title: More Than Telemonitoring: Health Provider Use and Nonuse of Life-Log Data in Irritable Bowel Syndrome and Weight Management.
abstract: BACKGROUND
  The quantified self, self-monitoring or life-logging movement is a trend to incorporate technology into data acquisition on aspects of a person's daily life in terms of inputs (eg food consumed), states (eg mood), and performance (mental and physical). Consumer self-monitoring mobile phone apps have been widely studied and used to promote healthy behavior changes. Data collected through life-logging apps also have the potential to support clinical care.
  
  
  OBJECTIVE
  We sought to develop an in-depth understanding of providers' facilitators and barriers to successfully integrating life-log data into their practices and creating better experiences. We specifically investigated three research questions: How do providers currently use patient-collected life-log data in clinical practice? What are provider concerns and needs with respect to this data? What are the constraints for providers to integrate this type of data into their workflows?
  
  
  METHODS
  We interviewed 21 health care providers-physicians, dietitians, a nurse practitioner, and a behavioral psychologist-who work with obese and irritable bowel syndrome patients. We transcribed and analyzed interviews according to thematic analysis and an affinity diagramming process.
  
  
  RESULTS
  Providers reported using self-monitoring data to enhance provider-patient communication, develop personalized treatment plans, and to motivate and educate patients, in addition to using them as diagnostic and adherence tools. However, limitations associated with current systems and workflows create barriers to regular and effective review of this data. These barriers include a lack of time to review detailed records, questions about providers' expertise to review it, and skepticism about additional benefits offered by reviewing data. Current self-monitoring tools also often lack flexibility, standardized formats, and mechanisms to share data with providers.
  
  
  CONCLUSIONS
  Variations in provider needs affect tracking and reviewing needs. Systems to support diagnosis might require better reliability and resolution, while systems to support interaction should support collaborative reflection and communication. Automatic synthesis of data logs could help providers focus on educational goals while communication of contextual information might help providers better understand patient values. We also discuss how current mobile apps and provider systems do, and do not, support these goals, and future design opportunities to realize the potential benefits of using life-logging tools in clinical care.
authors: Department of Human Centered Design & Engineering, Dub Group, University of Washington, Seattle, WA, United States. cfchung@uw.edu.
authors: Chia-Fang
authors: http://orcid.org/0000-0002-3374-2073
authors: CF
authors: Chung
authors: Jonathan
authors: http://orcid.org/0000-0001-8717-9127
authors: J
authors: Cook
authors: Elizabeth
authors: http://orcid.org/0000-0003-0586-795X
authors: E
authors: Bales
authors: Jasmine
authors: http://orcid.org/0000-0002-8251-7438
authors: J
authors: Zia
authors: Sean A
authors: http://orcid.org/0000-0002-0472-6138
authors: SA
authors: Munson
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D003625:Data Collection; D055991:Health Records, Personal; D006801:Humans; D043183:Irritable Bowel Syndrome; D063731:Mobile Applications; D009765:Obesity; D011369:Professional-Patient Relations; D015203:Reproducibility of Results
keywords: behavioral self-monitoring; chronic disease; clinical care; health; life logs; personal informatics; quantified self; wellness