A qualitative analysis of remote patient monitoring: how a paradox mindset can support balancing emotional tensions in the design of healthcare technologies

TL;DR

This study explores the emotional needs of diverse patients in remote patient monitoring, revealing tensions and proposing design strategies based on a paradox mindset to enhance health equity and emotional well-being.

Contribution

It is the first qualitative analysis to identify emotional tensions in RPM design and offers novel paradox-based recommendations for balancing these tensions.

Findings

Identified four key emotional tensions in RPM: heard vs. exploited, seen vs. deprioritized, empowered vs. anxious, cared for vs. detached.

Developed design recommendations using a paradox mindset to manage emotional tensions.

Highlighted the importance of addressing emotional needs for health equity in RPM.

Abstract

Remote patient monitoring (RPM) is the use of digital technologies to improve patient care at a distance. However, current RPM solutions are often biased toward tech-savvy patients. To foster health equity, researchers have studied how to address the socio-economic and cognitive needs of diverse patient groups, but their emotional needs have remained largely neglected. We perform the first qualitative study to explore the emotional needs of diverse patients around RPM. Specifically, we conduct a thematic analysis of 18 interviews and 4 focus groups at a large US healthcare organization. We identify emotional needs that lead to four emotional tensions within and across stakeholder groups when applying an equity focus to the design and implementation of RPM technologies. The four emotional tensions are making diverse patients feel: (i) heard vs. exploited; (ii) seen vs. deprioritized for efficiency; (iii) empowered vs. anxious; and (iv) cared for vs. detached from care. To manage these emotional tensions across stakeholders, we develop design recommendations informed by a paradox mindset (i.e., "both-and" rather than "and-or" strategies).