Utility and usability of an automated COVID-19 symptom monitoring system (CoSMoS) in primary care during COVID-19 pandemic: A qualitative feasibility study

Abstract

Background COVID-19 telemonitoring applications have been developed and used in primary care to monitor patients quarantined at home. There is a lack of evidence on the utility and usability of telemonitoring applications from end-users’ perspective. Objectives This study aimed to evaluate the feasibility of a COVID-19 symptom monitoring system (CoSMoS) by exploring its utility and usability with end-users. Methods This was a qualitative study using in-depth interviews. Patients with suspected COVID-19 infection who used CoSMoS Telegram bot to monitor their COVID-19 symptoms and doctors who conducted the telemonitoring via CoSMoS dashboard were recruited. Universal sampling was used in this study. We stopped the recruitment when data saturation was reached. Patients and doctors shared their experiences using CoSMoS, its utility and usability for COVID-19 symptoms monitoring. Data were coded and analysed using thematic analysis. Results A total of 11 patients and 4 doctors were recruited into this study. For utility, CoSMoS was useful in providing close monitoring and continuity of care, supporting patients’ decision making, ensuring adherence to reporting, and reducing healthcare workers’ burden during the pandemic. In terms of usability, patients expressed that CoSMoS was convenient and easy to use. The use of the existing social media application for symptom monitoring was acceptable for the patients. The content in the Telegram bot was easy to understand, although revision was needed to keep the content updated. Doctors preferred to integrate CoSMoS into the electronic medical record. Conclusion CoSMoS is feasible and useful to patients and doctors in providing remote monitoring and teleconsultation during the COVID-19 pandemic. The utility and usability evaluation enables the refinement of CoSMoS to be a patient-centred monitoring system. (271 words)

Health Care Professionals’ Perspectives on the Utilisation of a Remote Surveillance and Care Tool for Patients With COVID-19 in General Practice: a Qualitative Study

“…Notwithstanding, VERAHs emphasized that they enjoyed the CovidCare management due to the patients' positive feedback and previous experience with the software facilitated the familiarization with it. Considering other prerequisites that enable an easy integration into daily practice and therefore the utilisation of a tool, previous research underscored that it is crucial that monitoring and surveillance data can be integrated into the existing practice management software [7,8,12] , which is in line with our ndings.…”

“…Besides, apps, e.g. to support HCP, to collect data on the health status of patients who are selfmanaging [9,10] in home-quarantine have also been developed [11][12][13]. As most COVID-19 patients are treated in general practices, a comprehensive approach is necessary to support them in the management of COVID-19 patients, providing a structured way to detect deterioration, treat patients individually, and reducing uncertainty for both patients and HCP.…”

COVID-box Experiences of Patients and Health Care Professionals (COVID-box Project): Single-Center, Retrospective, Observational Study

“…During the extraordinary situation of the COVID-19 pandemic, remote telemonitoring has been quickly implemented in different ways [5][6][7][10][11][12][13]. In general, many patients and health care professionals are very positive about this concept.…”

“…The implementation of several home monitoring programs has resulted in a reduction in hospital admissions by allowing for the safe survey of clinical symptoms and vitals [3][4][5][6][7][8][9]. Although many observational studies have studied the effectiveness of home monitoring, few studies have reported on patients' and doctors' experiences with telemonitoring [5,[10][11][12][13]. We focused on the COVID-box experiences of patients and health care professionals.…”

Editorial: Special issue on “The Primary Care Informatics response to COVID-19”

“…More than half of patients reported in an online survey that they did not have a good experience with a customised “store-and-forward voice and text messaging teleconsultation service” in a low-income and low-resource country [6] . On the other hand, a qualitative study explored the utility and usability of a COVID-19 symptom monitoring system (CoSMoS) with patients and doctors in a middle-income country and found more positive experiences, with doctors preferring to integrate CoSMoS into the electronic medical record [7] . This also reflects the importance of a careful choice of digital health and PCI interventions, implementation strategies and evaluation methodologies [8] .…”