Pharmaceutical and medical device companies are embracing technology to increase patient engagement and improve adherence to costly and sometimes complex medication therapies. One solution includes developing drug delivery devices that connect to mobile medical applications (MMAs) to support patients in managing and tracking their medications. Developing an adherence system requires understanding users in their use environment, their challenges with taking medications, their health goals, and the behaviors to target for change. Device developers have long relied on in-person ethnography or in-person human factors studies in a research facility to gather these data. Unfortunately, this process is time-consuming, labor intensive, and costly. When considering a rare patient population, collecting data in person becomes even more complex. This work explores how collecting patient data using a remote ethnography platform addresses challenges with in-person studies early in the device development process, and shares a case example of the use of remote ethnography to better understand patients with cystic fibrosis (CF) to design and refine a medication adherence system prior to taking prototypes into in-person testing.