Elg Mattias, Kabel Daan, Gremyr Ida, Olsson Jesper, Martin Jason, Smith Frida
Department of Management and Engineering, Linköping University, Linköping, Sweden.
Department of Technology Management and Economics, Chalmers University of Technology, Gothenburg, Sweden.
J Med Internet Res. 2025 Apr 3;27:e58264. doi: 10.2196/58264.
Digital health care self-monitoring has gained prominence as a tool to address various challenges in health care, including patient autonomy, data-informed decision-making, and organizational improvements. However, integrating self-monitoring solutions across a diverse ecosystem of stakeholders-patients, health care providers, policy makers, and industry-can be complicated by differing priorities and needs.
This study aimed to identify and categorize the distinct purposes underpinning the use of digital health care self-monitoring. By mapping these purposes, the research seeks to clarify how technology design and implementation can be better aligned with stakeholder expectations, thereby enhancing adoption and impact.
A qualitative design was used, drawing on 31 in-depth, semistructured interviews conducted with stakeholders in the Swedish health care ecosystem. Participants included patients, advocacy groups, health care professionals, policy makers, pharmaceutical representatives, and technology developers. Data were analyzed thematically using an inductive coding approach supported by NVivo 12 (Lumivero). Emerging themes were refined through iterative discussion among the research team and validated by presentation to health care practitioners.
A total of 8 distinct purposes of digital health care self-monitoring emerged: (1) emancipate (enhance patient autonomy), (2) learn (understand health behaviors), (3) improve (enhance patient health), (4) engage (bolster patient involvement), (5) control (manage adherence and symptoms), (6) evaluate (assess health parameters), (7) innovate (advance interventions and processes), and (8) generate (drive new initiatives). These purposes form three categories of value creation: (1) improving the patient-provider link, (2) leveraging big data analytics for knowledge creation, and (3) using digital infrastructure to develop new care processes.
Our findings demonstrate that digital health care self-monitoring serves multifaceted aims, ranging from individual patient empowerment to ecosystem-wide innovation. Designing and implementing these tools with an explicit understanding of all stakeholders' "why" can help address potential conflicts (eg, balancing patient autonomy with clinical control) and facilitate more holistic adoption. Ultimately, this study underscores the importance of clear, purpose-driven approaches to promote better health outcomes, knowledge generation, and care process improvements.
数字医疗自我监测作为一种应对医疗保健领域各种挑战的工具已日益突出，这些挑战包括患者自主权、基于数据的决策制定以及组织改进。然而，在患者、医疗保健提供者、政策制定者和行业等不同利益相关者构成的多元生态系统中整合自我监测解决方案，可能会因不同的优先事项和需求而变得复杂。
本研究旨在识别并分类数字医疗自我监测背后的不同目的。通过梳理这些目的，该研究旨在阐明技术设计和实施如何能更好地与利益相关者的期望保持一致，从而提高其采用率和影响力。
采用定性设计，对瑞典医疗保健生态系统中的利益相关者进行了31次深入的半结构化访谈。参与者包括患者、倡导团体、医疗保健专业人员、政策制定者、制药代表和技术开发者。使用NVivo 12（Lumivero）支持的归纳编码方法对数据进行主题分析。通过研究团队的反复讨论对新出现的主题进行提炼，并向医疗保健从业者展示以进行验证。
共出现了数字医疗自我监测的8个不同目的：（1）解放（增强患者自主权），（2）学习（了解健康行为），（3）改善（增进患者健康），（4）参与（促进患者参与），（5）控制（管理依从性和症状），（6）评估（评估健康参数），（7）创新（推进干预措施和流程），以及（8）产生（推动新倡议）。这些目的形成了三类价值创造：（1）改善患者与提供者的联系，（2）利用大数据分析进行知识创造，以及（3）利用数字基础设施开发新的护理流程。
我们的研究结果表明，数字医疗自我监测具有多方面的目标，从增强个体患者权能到全生态系统的创新。在明确理解所有利益相关者的“目的”的情况下设计和实施这些工具，有助于解决潜在冲突（例如，平衡患者自主权与临床控制）并促进更全面的采用。最终，本研究强调了明确的、以目的为导向的方法对于促进更好的健康结果、知识生成和护理流程改进的重要性。
