Assessing Mobile Health Readiness among Patients at a Southern Indian Eye Hospital: Access, Proficiency, and Attitudes Toward mHealth Tools.

BACKGROUND: Mobile health (mHealth) technologies have the potential to transform health care delivery in low- and middle-income countries, particularly in ophthalmology. However, effective implementation depends on patients' readiness, access to mobile devices, and ability to use them. This study aimed to assess patients' readiness for mHealth by examining mobile phone ownership patterns, evaluating proficiency in phone use, and exploring attitudes toward adopting mHealth tools. METHODS: A cross-sectional questionnaire-based survey was conducted across three care settings at a tertiary eye hospital: the free section, paying section, and vision centers (VCs). Patients were randomly selected from clinic populations to reduce interviewer bias. Prior focus group discussions informed questionnaire refinement to capture diverse digital usage patterns. Sampling was structured according to average patient volume in each clinic. Data were collected from August to October 2023. RESULTS: Totally, 946 patients were interviewed: 41% were feature phone owners (FPOs), 37% smartphone owners (SPOs), and 21% had no phone (NPOs). Smartphone ownership was highest in the paying section (53%), feature phone ownership in the subsidized section (45%), and no-phone ownership in VCs (45%). Among NPOs, 80% were women. Patients aged over 60 were significantly less likely to own smartphones than feature phones (odds ratio [OR] = 0.10, p < 0.001) or have no phone (OR = 0.18, p < 0.001). Higher literacy levels were strongly associated with smartphone ownership. Nearly all SPOs and FPOs could receive calls, but far fewer FPOs could read (15-33%) or send short message service (2-8%). Only 22% of SPOs sought health information online, while most FPOs and NPOs did not use the internet. Electronic consent was acceptable to most SPOs and FPOs, but not among NPOs. CONCLUSIONS: Significant disparities in mobile phone ownership, digital proficiency, and attitudes toward mHealth exist among patients. mHealth interventions must therefore align with patient capabilities to ensure equitable and effective implementation.