Available via license: CC BY 4.0
Content may be subject to copyright.
Original Paper
User-experience of Paents with Telehealth: Complemenng a
Clinical Trial with Human-Computer Interacon
Abstract
Background:
!
"#$"#%
"#
$&'%
Objective: ()$()%*&'
+&'
"#
Methods: +
,
()+"&-
$"&-%()
Results:.
/*
*
0*
()
Conclusions: "#
()*&'"#
Trial Registration:
Keywords: "11(1
111
11
Introducon
()*1()
232(444526(426
7268(426&9):3;
2(<*7268
()
7258-
72:8
(
)$()%#"
$#"%7289
()
7(;8=
()
$
%
()7(;8
>$/"%
?*9
+
@
75680()
2=2=
#2=
()
"
76(8
"#
="#
$&'%
&'
738
+ ()
+$2%"#
()*&'
2"#
! .0 /
A
Applied
Ethnography [8]
long term immersive
fieldwork; observation
combined with
participation
Researcher moves
into users’ world
"
)$")%7B8
1
C
/
*
-
)7248
?*
/
*
D
)$D)%
7228
&
*
")72(8 !
1
&
*
E&
=72;8
&
*
&2
#
>
+
*
+,
"#
$"&-%7;8+
"#"&-
()&'
Research Objecve
F*&'
F
,"&-G
Q1. What happens at the patient’s home during the use of the telehealth device?
Q2. How do patients feel while using the telehealth device?
Q3. Which function/s and designs of the device satisfies /dissatisfies the patients?
Methods
Research Method
=(425
()
$%7;8
"&-"&-$02%9
,*)
,*
*9
,,*1,
9
#"
H"&
-$2(%
02"&-
)"&-"#
"&-
;447238
"&-F(
$%
()"&-"
Parcipants
"&-!
!E$!!E%>I=72C8=(24
!JD
"&-G
"&-- "
#
#*
#*
A
F
9K =
"#,
/,
/ "&-
1
/
=
$
=%
"
,
# "
"#
"
L
/ D
E
- D,
9
=
-1
J$%1
)(2(1
M"&-
D"&-=2(
"&-
>
"&-0
:564:;$;%
D
*J
A
,
;D)
Participants
pseudonyms
Sex Age Computer use
(hours /week)
Time in Clinical
Trial (months)
Diagnosed
with T2D
(years)
& 0 35 4 6 2(N
O ! 34 34 C 24N
P 0 :C (4 : 3
M ! :: (4 : 24N
J ! :5 5 6 (4
0 :4 ( 6 (6
9 0 66 2( ; (
D ! 6; ( : 2
! 6( :4 : (
Equipment
D22
$0(%
=
0(
Data Analysis
#,
,
$!=2%
>M24
Results
A0
*9*
Current Design: Technology-User Fit
+$5%
G$5%
$(%$(%$2%#L
$;%$5%$2%$2%
5D9
E 9 J
D
#
9 ( 2 ;
" 2 2
" 2 2 2 2 5
9
! 2 2
/ 5 ( ( 2
),
$9!=%
O*,
$05%G$%
$%
$%
05-,;
Lack of wireless capability:#
*
9&
“Apart from when you gotta be home two hours after eating to do it can be a little bit
difficult like..Oh my God I have gotta get home so I mean time wise that’s it if I am not
gonna be at home..” $%
+&
9
“I can take this (her own glucometer that she bought) with me, I can't do the blood
pressure, I take this with me and do the blood sugar and then put it down in a book.”
$&%
Undesirable experience from sphygmomanometer:-
##
“The blood pressure cuff I have more difficulty with. I put it here where my doctor
would put it. It re pumps and it takes ages to do it. It marks my arm.”$P%
P9
Lack of visual data:#
0
D
“I know it does it here (glucometer) but it would be good to see every day’s. But it
doesn´t show you. Like last week I might have been 5.5 and this week I am 7.5 why?
Why am I? Then I would do exactly the same things that I did last week.” $J%
MF
MF
M*
M*+G “It would be much better if he could just push a button and see the last
three weeks of his readings.”
“Coz he is adjusting his insulin and he needs to know---all the time.”
“Probably I would like to see a graph of my results, more often. Like even once a month
would be good to show it on a graph. How my results are going, because you just see
number everyday, but you want to know your ups and downs, and you want to know
using that computer why my diabetes goes higher, I know the reason now why it goes
higher, before I didn´t know the reasons. But now I do. And it’s just the difference the
food that I have eaten and the foods prepared and I have found that because I am
monitoring my blood glucose carefully.” $D%
OO
,
“There is nothing like graphs to see trends. They have to display in a sensible way, if
that makes sense. I will be thinking that a progressive graph will do it.” $O%
Lack of medication name:P
P
“To see my change of insulin and I couldn’t find on here so I went back through here
with my computer and Internet. My medicine is also here… and insulin is not there but
I looked that up at the computer. Not everyone has that. When I want to see what that
thing do I check it up here. I don’t ever touch the unit because it automatically shuts
down. It’s simple as that, quite easy to use. Bit challenging at the beginning.” $P%
O
Mismatch with life due to immobility of the device:
#=
&*9
“I can take this with me, I can't do the blood pressure, I take this with me and do the
blood sugar and then put it down in a book.” (Uma)
Glucometer Discomfort and Pain:+
9
(),
9
,
“Problem I see with this is you have to prick your finger every time you use it. It’s not
that bad but after a while you are bruising your fingertips sore so in that respect I
guess it’s not really something that one looks forwards to going and doing.” $%
-=
O
#
Feelings and Percepons
D
“And it’s good that they(nurses), that someone else is keeping an eye on you, back at
office, nurses.” (Vince)
D
“I think it’s a great benefit for me, I wish it probably could stay and I would like to keep
it. I don´t know how I am gonna go, I am obviously in the habit of doing it every morning
now, I am gonna have it. It´s a habit now. So next week it’s gonna go and I can still
maintain the regime that I am doing it now, you know.” (Pete)
-9
9
9*
“It’s more like a -- there's a regime for everyday 10 minutes
before eating and after eating, she tastes it and morning, afternoon-- it's 10 minutes or 5
minutes—doesn’t affect much. But it improved her overall awareness.” (Serena’s son)
M
It (the device) makes you, wanna do it (the blood glucose reading) $M%
,#?,
*
You know when you haven't done this for a week and oh you should do it. It's like
quitting smoking, you know that you have to ring up somebody every time you have to
ring up. So it's that extra incentive you know. $%
)#M
“It´s sort of like a safety net. You know there’s someone in the background always
watching and they will ring you up.” (Vince’s Wife)
0&$35%#&*
9*9*
D
#
D
-
035
&
,=$(6
%&G
&GI don't know what's wrong with it, it suddenly slowed down.
/GDid it slow down today or--?
&GNo, it has been doing this for a few days. I was talking to the lady (Nurse1) on
the phone and-- come on
&come on
&: I have to go through this every morning. It's--aaah
&
I don't know whether it’s because it's---Aaaahhhhh$&%
=&
!
=$%
F$0;%#
“It’s not really a one-man job.”
0;$%&$%
Discussion
=P
@
-
&'0()
-
Design Implicaons for future telehealth for T2D
+Q
()
Domescaon of the device
F"72B8
+"*7(481
AM
P
In+uence on paents from the use of the technology
D0
D$D%
*
7(28A.1
7(((;8D
#
M
D
9
9
9*9
=MD
/
*D7(58#
7(68()
Categorizaon of the paents as users
=+
2("&-+
"&-G
7;8
Limitaons of the Research
"&-K
()
,
Comparison with Prior Work
!F
7(:(C8
*1
7(B8
$%
"&-0
63<7;48
"&-,
#"
"#
#
()(42:
7;28"&-,
7;(8
D,7;;8
7;;8()
9"&-
"##"Q"#
$()%
=()
7;58"&-/
()
Conclusions
#
=
7:89
C4<7;6;:8&'
"#
*&'()>I+
()D*
()
R
,+"#
*&'
Acknowledgements
!!E
F()/"72B89
()))
Con+icts of Interest
>
Abbreviaons
"&-G"&-
"#G"#
#"G#"
DGD
()G()
!!EG!!E
&'G&-
References
2 ."9.>/KJEMHJ!
GJ!H
(42313$C%G42:(5(
( +9E.""P"99">"
(G=
9/$>D
Q%(42313G2
; H9!=#=!9JA
"()"&-
-$"&-%H(4261;B$;%G2(2
5 J=)"HD"="".J
,GDE9
(4221C$2%G2444;C3
6 .9!&G
&1(42(#9J>GB4;:6;523C
: >F>QG
G&1(422#9J>GB4;:6;2;;4
3 >)>H>>L>>
QGLLLLL$
(42:4323%(42:
C 9E!"="!
2BB61;C$B%G6::5
B JK."G
G!.12BB3#9J>G44C464;453
24 D"E.9DHG=
D5
#")DD#
)DD#S4B"A(44B1(44BG&"
22 9KK"
(44616($(%G2:;35
2( 9-J>9DH""
(44C15$2%G62C
2; ETF""E&G
/U)!(4451;5$6%G66;:C
25 )=E)==(4237(4235
!(42381=GGLLL
26 #)0#)0(423
7(423!2;81=GGLLLL
2: J!JV!0-/)JEWQ+
GR
5#"D"
$D%1(((6!1!QG#---1(4242C
23 M>/"D,2BB(1;3$24%G24B3C
2C ".+/9D"/"
#!##A(
)G9D9#
(42(12C($2%G5;GGLLL24;(;;LB3C2:25BB26(:5;
2B "=/D!/EJD
GD
&,"(42612B$2%G(4;26
(4 "=)G=
G99UJ!1(44;#9J>G2C6(;;32C5
(2 0JHDG
&,(44(1(44($)%G6
(( A.F!DG.
"=
#9(44B1(5$2%G(C
(; .A.DG
D5
1(44BG="!
(5 H9AF/#D
=()DDKD
1(42:
(6 AF/MH!/EEG
D&,"(42;123$:%G2(22(2
(: +>DK)0.)!/D"/=2
()D0E99"G=
/K"H!#/(42624L46
4:L(:L
43L(CL,
4CL4:L
4CL2(L123$24%G((5D!#)GD!"5:5(3B5G24(2B:LF5C32
(3 +>)H+=.EV!-
+J#"=D+
()"EJDG/K"H
!#/(4264;L4;
4BL;4L
22L4:L,
2(L23L
2(L(;L123$;%G6;D!#)GD!"5;3:4B3G24(2B:LF;B45
(C F!JHJ)/>-..
)+J##+J()X=
9/!=H!#/(42:A(212C$24%G(34
D!#)G(33:BB66G24(2B:LF6BB2
(B ="/"#!D/>0)D
0=
(G
H#
(42:12C$5%
;4 9QQ-0)QJJQ=9#
")!=D
AG=9/H!#/(4264(L(5
24L2:L
2(L;2L,
42L(2L
42L(2L123$(%G6(D!#)GD!"5;3:(4CG24(2B:LF;B62
;2 E99.JA-/Q!AJ)0
#=+()G=I9H!
#/(42346L;4
4(L24L
4;L4(L,
45L24L
45L25L12B$6%G2C3D!#)GD!"653444CG24(2B:LF353B
;( M0QDFE)F.>F>9-9
!G
H(4431B$6%
;; +HM-E=JPM/D
-
(G=
)/"D(44C!13B$;%G;33CC
D!#)G23:5;65:G24242:LF(4434:44:
;5 M!+!"F+90H&
,(G
H!#/(42;)2;126$2(%G(3BD!#)G(5;;5(;4
G24(2B:LF(C44
;6 -QE=H!#/
(446H!
4;L;2
4;L;2L
4;L;2L13$2%G22D!#)GD!"2664:;2G24(2B:LF3222
;: )E">9E>J#JQK>=
9/#=-
H!#/(422H9
4CL46
4(L25L
4;L24L,
46L(5L
46L46L12;$;%G6(D!#)GD!";(((2:(G24(2B:LF233(