How mHealth can facilitate collaboration in diabetes care: qualitative analysis of co-design workshops

Abstract

Background: Individuals with diabetes are using mobile health (mHealth) to make and track their decisions regarding self-management. However, individuals can understand even more about their diabetes by sharing these patient-gathered data (PGD) with health professionals. We conducted experience-based co-design (EBCD) workshops, with the aim of gathering end-users’ needs and expectations for a PGD-sharing system. Methods: The first workshop (2017) included patients with Type 2 Diabetes (T2D) (n=4) and general practitioners (GPs) (n=3). The second workshop (2018) included patients with Type 1 Diabetes (T1D) (n=5), diabetes specialists (n=2) and a nurse. The workshops involved two sessions: separate morning sessions for patients and healthcare providers (HCPs), followed by a joint lunch and afternoon session for all participants together. A discussion guide was used to gather input regarding end-users’ expectations for the system. Participants then created and explained their own ideas for a data-sharing system, using paper-prototypes. Workshops were audio recorded, transcribed and translated from Norwegian to English. Inductive thematic analysis was performed. Results: The main emergent themes were mHealth technologies’ impacts on end-users, and functionalities of a data-sharing system. Patients and providers agreed that PGD could be used by HCPs to provide more concrete self-management recommendations. Participants made paper-prototypes to explain which data types to gather and display, and how the systems could be used to facilitate shared-decision making. However, all also agreed that a data-sharing system alone was not enough to achieve the full effect of mHealth. Conclusion: Participants’ feedback revealed that both patients and HCPs alike acknowledge that for mHealth integration to be successful, not only must the technology be validated but feasible changes throughout the healthcare education and practice must be addressed. Only then can both sides be adequately prepared for mHealth data-sharing in diabetes consultations. Subsequently, the design of the joint workshop sessions demonstrated that involving both participant groups in the same sessions led to efficient and concrete discussions about realistic solutions and limitations of sharing mHealth data in consultations.