TY - JOUR

T1 - Aligning Concerns in Telecare

T2 - Three Concepts to Guide the Design of Patient-Centred E-Health

AU - Andersen, Tariq Osman

AU - Bansler, Jorgen Peter

AU - Kensing, Finn

AU - Moll, Jonas

AU - Monsted, Troels

AU - Nielsen, Karen Dam

AU - Nielsen, Olav Wendelboe

AU - Petersen, Helen Hogh

AU - Svendsen, Jesper Hastrup

PY - 2018

Y1 - 2018

N2 - The design of patient-centred e-health services embodies an inherent tension between theconcerns of clinicians and those of patients. Clinicians’ concerns are related to professional issues to dowith diagnosing and curing disease in accordance with accepted medical standards. In contrast, patients’concerns typically relate to personal experience and quality of life issues. It is about their identity, theirhopes, their fears and their need to maintain a meaningful life. This divergence of concerns presents afundamental challenge for designers of patient-centred e-health services. We explore this challenge inthe context of chronic illness and telecare. Based on insights from medical phenomenology as well asour own experience with designing an e-health service for patients with chronic heart disease, weemphasise the importance – and difficulty – of aligning the concerns of patients and clinicians. To dealwith this, we propose a set of concepts for analysing concerns related to the design of e-health services:A concern is (1) meaningful if it is relevant and makes sense to both patients and clinicians, (2)actionable if clinicians or patients – at least in principle – are able to take appropriate action to dealwith it, and (3) feasible if it is easy and convenient to do so within the organisational and social context.We conclude with a call for a more participatory and iterative approach to the design of patient-centred ehealthservices.

AB - The design of patient-centred e-health services embodies an inherent tension between theconcerns of clinicians and those of patients. Clinicians’ concerns are related to professional issues to dowith diagnosing and curing disease in accordance with accepted medical standards. In contrast, patients’concerns typically relate to personal experience and quality of life issues. It is about their identity, theirhopes, their fears and their need to maintain a meaningful life. This divergence of concerns presents afundamental challenge for designers of patient-centred e-health services. We explore this challenge inthe context of chronic illness and telecare. Based on insights from medical phenomenology as well asour own experience with designing an e-health service for patients with chronic heart disease, weemphasise the importance – and difficulty – of aligning the concerns of patients and clinicians. To dealwith this, we propose a set of concepts for analysing concerns related to the design of e-health services:A concern is (1) meaningful if it is relevant and makes sense to both patients and clinicians, (2)actionable if clinicians or patients – at least in principle – are able to take appropriate action to dealwith it, and (3) feasible if it is easy and convenient to do so within the organisational and social context.We conclude with a call for a more participatory and iterative approach to the design of patient-centred ehealthservices.

KW - Patient-centred e-health

KW - Patient-clinician interaction

KW - Patient-provider relationship

KW - Medical phenomenology

KW - Participatory design

KW - Alignment of concerns

U2 - 10.1007/s10606-018-9309-1

DO - 10.1007/s10606-018-9309-1

M3 - Journal article

VL - 27

SP - 1181

EP - 1214

JO - Computer Supported Cooperative Work

JF - Computer Supported Cooperative Work

SN - 0925-9724

IS - 3-6

ER -