%), as well as the inclusion of all medical disciplines (84.1%). 79.5% considered an emergency doctor function with a contact person in the event of health problems to be important, 68.2% an overview of medical on-call service as well as 67.0% activities, sports, and doctor contacts specially tailored to them and their illness.

For the basic type of contact, 75.0% preferred a phone call and 58.0% e-mail. This was followed by SMS (21.6%) and videotelephony (15.9%). There was no significant difference in age groups (< 63- vs ≥ 63-year-olds: telephone 77.1 vs 72.5%, p = 0.621; e-mail 54.2 vs 62.5%, p = 0.430; SMS 18.8 vs 25.0%, p = 0.478; video 16.7 vs 15.0%, p = 0.831). Regarding 24-h availability, 71.6% preferred contact by telephone, 22.7% by e-mail, and each 12.5% by SMS or videotelephony.

Medication management

In terms of medication management, the most important feature was a medication plan (87.5%) and its digital transmission to the treating physicians (79.5%). 71.6% would like the app to indicate drug interactions within the plan or with new medications. 62.5% wished a signal from the app when medication has been used up to order new ones, and 61.4% the declaration of usual dosage ranges/schemes.

Knowledge transfer

64.8% considered an overview of relevant terms and abbreviations in the app to be important. Furthermore, 47.7% valued education possibilities to be important, 34.1% to be unimportant. Regarding education possibilities in the context of the app, 69.3% wished an education for general use of the app, 56.8% for functions of document management, and 53.4% in appointment/consultation arrangement and administration. For further education possibilities in the context of the illness and in general, the most requested topic was knowledge about one’s own illness (60.2%). Other themes were education on relaxation exercises (44.3%), in addition to conventional medicine, information about naturopathy or alternative medicine (43.2%) as well as nutrition (43.2%).

Regarding the education format, the respondents preferred training videos with 46.6% and reading material with 44.3%. A comparison of age groups shows that the < 63-year-olds indicated videos significantly more often (58.3 vs 32.5%, p = 0.016), while there was no significant difference in age groups regarding reading material (37.5 vs 52.5%, p = 0.158). Desired functions in the education area of the app were a signal when new training courses are available (69.3%) and activities specifically tailored to the patients and their illness (67.0%).

General aspects

62.5% (of n = 88) expected a reduction in organizational effort of their medical care through the app, 31.8% a partial reduction (Fig. 2). Overall, 94.3% therefore expected at least a partial reduction in organizational effort. There was no significant difference between age groups in relation to an at least partially expected reduction (91.7 vs 97.5%, p = 0.239). In contrast, with regard to concerns, only 11.4% expected a relief and 25.0% a partial relief. 36.4% therefore expected at least a partial relief from their worries. 48.9% expected no relief and 14.8% stated that they had no worries. There was again no significant difference between age groups regarding an at least partially expected relief (31.3 vs 42.5%, p = 0.275).

Fig. 2

Expected relief from the app

Of the patients surveyed, 60.0% (of n = 100) indicated a willingness to use the app and another 24.0% were potentially willing to do so. Furthermore, significantly more patients < 63 years stated a willingness or potential willingness to use the app (92.0 vs 76.0%, p = 0.029; Fig. 3). The preferred type of application was the app with 59.1% (of n = 88), a web portal was desired in 15.9%, and 21.6% were indifferent.

Fig. 3

Willingness to use the app

For those considering app usage in general (n = 88), the most favoured features, when choosing a maximum of three functions, were document management (81.8%) and medication management (65.9%; Fig. 4). Furthermore, monitoring was at 48.9% and administration/telemedicine at 47.7%. Knowledge transfer was desired by 35.2%.

Fig. 4

Importance of different functions for the design of the app