Building Digital Health Systems to Support Treatment Administration: A Preliminary Case Study

Abstract

The emergence of Digital Health Systems (DHS) has had an impact on the understanding of the diagnosis, treatment and cure of diseases. In the case of chronic or long-term illnesses, these systems may improve the disease follow-up. However, these target scenarios also raise specific challenges. For example, due to the long-term nature of treatments, it may be harder for patients to maintain active use of the technology assets, being this aspect key to leverage DHS potential. From a review of the literature, this article analyzes the aspects surrounding patient adherence, to compile a concept model to drive DHS design. The concept model is applied over a DHS focused on patients under a specific health condition (kidney disease) that implies a long-term treatment (peritoneal dialysis). Under this treatment, clinical follow-up and medication adjustment require patients to track daily practical aspects and register health status, to dynamically manage daily life and disease. The availability of granular information also helps clinicians to optimize the judgement of treatment’s effectiveness and counter effects. The result is a DHS that relies on a mobile application and a secure backend server accessible to the professionals in charge of patient management. It is focused on simplifying patient’s data gathering, data continuity and completeness, and meaningful data retrieval and visualization for the parties involved (patient and clinician). The article explains the design process, with adherence in mind, and, as partial validation, an analysis of the user experience of four ‘lead’ users (volunteer patients and practitioners), with a review of the adherence results on the patients’ side.