JMIR Publications

ABSTRACT

Background:

Background:

Digital self-monitoring allows patients to produce and share personal health data collected at home. This creates a novel situation in which healthcare providers and patients must engage in a reconfiguration of roles and responsibilities. While existing research pays considerable attention to the motivations and perceptions of patients regarding digital self-monitoring, less attention is paid to the needs, wishes, and concerns of healthcare providers. As several companies are developing and testing digital self-monitoring at the time of writing, it is timely and relevant to explore how healthcare providers envision using these technologies in their daily work practices and whether they are willing and able to use them. Our findings can be considered in decision-making processes concerning the further development and implementation of digital self-monitoring.

Objective:

Objective:

We aim to explore how healthcare providers envisage using smartphone apps for digital self-monitoring of multiple sclerosis (MS) in their daily work practices, with a particular focus on doctor-patient communication and on how healthcare providers respond to self-monitoring data and delegate tasks and responsibilities to patients.

Methods:

Methods:

We conducted semistructured in-depth interviews with 14 MS healthcare providers: four neurologists, seven MS specialist nurses, and three rehabilitation professionals. They are affiliated with three different hospitals in the Netherlands that are going to participate in a pilot study to assess the efficiency and efficacy of a specific smartphone app for self-monitoring MS.

Results:

Results:

The interviewed healthcare providers seemed willing to use these smartphone apps and valued the quantitative data they produce that can complement the narratives that patients provide during medical appointments. The healthcare providers primarily want to use digital self-monitoring via prescription, meaning that they want a standardized smartphone app and want to act as its gatekeeper. Furthermore, they envisioned delegating particular tasks and responsibilities to patients via digital self-monitoring, such as sharing data with the healthcare providers or acting on the data if necessary. The healthcare providers expected patients to become more proactive in the management of their disease. However, they also acknowledged that not all patients are willing or able to use digital self-monitoring apps and were concerned about the potential psychological and emotional burden on patients caused by this technology.

Conclusions:

Conclusions:

Our findings show that healthcare providers envisage a particular type of patient empowerment and personalized healthcare in which tensions arise between healthcare providers acting as gatekeepers and patient autonomy; between patient empowerment and patient disempowerment; and between the weight given to quantitative “objective” data and that given to patients’ “subjective” experiences. In future research, it would be very interesting to investigate the actual experiences of healthcare providers with regard to digital self-monitoring to ascertain how the tensions mentioned in this paper play out in practice.