Abstract
BackgroundA paradigm shift in health care from illness to wellbeing requires new assessment technologies and intervention strategies. Self-monitoring tools based on the Experience Sampling Method (ESM) might provide a solution. They enable patients to monitor both vulnerability and resilience in daily life. Although ESM solutions are extensively used in research, a translation from science into daily clinical practice is needed.ObjectiveTo investigate the redesign process of an existing platform for ESM data collection for detailed functional analysis and disease management used by psychological assistants to the general practitioner (PAGPs) in family medicine.MethodsThe experience-sampling platform was reconceptualized according to the design thinking framework in three phases. PAGPs were closely involved in co-creation sessions. In the ‘understand’ phase, knowledge about end-users’ characteristics and current eHealth use was collected (nominal group technique – 2 sessions with N = 15). In the ‘explore’ phase, the key needs concerning the platform content and functionalities were evaluated and prioritized (empathy mapping – 1 session with N = 5, moderated user testing – 1 session with N = 4). In the ‘materialize’ phase, the adjusted version of the platform was tested in daily clinical practice (4 months with N = 4). The whole process was extensively logged, analyzed using content analysis, and discussed with an interprofessional project group.ResultsIn the ‘understand’ phase, PAGPs emphasized the variability in symptoms reported by patients. Therefore, moment-to-moment assessment of mood and behavior in a daily life context could be valuable. In the ‘explore’ phase, (motivational) functionalities, technological performance and instructions turned out to be important user requirements and could be improved. In the ‘materialize’ phase, PAGPs encountered barriers to implement the experience-sampling platform. They were insufficiently facilitated by the regional primary care group and general practitioners.ConclusionThe redesign process in co-creation yielded meaningful insights into the needs, desires and daily routines in family medicine. Severe barriers were encountered related to the use and uptake of the experience-sampling platform in settings where health care professionals lack the time, knowledge and skills. Future research should focus on the applicability of this platform in family medicine and incorporate patient experiences.
Highlights
Modern health care is faced with two challenges: refocus from an overemphasis on illness to wellbeing to better realize the multidimensional experience of positive health; and the design and implementation of new technologies that support this process
The aim of the current study was to investigate the redesign process of the Experience Sampling Method (ESM) application PsyMateTM as a tool for detailed functional analysis and disease management used by PAGPs in family medicine
The approach and methodology of this study identified barriers and opportunities for implementing a mHealth tool in family medicine which may be relevant to organizations intending to implement mHealth tools
Summary
Modern health care is faced with two challenges: refocus from an overemphasis on illness to wellbeing to better realize the multidimensional experience of positive health; and the design and implementation of new technologies that support this process. Their supportive environment should be empowered to realize sustainable solutions These developments are in line with the new definition of health, “as the ability to adapt and control your own life, in the light of social, mental and physical challenges in life,” proposed in alternative to the WHO definition of health that was criticized because it tended to medicalize all deviations of optimal functioning (Huber et al, 2011). Health is defined in relation to personal goals It requires a personalized psychiatry which takes into account patients’ characteristics, needs and desires in their care process (Perna et al, 2018). These developments create a paradigm shift from illness to wellbeing. ESM solutions are extensively used in research, a translation from science into daily clinical practice is needed
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