The ICT monitoring of chronic patients as a longitudinal survey: an innovative approach and a challenge for internet survey methodologists

Purpose of the study Significant efforts have been made to design telemedicine systems. But few researchers have taken into account the collection of data and information given from the patients. Yet the clinicians agree in the role of the “clinical interview” in health status monitoring of chronic patients. Design/methodology/approach The “classic” clinical interview (that can be seen as a face-to-face interview) can be transformed in a virtual medical visit, carried out with ICT tools (as a CAWI). Moreover, in a telemedicine system the questionnaires are collected daily and a longitudinal survey of chronic patients. This innovative approach is a challenge for survey methodologists: at least new data quality measures are needed, and the asssessment of the effectiveness of data collected. Findings In Tuscany 11 heart failure patients were enrolled the telemedicine study named ASCOLTA (Romano and al, 2014). After a training, they had to compile daily a web questionnaire at home. After 2 months we had 478 questionnaires (243 in the first and 235 in the second month) As a measure of cooperation we calculated the rate of missing questionnaires (6%) and of item non responses (from 0% to 7.4%). Using paradata, we calculated the time spent to complete the questionnaires (mean =1 minute and 31 seconds ). The hypothesis of “automated” or repetitive responses was rejected: no difference were found in completion time between the first and second month for each patient. Originality/value The tools and methodology developed for web surveys can be used to simulate a "face-to-face" situation between patient and doctor: continuous and remote health monitoring could be a challenge for survey methodologists. Our results, although preliminary, appear promising and, in our opinion, could be of significance on the ongoing debate on the most appropriate type of telemonitoring and remote care of patients. Furthermore, these longitudinal surveys have few missing data and have a very high response rate, due to the strong involvement of respondents. Research limitations/implications The results presented here have several limitations, also critical, such as: the small number of patients studied; the short follow-up of patients; the results relate only to heart failure patients. Practical implications In the last years, the increasing diffusion of smartphones and tablets has generated a still increasing number of health apps (not only for diagnosed patients). Skills and competencies of survey methodologists and statisticians have to guide data collection and data analysis in this new application field. References Anker SD, Koehler F, Abraham WT (2011) Telemedicine and remote management of patients with heart failure, The Lancet, 378, 731-739. Antonelli D., Bellomo D, Bruno G, Villa A (2012) Evaluating collaboration effectiveness of patient-to-doctor interaction in a healthcare territorial network, IFIP Advances in Information and Communication Technology, 380 AICT, pp. 128-136. Couper MP (2011), The Future of Modes of Data Collection, Public Opinion Quarterly, 75(5): 889-908. Nangalia V, et al. (2010) Health technology assessment review: Remote monitoring of vital signs - current status and future challenges. Critical Care, 14:233. Romano MF, Sardella MV, Alboni F, L’Abbate A, Mariotti R, Di Bello V (2014), The incremental value of the “virtual clinic visit” versus the instrumental conventional parameters’ information in a new heart failure telemonitoring integrated system. Telemedicine and e-Health., 20(6): 508-521. doi:10.1089/tmj.2013.022