Complementing a Clinical Trial With Human-Computer Interaction: Patients’ User Experience With Telehealth (Preprint)

Abstract

Background: The use of telehealth to monitor patients from home is on the rise. A telehealth technology is evaluated in a clinical trial with measures of health outcomes and cost effectiveness. However, what happens between a technology and the patients are not investigated during a clinical trial −the telehealth technology remains as a "black box". Meanwhile three decades of research in the discipline of Human-Computer Interaction (HCI) presents design, implementation and evaluation of technologies with a primary emphasis on users. HCI research exposed the importance of user-experience (UX) as an essential part of technology development and evaluation. Objective: This research investigates Type 2 Diabetes (T2D) patients' experiences of a telehealth in-home monitoring technology through HCI approach. How HCI could complement future telehealth clinical trials for patient-centred design and evaluation is also explored. Methods: We adopted an ethnographic philosophy to conduct a contextual inquiry due to time-limitations and semi-structured interviews of nine T2D patients. We defined the method as Clinical User-experience Evaluation (CUE). The patients were enrolled in a telehealth clinical trial of T2D. However, this research is an independent HCI study, conducted by information technologists and health researchers for a patient-centred evaluation of telehealth. Results: Key analytical findings depicted that patients value the benefits of in-home monitoring but the current device did not possess all functionalities that patients want. Results contain patients' experiences and emotions while using the device, patients' perceived benefits of the device, and domestication of the device in their homes. Further analysis showed the influence of the device on patients' awareness, family involvement, and design implications for telehealth for T2D. Conclusions: CUE could complement the telehealth clinical trial and uncovered knowledges about T2D patients' experiences, future design implications and importance of understanding patients in telehealth. Trial Registration:Keywords: Clinical user-experience evaluation; telehealth; type 2 diabetes; userexperience; human-computer interaction; patient-centered; patient-technology interaction; ehealth; IntroductionTechnology mediated treatments, such as telehealth to monitor patients from their homes, is on the increase with chronic diseases such as Type 2 Diabetes (T2D).Telehealth is the use of Information and Communication Technologies (ICT) to provide clinical treatments over distances [1]. For a Telehealth treatment of T2D, patients generally send regular blood glucose data to nurses or health care providers via one of the following devices such as phone, tablet, computer, webbased system, video-conference, phone calls, short message services, etc. A nurse or healthcare provider is involved in T2D telehealth treatments continuously while the technology-intervention remains as a means of transferring data (e.g., blood glucose, blood pressure) and facilitates the communic...