title: A personalised mobile-based home monitoring system for heart failure: The SUPPORT-HF Study.
abstract: BACKGROUND
  Despite their potential for improving health outcomes, mobile-based home monitoring systems for heart failure have not yet been taken up widely by the patients and providers.
  
  
  OBJECTIVE
  To design and iteratively move towards a personalised mobile health monitoring system for patients living with heart failure, according to their health care and usability needs.
  
  
  METHODS
  We present an iterative approach to refining a remote health monitoring system that is based on interactions between different actors (patients, clinicians, social scientists and engineers) and supports the collection of quantitative and qualitative information about user experience and engagement. Patients were provided with tablet computers and commercially available sensing devices (a blood pressure monitor, a set of weighing scales, and a pulse oximeter) in order to complete physiological measurements at home, answer symptom-specific questionnaires, review their personal readings, view educational material on heart failure self-management, and communicate with their health professionals. The system supported unobtrusive remote software upgrades via an application distribution channel and the activation or deactivation of functional components by health professionals during run-time operation. We report early findings from the application of this approach in a cohort of 26 heart failure patients (mean age 72±15 years), their caregivers and healthcare professionals who participated in the SUPPORT-HF (Seamless User-centred Proactive Provision Of Risk-stratified Treatment for Heart Failure) study over a one-year study period (mean patient follow-up duration=270±62 days).
  
  
  RESULTS
  The approach employed in this study led to several system upgrades dealing in particular with patient requirements for better communication with the development team and personalised self-monitoring interfaces. Engagement with the system was constantly high throughout the study and during the last week of the evaluation, 23 patients (88%) used the system at least once and 16 patients (62%) at least three times.
  
  
  CONCLUSIONS
  Designers of future mobile-based home monitoring systems for heart failure and other chronic conditions could leverage the described approach as a means of meeting patients' needs during system use within the home environment and facilitating successful uptake.
authors.affiliation: Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK. Electronic address: andreas.triantafyllidis@eng.ox.ac.uk.
authors.forename: Andreas
authors.initials: A
authors.lastname: Triantafyllidis
authors.affiliation: Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Velardo
authors.affiliation: George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
authors.forename: Tracey
authors.initials: T
authors.lastname: Chantler
authors.affiliation: Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK.
authors.forename: Syed Ahmar
authors.initials: SA
authors.lastname: Shah
authors.affiliation: George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Paton
authors.affiliation: George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
authors.forename: Reza
authors.initials: R
authors.lastname: Khorshidi
authors.affiliation: Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK.
authors.forename: Lionel
authors.initials: L
authors.lastname: Tarassenko
authors.affiliation: George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
authors.forename: Kazem
authors.initials: K
authors.lastname: Rahimi
mesh_terms: D000368:Aged; D034201:Computers, Handheld; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory / Q000295:instrumentation* / Q000379:methods; D010358:Patient Participation / Q000379:methods; D018802:Patient-Centered Care / Q000379:methods; D012098:Reproduction; D012648:Self Care / Q000295:instrumentation* / Q000379:methods; D012680:Sensitivity and Specificity; D012984:Software; D017216:Telemedicine / Q000295:instrumentation* / Q000379:methods; D014584:User-Computer Interface
keywords: Heart failure; Mobile health; Personalised healthcare; Remote health monitoring; Telemedicine; Usability