More Than Telemonitoring: Health Provider Use and Nonuse of Life-Log Data in Irritable Bowel Syndrome and Weight Management.
More Than Telemonitoring: Health Provider Use and Nonuse of Life-Log Data in Irritable Bowel Syndrome and Weight Management.
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DOI：
10.2196/jmir.4364
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发表时间：
2015-08-21
影响因子：
7.4
通讯作者：
Munson SA
中科院分区：
文献类型：
--
作者：
Chung CF;Cook J;Bales E;Zia J;Munson SA
量化的自我监测或生活记录运动是一种趋势，将技术结合到一个人日常生活的各个方面的数据采集中，这些方面涉及输入(例如，食物消耗)、状态(例如，情绪)和表现(例如精神和身体)。消费者自我监控手机应用程序已被广泛研究和使用，以促进健康行为的改变。通过生活记录应用程序收集的数据也有可能支持临床护理。我们试图深入了解供应商的促进者以及成功将生活日志数据整合到他们的实践中并创造更好体验的障碍。我们特别调查了三个研究问题：提供者目前如何在临床实践中使用患者收集的生活日志数据？提供商对此数据的关注和需求是什么？提供商将此类数据集成到其工作流中的约束条件是什么？我们采访了21名医疗保健提供者--医生、营养师、护士从业者和行为心理学家--他们为肥胖和肠易激综合征患者工作。我们根据主题分析和亲和力图表过程对访谈进行转录和分析。提供者报告使用自我监测数据来加强提供者与患者的沟通，制定个性化的治疗计划，并激励和教育患者，此外还将其用作诊断和依从性工具。然而，与当前系统和工作流程相关的限制为定期和有效地审查这些数据设置了障碍。这些障碍包括缺乏时间来审查详细的记录，对提供者审查记录的专业知识的质疑，以及对审查数据所提供的额外好处的怀疑。目前的自我监测工具也往往缺乏灵活性、标准化的格式和与供应商共享数据的机制。提供商需求的变化会影响跟踪和审查需求。支持诊断的系统可能需要更好的可靠性和分辨率，而支持交互的系统应该支持协作思考和交流。数据日志的自动合成可以帮助提供者专注于教育目标，而背景信息的交流可能有助于提供者更好地理解患者的价值。我们还讨论了当前的移动应用程序和提供商系统如何支持这些目标，以及未来的设计机会，以实现在临床护理中使用生命记录工具的潜在好处。
The quantified self, self-monitoring or life-logging movement is a trend to incorporate technology into data acquisition on aspects of a person's daily life in terms of inputs (eg food consumed), states (eg mood), and performance (mental and physical). Consumer self-monitoring mobile phone apps have been widely studied and used to promote healthy behavior changes. Data collected through life-logging apps also have the potential to support clinical care. We sought to develop an in-depth understanding of providers’ facilitators and barriers to successfully integrating life-log data into their practices and creating better experiences. We specifically investigated three research questions: How do providers currently use patient-collected life-log data in clinical practice? What are provider concerns and needs with respect to this data? What are the constraints for providers to integrate this type of data into their workflows? We interviewed 21 health care providers—physicians, dietitians, a nurse practitioner, and a behavioral psychologist—who work with obese and irritable bowel syndrome patients. We transcribed and analyzed interviews according to thematic analysis and an affinity diagramming process. Providers reported using self-monitoring data to enhance provider-patient communication, develop personalized treatment plans, and to motivate and educate patients, in addition to using them as diagnostic and adherence tools. However, limitations associated with current systems and workflows create barriers to regular and effective review of this data. These barriers include a lack of time to review detailed records, questions about providers' expertise to review it, and skepticism about additional benefits offered by reviewing data. Current self-monitoring tools also often lack flexibility, standardized formats, and mechanisms to share data with providers. Variations in provider needs affect tracking and reviewing needs. Systems to support diagnosis might require better reliability and resolution, while systems to support interaction should support collaborative reflection and communication. Automatic synthesis of data logs could help providers focus on educational goals while communication of contextual information might help providers better understand patient values. We also discuss how current mobile apps and provider systems do, and do not, support these goals, and future design opportunities to realize the potential benefits of using life-logging tools in clinical care.