More Than Telemonitoring: Health Provider Use and Nonuse of Life-Log Data in Irritable Bowel Syndrome and Weight Management

Abstract

BackgroundThe 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.ObjectiveWe 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?MethodsWe 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.ResultsProviders 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.ConclusionsVariations 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.

Health Care Provider Perceptions of Consumer-Grade Devices and Apps for Tracking Health: A Pilot Study (Preprint)

“…Past literature has suggested patient generated health data may lead to better communication between the patient and provider, help set goals, and discover patient habits and preferences [26]. Additionally, some studies have shown that when patients bring information to their visits better health outcomes were achieved [24,34,35].…”

“…The survey was developed through a literature review of provider perceptions regarding various technologies and patients bringing information to the visits [24,32]. The survey included 25 questions total pertaining to providers' use of these technologies (as defined above, the consumer-grade sensor devices (e.g., Fitbit) and Web/smartphone-based applications (e.g., MyFitnessPal) (apps)), their patients' use of these technologies, their perceptions on the usefulness of these technologies, and demographic questions.…”

“…), the evidence suggests that tracking may be beneficial [19][20][21][22][23], however, use in the clinical setting remains limited. Research on primary care providers' perceptions of information technologies that have been developed to be used as a diary for a specific illness, is also limited, with only a handful of studies identified [24][25][26][27][28].…”

Digital technology and clinical decision making in depression treatment: Current findings and future opportunities

“…While patients may wish to share this type of data with their clinical providers, there are few tools that help providers access, integrate, and review the large volumes of data that can be collected through mobile devices (Chung, Cook, Bales, Zia, & Munson, 2015; Torous & Baker, 2016). Additional research is needed to identify methods for efficiently extracting actionable information from mobile data with minimal effort on behalf of providers, and to understand the extent to which this data impacts clinical decision-making and depression outcomes.…”

"Not Just a Receiver"

“…For example, Lee and Dey’s embedded assessment tool provides patients with a way to effortlessly supply data to clinicians about their ability to perform everyday tasks [24]. Chung et al examine how providers use patient-generated life-logging data in their practice [9]. …”