A Remote Patient Monitoring System With Feedback Mechanisms Using a Smartwatch: Concept, Implementation, and Evaluation Based on the activeDCM Randomized Controlled Trial
BackgroundTechnological advances allow for recording and sharing health-related data in a patient-centric way using smartphones and wearables. Secure sharing of such patient-generated data with physicians would enable close management of individual health trajectories, monito...
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JMIR Publications
2024-11-01
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| Series: | JMIR mHealth and uHealth |
| Online Access: | https://mhealth.jmir.org/2024/1/e58441 |
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| author | Reto Wettstein Farbod Sedaghat-Hamedani Oliver Heinze Ali Amr Christoph Reich Theresa Betz Elham Kayvanpour Angela Merzweiler Christopher Büsch Isabell Mohr Birgit Friedmann-Bette Norbert Frey Martin Dugas Benjamin Meder |
| author_facet | Reto Wettstein Farbod Sedaghat-Hamedani Oliver Heinze Ali Amr Christoph Reich Theresa Betz Elham Kayvanpour Angela Merzweiler Christopher Büsch Isabell Mohr Birgit Friedmann-Bette Norbert Frey Martin Dugas Benjamin Meder |
| author_sort | Reto Wettstein |
| collection | DOAJ |
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BackgroundTechnological advances allow for recording and sharing health-related data in a patient-centric way using smartphones and wearables. Secure sharing of such patient-generated data with physicians would enable close management of individual health trajectories, monitoring of risk factors, and asynchronous feedback. However, most remote patient monitoring (RPM) systems currently available are not fully integrated into hospital IT systems or lack a patient-centric design.
ObjectiveThe objective of this study was to conceptualize and implement a user-friendly, reusable, interoperable, and secure RPM system incorporating asynchronous feedback mechanisms using a broadly available consumer wearable (Apple Watch). In addition, this study sought to evaluate factors influencing patient acceptance of such systems.
MethodsThe RPM system requirements were established through focus group sessions. Subsequently, a system concept was designed and implemented using an iterative approach ensuring technical feasibility from the beginning. To assess clinical feasibility, the system was used as part of the activeDCM prospective randomized interventional study focusing on dilated cardiomyopathy. Each patient used the system for at least 12 months. The System Usability Scale was used to measure usability from a subjective patient perspective. In addition, an evaluation was conducted on the objective wearable interaction frequency as well as the completeness of transmitted data classified into sensor-based health data (SHD) and patient-reported outcome measures (PROMs). Descriptive statistics using box plots and bootstrapped multiple linear regression with 95% CIs were used for evaluation analyzing the influence of age, sex, device experience, and intervention group membership.
ResultsThe RPM system comprised 4 interoperable components: patient devices, a data server, a data viewer, and a notification service. The system was evaluated with 95 consecutive patients with dilated cardiomyopathy (28/95, 29% female; mean age 50, SD 12 y) who completed the activeDCM study protocol. The system’s app achieved a mean System Usability Scale score of 78 (SD 17), which was most influenced by device experience. In total, 87% (83/95) of the patients could integrate the use of the app well or very well into their daily routine, and 71% (67/95) saw a benefit of the RPM system for management of their health condition. On average, patients interacted with the wearable on 61% (SD 26%) of days enrolled in the study. SHD were available on average for 78% (SD 23%) of days, and PROM data were available on 64% (SD 27%) of weeks enrolled in the study. Wearable interaction frequency, SHD, and PROM completeness were most influenced by intervention group membership.
ConclusionsOur results mark a first step toward integrating RPM systems based on a consumer wearable device for primary patient input into standardized clinical workflows. They can serve as a blueprint for creating a user-friendly, reusable, interoperable, and secure RPM system that can be integrated into patients’ daily routines. |
| format | Article |
| id | doaj-art-48b182485d5e4254940adee40f01d89a |
| institution | DOAJ |
| issn | 2291-5222 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | JMIR Publications |
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| series | JMIR mHealth and uHealth |
| spelling | doaj-art-48b182485d5e4254940adee40f01d89a2025-08-20T02:49:22ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222024-11-0112e5844110.2196/58441A Remote Patient Monitoring System With Feedback Mechanisms Using a Smartwatch: Concept, Implementation, and Evaluation Based on the activeDCM Randomized Controlled TrialReto Wettsteinhttps://orcid.org/0000-0003-3612-8658Farbod Sedaghat-Hamedanihttps://orcid.org/0000-0002-3266-0527Oliver Heinzehttps://orcid.org/0000-0002-6294-941XAli Amrhttps://orcid.org/0000-0002-2615-4089Christoph Reichhttps://orcid.org/0000-0002-2683-1369Theresa Betzhttps://orcid.org/0000-0001-5534-9259Elham Kayvanpourhttps://orcid.org/0000-0001-7285-2825Angela Merzweilerhttps://orcid.org/0000-0001-5895-7751Christopher Büschhttps://orcid.org/0000-0003-2664-7147Isabell Mohrhttps://orcid.org/0009-0000-6926-7342Birgit Friedmann-Bettehttps://orcid.org/0000-0002-2198-4083Norbert Freyhttps://orcid.org/0000-0001-7611-378XMartin Dugashttps://orcid.org/0000-0001-9740-0788Benjamin Mederhttps://orcid.org/0000-0003-0741-2633 BackgroundTechnological advances allow for recording and sharing health-related data in a patient-centric way using smartphones and wearables. Secure sharing of such patient-generated data with physicians would enable close management of individual health trajectories, monitoring of risk factors, and asynchronous feedback. However, most remote patient monitoring (RPM) systems currently available are not fully integrated into hospital IT systems or lack a patient-centric design. ObjectiveThe objective of this study was to conceptualize and implement a user-friendly, reusable, interoperable, and secure RPM system incorporating asynchronous feedback mechanisms using a broadly available consumer wearable (Apple Watch). In addition, this study sought to evaluate factors influencing patient acceptance of such systems. MethodsThe RPM system requirements were established through focus group sessions. Subsequently, a system concept was designed and implemented using an iterative approach ensuring technical feasibility from the beginning. To assess clinical feasibility, the system was used as part of the activeDCM prospective randomized interventional study focusing on dilated cardiomyopathy. Each patient used the system for at least 12 months. The System Usability Scale was used to measure usability from a subjective patient perspective. In addition, an evaluation was conducted on the objective wearable interaction frequency as well as the completeness of transmitted data classified into sensor-based health data (SHD) and patient-reported outcome measures (PROMs). Descriptive statistics using box plots and bootstrapped multiple linear regression with 95% CIs were used for evaluation analyzing the influence of age, sex, device experience, and intervention group membership. ResultsThe RPM system comprised 4 interoperable components: patient devices, a data server, a data viewer, and a notification service. The system was evaluated with 95 consecutive patients with dilated cardiomyopathy (28/95, 29% female; mean age 50, SD 12 y) who completed the activeDCM study protocol. The system’s app achieved a mean System Usability Scale score of 78 (SD 17), which was most influenced by device experience. In total, 87% (83/95) of the patients could integrate the use of the app well or very well into their daily routine, and 71% (67/95) saw a benefit of the RPM system for management of their health condition. On average, patients interacted with the wearable on 61% (SD 26%) of days enrolled in the study. SHD were available on average for 78% (SD 23%) of days, and PROM data were available on 64% (SD 27%) of weeks enrolled in the study. Wearable interaction frequency, SHD, and PROM completeness were most influenced by intervention group membership. ConclusionsOur results mark a first step toward integrating RPM systems based on a consumer wearable device for primary patient input into standardized clinical workflows. They can serve as a blueprint for creating a user-friendly, reusable, interoperable, and secure RPM system that can be integrated into patients’ daily routines.https://mhealth.jmir.org/2024/1/e58441 |
| spellingShingle | Reto Wettstein Farbod Sedaghat-Hamedani Oliver Heinze Ali Amr Christoph Reich Theresa Betz Elham Kayvanpour Angela Merzweiler Christopher Büsch Isabell Mohr Birgit Friedmann-Bette Norbert Frey Martin Dugas Benjamin Meder A Remote Patient Monitoring System With Feedback Mechanisms Using a Smartwatch: Concept, Implementation, and Evaluation Based on the activeDCM Randomized Controlled Trial JMIR mHealth and uHealth |
| title | A Remote Patient Monitoring System With Feedback Mechanisms Using a Smartwatch: Concept, Implementation, and Evaluation Based on the activeDCM Randomized Controlled Trial |
| title_full | A Remote Patient Monitoring System With Feedback Mechanisms Using a Smartwatch: Concept, Implementation, and Evaluation Based on the activeDCM Randomized Controlled Trial |
| title_fullStr | A Remote Patient Monitoring System With Feedback Mechanisms Using a Smartwatch: Concept, Implementation, and Evaluation Based on the activeDCM Randomized Controlled Trial |
| title_full_unstemmed | A Remote Patient Monitoring System With Feedback Mechanisms Using a Smartwatch: Concept, Implementation, and Evaluation Based on the activeDCM Randomized Controlled Trial |
| title_short | A Remote Patient Monitoring System With Feedback Mechanisms Using a Smartwatch: Concept, Implementation, and Evaluation Based on the activeDCM Randomized Controlled Trial |
| title_sort | remote patient monitoring system with feedback mechanisms using a smartwatch concept implementation and evaluation based on the activedcm randomized controlled trial |
| url | https://mhealth.jmir.org/2024/1/e58441 |
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