# From predefined indicators to a management dashboard for heart failure telemonitoring: a modified nominal group technique approach in Portuguese hospitals

## TL;DR

This paper presents a collaborative method for creating heart failure telemonitoring dashboards in Portuguese hospitals using user input and a modified group decision-making technique.

## Contribution

A modified nominal group technique is introduced to co-create tailored dashboards with health professionals and stakeholders.

## Key findings

- Two real-world cases demonstrated the method's effectiveness in co-creating dashboards with tailored visuals for heart failure telemonitoring.
- The approach improved dashboard ownership, usability, and alignment with user needs and program objectives.
- A functional dashboard prototype with five pages was developed, reflecting users' management needs and protocol specifics.

## Abstract

Clinical, operational, and financial data drive healthcare decisions, but deriving insights from complex datasets is challenging and error-prone. Dashboards simplify analytics, yet adoption is constrained by skepticism about generic solutions designed without user input. While participatory methods have allowed consultation in dashboard-building tasks, collaboration between users is required to ensure consensual and needs-oriented tools.

We modified the nominal group technique – leveraging a priori idea generation and iterative voting through literature review, questionnaire, and workshop processes – to engage prospective users in creating consensual dashboards from predefined key performance indicators (KPIs). First, sets of suitable visuals for each KPI are identified through a literature-informed decision table. Next, users individually state their preferential visuals via an online questionnaire. Finally, a collaborative dashboard-building workshop enables users to (1) discuss and select final KPI visuals and (2) integrate selected visuals into a prototype dashboard. Two real-world cases (UC1 and UC2) in telemonitoring for heart failure (HF) management in Portuguese hospitals are reported.

UC1 reports the collaborative analysis of 23 KPIs on HF telemonitoring program’s Case-mix, Access and Clinical aspects by health professionals and medical technology providers (n = 6), co-creating three dashboard pages. In UC2, cardiologists (n = 5) validated UC1’s choices, assessed 12 new KPIs on Acceptability and Costs, and a functional dashboard prototype comprising five pages (average 7.2 visuals per page) was developed. While both cases adhere to a common KPI set, visuals reflect each telemonitoring protocol and are tailored to users’ management needs and program objectives.

The proposed approach revealed well-structured while expedite, aligning health professionals and managers' needs with developers' design perspectives. It allows translating narrative management concepts into interactive and actionable information. Moreover, by fostering user collaboration, dashboard ownership, trust, usability, adoption, and workflow integration are enhanced.

The online version contains supplementary material available at 10.1186/s12913-026-14031-1.