JMIR Publications

ABSTRACT

Background:

Epilepsy, multiple sclerosis (MS) and depression are chronic conditions where technology holds potential in clinical monitoring and self-management. Over five years, the RADAR-CNS consortium is exploring the application of remote measurement technology (RMT) to the management and self-management of patients in these clinical areas. The consortium is large and includes clinical and non-clinical researchers as well as a patient advisory board.

Objective:

Early in the research project, a formative development study was conducted to understand how consortium members viewed the potential of RMT in these conditions, aiming to align views and reach consensus within the consortium on the system under development.

Methods:

In this qualitative survey study, we developed a methodological tool, Universal Points of Care (UPOC), to elicit knowledge about the potential use, acceptance and value of a novel Remote Measurement Technology (RMT) platform across three chronic conditions (MS, epilepsy and depression). UPOC builds upon use case scenario methodology, utilising expert elicitation and analysis of care pathways to develop scenarios applicable across multiple conditions. After developing scenarios, we elicited views on the potential of RMT in these different scenarios through a survey administered to 28 subject matter experts, consisting of 16 healthcare practitioners, 5 healthcare services researchers, and 7 people with lived experience of MS, epilepsy or depression. Survey results were analysed thematically and using an existing framework of factors describing links between design and context.

Results:

Through use of UPOCs, the survey elicited potential beneficial applications of the RADAR-CNS RMT system, as well as patient, clinical and non-clinical requirements of RMT across the three conditions of interest. Potential applications included recognition of early warning signs of relapse from sub-clinical signals for MS, seizure precipitant signals for epilepsy, and behaviour change in depression. RMT was also thought to have potential to overcome the problem of under-reporting which is especially problematic in epilepsy, and to allow capture of secondary symptoms that are not generally collected in MS, such as mood.

Conclusions:

The UPOC methodology was effective in directing respondents to consider the value of healthcare technologies in condition-specific experiences of everyday life and working practice, and enabled expression of discord and nuance within responses.