Investigating User Identification in Remote Patient Monitoring Devices

Abstract

Abstract: With the increase in the number of people having a chronic disease, there is an increase in households having more than a single person suffering from the same chronic illness. One problem of monitoring such patients in their own home is that current devices have a limitation in the number of people who can use a single device. This study investigates the use of Near Field Communication (NFC) for identification in a multi-user environment. Methods: A mixed-method qualitative and quantitative approach was adopted, including focus groups, observations and a field trial. Data were collected in three phases. In Phase 1, five focus groups were conducted with patients to determine their beliefs, concerns and issues with using identification in remote patient monitoring devices. In Phase 2, participants were given a blood pressure monitor modified to include an NFC reader to enable identification. The modified device was given to patients living as a couple in the same household and both suffering from hypertension. Both patients used the device for a period of two weeks to observe their acceptance of the technology and determine their experience of usage. A total of 40 (20 couples) patients participated in the trial. Non-adherence to the full monitoring regimen was low and was mainly due to usability issues or commitments taking them away from the home and thus unable to take readings. After the trial period participants were invited to discuss their experiences with the technology in a focus group discussion (Phase 3), a total of five focus groups were conducted. Focus group discussions with the patients revealed that most participants liked using the system and were not apprehensive towards Healthcare Information Technology (HIT). The participants also had suggestions for improvements that could be made to the modified blood pressure monitor (such as, rechargeable in place batteries, integrate the components, easier to use cuff, and increased sensitivity of the NFC reader) that might improve the overall experience of the proposed technology and its acceptance. Conclusion: The study proposes a new framework, the Senior Patient Technology Acceptance Model (SPTAM) that offers an understanding of the needs of the elderly towards technology use and the factors that influence its acceptance. SPTAM emphasises that involving the patient in the early stages of development can lead to a more user-centred technology and help in identifying any underlying issues at an early stage, thus avoiding adding features which patients do not need. The findings from this empirical research can be used as recommendations to improve current RPM devices, save the NHS costs, inform standardization groups.