Accepted for/Published in: JMIR Cardio
Date Submitted: Oct 24, 2022
Open Peer Review Period: Oct 24, 2022 - Oct 31, 2022
Date Accepted: Feb 19, 2023
(closed for review but you can still tweet)
Implementation and User Evaluation of an eHealth Technology Supporting Patients with Cardiovascular Disease in Managing their Health after a Cardiac Event: Mixed Methods Study
ABSTRACT
Background:
Supporting patients with cardiovascular disease (CVD) to adopt and maintain a healthy lifestyle is a challenging and ongoing process. eHealth technology can help patients with CVD in this challenge, by supporting self-management, offering guidance, coaching and tailored information. However, to be able to assist patients over time, the eHealth technology needs to blend in with patient’s treatment and daily lives. In this study, we focus on the user-centered implementation and evaluation of an online lifestyle platform: the ‘Vital10’ Personal Health Platform (Vital10 PHP).
Objective:
The aim of this study is to identify and monitor patients’ needs regarding an online health management platform, and how these needs change over time. We aim to answer the following research questions: “How do novice and more advanced users experience the Vital10 PHP?”, “What user experiences support or hinder the adoption of Vital10 PHP, from a user perspective?” and “How does actual usage relate to user experiences and adoption?”.
Methods:
A mixed method design was applied. First method was two rounds of usability testing followed with interview questions conducted with ten (round one, at 0 months) and twelve (round two, at 6 months) patients. In addition, in the second method, log data was collected to describe the actual platform usage.
Results:
After starting cardiac rehabilitation, the platform is used frequently. Patients mentioned they need to have an incentive, set goals, self-monitor their lifestyle and health data and feel empowered by the platform in this respect. However, soon after the rehabilitation program stopped usage of the platform declined or patients even quit, due to the lack of continued tailored or personalized advice. The reward system motivate them to log data, but most participants indicated that being healthy should be the main focus, not receiving gifts. Using an online platform is flexible, accessible, and without obligations, however, it should be implemented not only as an addition of the cardiac rehabilitation but as an addition to the regular care.
Conclusions:
Patients feel empowered by Vital10 PHP to improve their lifestyle and the platform is used frequently. On the longer term, however, the usage declines. Future research should identify if patients who discontinued using the platform were indeed capable of maintaining a healthy behavior themselves, or if they miss a personal component or supporting guidance on the longer term. It should be kept in mind however that the key to success should not be user adherence to a platform, but adherence to healthy lifestyle habits. In this regard, the platform can still play a role in the patients’ life as (back-up) support, especially in case of relapse or health related questions, focusing on helping patients to live healthier and make them aware of supporting products and services in the neighborhood.
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