Roessingh Research and Development, Roessinghsbleekweg 33b, 7522 AH Enschede, The Netherlands.
J Telemed Telecare. 2010;16(6):294-301. doi: 10.1258/jtt.2010.006002.
A telemedicine application has a better chance of being accepted if the users can easily handle it and if the application fulfils the clinical needs of both patients and professionals. This requires a methodology for development in which three key matters need to be dealt with: (1) clinical content; (2) design; and (3) outcome. Concerning the clinical content, telemedicine services for patients with chronic disorders that aim to increase their level of functioning need to monitor aspects of the patient's functioning and provide adequate feedback about this. Promising parameters of functioning are related to general physical activity and muscle activation patterns. Providing adequate feedback requires choices about the content of the information, the modality of the feedback and its timing. Unfortunately, research into effective feedback strategies is still in its infancy. Concerning the design it appears that the different stakeholders involved speak different languages, that there is a lack of knowledge about aspects related to acceptance and a lack of good methods to define user requirements. Scenario-based requirements analysis is a promising technique to overcome these barriers. Concerning the outcome, evaluation of telemedicine services in everyday clinical practice has been mainly directed at measurement of technical performance and user satisfaction. Large scale clinical evaluation studies with multiple end points are needed. This development methodology with its three aspects was used for a myofeedback-based teletreatment service. This showed that telemedicine applications can be developed that have the potential to make health care more effective, efficient and accessible.
如果用户能够轻松地使用应用程序，并且该应用程序满足患者和专业人员的临床需求，那么远程医疗应用程序更有可能被接受。这需要一种开发方法，其中需要处理三个关键问题：（1）临床内容；（2）设计；（3）结果。关于临床内容，针对旨在提高患者功能水平的慢性疾病患者的远程医疗服务需要监测患者功能的各个方面，并对此提供适当的反馈。功能的有希望的参数与一般身体活动和肌肉激活模式有关。提供适当的反馈需要对信息内容、反馈方式及其时间进行选择。不幸的是，关于有效反馈策略的研究仍处于起步阶段。关于设计，似乎涉及的不同利益相关者使用不同的语言，缺乏与接受相关的方面的知识，并且缺乏定义用户需求的好方法。基于场景的需求分析是克服这些障碍的有希望的技术。关于结果，在日常临床实践中对远程医疗服务的评估主要集中在技术性能和用户满意度的测量上。需要进行具有多个终点的大规模临床评估研究。该具有三个方面的开发方法用于基于肌电反馈的远程治疗服务。这表明，可以开发出具有使医疗保健更有效、更高效和更便捷的潜力的远程医疗应用程序。
