Abstract
Background: Remote patient monitoring (RPM) was effective in providing care during COVID-19 restrictions yet scaling and sustaining these initiatives proved challenging. Poor integration into existing workflows, stakeholder misalignment, and technological complexities constitute key barriers. A scoping review (Miranda et al., 2023) of RPM-based integrated care initiatives identified clinical and management dashboards as structural tools for tracking patient health and program key performance indicators (KPIs), supporting data-driven care coordination and continuous program improvement. However, dashboard adoption is often hindered by user unfamiliarity, lack of training, scepticism regarding data quality, and insufficient user involvement in tool design.
Approach: Our study proposes a novel collaborative approach for engaging users in designing prototype RPM management dashboards with an existing list of KPIs. KPIs are first analysed based on their characteristics (e.g., variables and communication purpose) to identify multiple suitable data visualisation (DataViz) formats. A collaborative dashboard-building (CDB) workshop then employs a modified nominal group technique to select preferred formats for each KPI. Dashboard-building software displays multiple DataViz options for a KPI at a time, which participants evaluate and vote on. Voting results are analysed, and participants can provide anonymous comments to enrich group discussions. After discussions, a final vote determines the chosen format. Once formats are selected, dashboard pages are developed for aggregating KPIs that should be visualised together, and participants review a prototype dashboard, suggesting improvements for visual coherence. To assess the acceptance and effectiveness of the developed approach, a post-workshop survey collects participants' feedback and insights on the methodology.
Results: A use case in RPM for managing heart failure (HF) patients in a Portuguese public hospital describes the approach application under real-world conditions. Six HF RPM program stakeholders and potential dashboard users (including a cardiologist/RPM program coordinator, two HF nurses, a project manager from the telemonitoring platform provider, an application specialist for the platform, and a hospital consultant for care pathway design) were engaged in a hybrid-format workshop to collectively analyse 21 KPIs relating to RPM program case-mix, access to care and clinical aspects. This collaborative process promoted consensus in selecting visualisation formats for the analysed KPIs, resulting in three co-created and validated dashboard pages, aligned with end-user needs and program objectives. A post-workshop survey revealed a consensus in respondent satisfaction with the proposed approach, endorsing its use.
Implications: Unlike traditional technocentric approaches, this collaborative process engages health professionals, managers, industry, and technology developers to foster consensus through a structured, yet user-friendly methodology. By making users co-developers, dashboard design aligns better with diverse needs while demystifying the technology. Such cooperative effort supports value co-creation and group decision-making by overcoming syntax, semantic, and pragmatic knowledge gaps among stakeholders (Pillar 1), aligning with technology user with organisational goals (Pillar 7) and enabling transparent understanding of RPM outcome measurement (Pillar 9) – key pillars of integrated care. Future work will focus on dashboard implementation, impact evaluation, and advanced features like temporal analysis, expanded KPIs (e.g., acceptability and cost dimensions), and multicriteria evaluation models.