title: A Wireless Health Outcomes Monitoring System (WHOMS): development and field testing with cancer patients using mobile phones.
abstract: BACKGROUND
  Health-Related Quality of Life assessment is widely used in clinical research, but rarely in clinical practice. Barriers including practical difficulties administering printed questionnaires have limited their use. Telehealth technology could reduce these barriers and encourage better doctor-patient interaction regarding patient symptoms and quality-of-life monitoring. The aim of this study was to develop a new system for transmitting patients' self-reported outcomes using mobile phones or the internet, and to test whether patients can and will use the system via a mobile phone.
  
  
  METHODS
  We have developed a prototype of a Wireless Health Outcomes Monitoring System, which allows structured questionnaires to be sent to the patient by their medical management team. The patients' answers are directly sent to an authorised website immediately accessible by the medical team, and are displayed in a graphic format that highlights the patient's state of health. In the present study, 97 cancer inpatients were asked to complete a ten-item questionnaire. The questionnaire was delivered by display on a mobile phone, and was answered by the patients using the mobile phone keypad.
  
  
  RESULTS
  Of the 97 patients, 56 (58%) attempted the questionnaire, and all of these 56 completed it. Only 6% of the total number of questions were left unanswered by patients. Forty-one (42%) patients refused to participate, mostly due to their lack of familiarity with mobile phone use. Compared with those who completed the questionnaire, patients who refused to participate were older, had fewer years of education and were less familiar with new communications technology (mobile phone calls, mobile phone SMS, internet, email).
  
  
  CONCLUSIONS
  More than half of the patients self-completed the questionnaire using the mobile phone. This proportion may increase with the use of multichannel communications which can be incorporated into the system. The proportion may also increase if the patient's partner and/or family were able to assist the patient with using the technology. These preliminary results encourage further studies to identify specific diseases or circumstances where this system could be useful in patients' distance monitoring. Such a system is likely to detect patient suffering earlier, and to activate a well-timed intervention.
authors.affiliation: Reply-PlaneT, Via Ripamonti 89, 20139 Milan, Italy. e.bielli@reply.it
authors.forename: Emilia
authors.initials: E
authors.lastname: Bielli
authors.forename: Fabio
authors.initials: F
authors.lastname: Carminati
authors.forename: Stella
authors.initials: S
authors.lastname: La Capra
authors.forename: Micaela
authors.initials: M
authors.lastname: Lina
authors.forename: Cinzia
authors.initials: C
authors.lastname: Brunelli
authors.forename: Marcello
authors.initials: M
authors.lastname: Tamburini
mesh_terms: D040421:Cell Phone / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000592:standards*; D010358:Patient Participation / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000379:methods*; D011788:Quality of Life; D011795:Surveys and Questionnaires