Skip to main content

Table 10 Summary of responses to perceptions of mHealth and patient-gathered data being integrated into healthcare providers’ electronic health record (EHR) systems

From: How mHealth can facilitate collaboration in diabetes care: qualitative analysis of co-design workshops

Groups

Codes

Summary

Example quotations

Participants with T1D

Concerns

• Data overload

• That healthcare providers still would not be able to use data to generate personalized recommendations

“Giving up all of my blood sugar measurements is very much information” (T1D_P4)

“[I shared] a lot of data … I got little use out of meeting the diabetes nurse...Last time she said it wasn’t much she could help me with” (T1D_P3)

Specialists

Concerns

• Priorities of healthcare providers would be hindered

• Healthcare providers’ capacity, i.e. time required to use and knowledge about how to use technology

“The CGM technology is very good, but our nurses – it means that 80% of their time is working with the functional learning patients and [complaints about] “it doesn’t work”, “how can it do it and change”. So instead of actually talking to the patients about “how are you” – we are dealing with problems about “I can’t fit it” (Specialist1)

“10% [of patients] use the CGM. Then those patients get much more consultations with the nurses because they need to be taught the CGM and they need follow-ups. So this small group … maybe they use 80% of the nurses’ time” (Specialist2). Also, continuous data transfer potentially meant the need “to have a diabetes nurse continuously, 24 h-a-day, checking on continuous glucose monitors (CGMs), like we do with hospital patients. We don’t have resources for this” (Specialist1).

“There is a lot of different technology now. It is Freestyle and it is CGM and it is 640 G and Freestyle Libre. Of course patients are oriented about this because they talk to other patients, search on internet and so on. But the doctors have very little possibilities … so, we have little time to learn these new systems and to understand how to optimally use them” (Specialist2).

“During this 30mins where I am also supposed to have nice communication with the patients and also do blood pressure and check their feet and check if they have been to the eye doctors, checking and requiring lab measurements and prescribing insulin– I need to get these data in. That’s a problem of time. The other thing is the problem of methodology of how to get the data presented in a way so that it is not time consuming for me” (Specialist1).

Alternatives

• PGD could complement and be used together with EHR systems, if it were to be integrated automatically

“I work in an [electronic health record system] so there we have a lot established already. And what I want is a new screenshot showing blood glucose...and the insulin. It has to happen automatically, either with pen or pump. And then something about physical activity. And then something [about] food, and short [remarks] about stress and questions for the doctor … And then we look at it on the screen together. Then it is easier to see and explain, and with things already in [the electronic health record]” (Specialist1).