Evaluation of Internet-Based Technology for Supporting Self-Care: Problems Encountered by Patients and Caregivers When Using Self-Care Applications

Abstract

BackgroundPrior studies have shown that many patients are interested in Internet-based technology that enables them to control their own care. As a result, innovative eHealth services are evolving rapidly, including self-assessment tools and secure patient-caregiver email communication. It is interesting to explore how these technologies can be used for supporting self-care.Objective The aim of this study was to determine user-centered criteria for successful application of Internet-based technology used in primary care for supporting self-care.Methods We conducted scenario-based tests combined with in-depth interviews among 14 caregivers and 14 patients/consumers to describe the use of various self-care applications and the accompanying user problems. We focused on the user-friendliness of the applications, the quality of care provided by the applications, and the implementation of the applications in practice.Results Problems with the user-friendliness of the self-care applications concerned inadequate navigation structures and search options and lack of feedback features. Patients want to retrieve health information with as little effort as possible; however, the navigation and search functionalities of the applications appeared incapable of handling patients’ health complaints efficiently. Among caregivers, the lack of feedback and documentation possibilities caused inconvenience. Caregivers wanted to know how patients acted on their advice, but the applications did not offer an adequate feedback feature. Quality of care problems were mainly related to insufficient tailoring of information to patients’ needs and to efficiency problems. Patients expected personalized advice to control their state of health, but the applications failed to deliver this. Language (semantics) also appeared as an obstacle to providing appropriate and useful self-care advice. Caregivers doubted the reliability of the computer-generated information and the efficiency and effectiveness of secure email consultation. Legal or ethical issues with respect to possible misuse of email consultation also caused concerns. Implementation problems were mainly experienced by caregivers due to unclear policy on email consultation and the lack of training for email consultations.Conclusions Patients’ and caregivers’ expectations did not correspond with their experiences of the use of the Internet-based applications for self-care. Patients thought that the applications would support them in solving their health problems. Caregivers were more reserved about the applications because of medico-legal concerns about misuse. However, the applications failed to support self-care because eHealth is more than just a technological intervention. The design of the applications should include a way of thinking about how to deliver health care with the aid of technology. The most powerful application for self-care was secure email consultation, combined with a suitable triage mechanism to empower patients’ self-awareness. Future research should focus on the effec...

Family attitudes towards an electronic personal health record in a long term care facility

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“…[41] Upon examining three case studies, they determined that there were some critical questions, similar to those examined within the current study, which should be examined when considering the adoption of an EPHR. [43] The key questions identified were: 1) Should the entire problem list be shared? 2) Should all laboratory and diagnostic tests be shared?…”

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Impacto de un brote epidémico de dengue sobre las búsquedas en Google en Perú

“…Editor. Los problemas en salud pública tienen un impacto inmediato en medios de comunicación, en los últimos años Internet ocupa un lugar importante en ellos por la rapidez y facilidad con que se transmite la información siendo consultado especialmente por poblaciones de grandes ciudades, tanto a través de páginas especializadas como de buscadores generales (1,2) .Estas búsquedas quedan registradas en Internet y se han utilizado con éxito para predecir el comportamiento de un brote epidémico, mostrando un potencial valor y costo efectividad como herramienta de vigilancia para identificar tempranamente brotes epidémicos, incluso antes de que este sea anunciado oficialmente por instituciones de salud; la vigilancia basada en las tendencias de búsquedas de términos específicos, ingresados por usuarios de Internet a motores de búsqueda como Google, abren además un nuevo campo de investigación denominado epidemiología de la información o infodemiología; sin embargo, esta novedosa forma de pesquisa de epidemias no ha sido diseñada para reemplazar a las redes de vigilancia tradicional (3)(4)(5) .Con el objetivo de evaluar si existe una correlación entre las búsquedas en Google realizadas por usuarios de Internet en Perú para el término "dengue" y los casos notificados de un reciente brote en la costa norte del Perú, se elaboró un modelo con el volumen relativo de ambos, donde se incluye, además, el número de artículos periodísticos peruanos relacionados con el dengue, disponibles en Internet, buscando determinar si el incremento de búsquedas en Google es proporcional al incremento en el número de artículos periodísticos en Internet.El número total de casos de dengue notificados por las direcciones regionales de salud de Piura, Lambayeque, La Libertad y Tumbes, se obtuvo de los boletines semanales de la Dirección General de Epidemiología (DGE), disponibles en su página web (www.dge.gob.pe/ boletin2010.php).La frecuencia de búsquedas realizadas por usuarios de Internet en Perú usando la palabra "dengue" se obtuvo de la aplicación para estadísticas de búsquedas de Google denominada "Google Insight" (www.google.com/insights/ search/#), del cual se exportó los registros históricos de búsquedas durante las primeras 26 semanas del año 2010, estos datos se expresan como volumen relativo, es decir datos normalizados en una escala del 0 al 100, donde este último valor representa el máximo de búsquedas realizadas en el periodo de búsqueda, similar estrategia fue usada para analizar la curva de casos notificados de dengue. Los resultados se encuentran en la siguiente dirección Web: http://bit.ly/e2p5Q6…”