Design to Reassure: Fostering Engagement in Remote Patient Monitoring of Post-Operative Cancer Care

Patients who recover at home after major cancer surgery face emotional and practical challenges, along with the risks of further complications, readmission and potentially surgery-related death. These risks could be prevented if continuous monitoring provided by hospital clinical teams could also be leveraged at home. An emerging technology, already introduced in clinical settings, Remote Patient Monitoring (RPM), offers a comprehensive evaluation of patient recovery through the collection of vital signs and Patient-Reported Outcome Measures (PROMs). However, its effectiveness is often limited by low patient engagement, a fundamental factor in allowing widespread adoption and achieving the full potential of RPM. This challenge is addressed through an integrative approach that involves three sequential studies informed by the fields of Human-Computer Interaction (HCI) and digital health. Study 1, an observational clinical pilot study, established the motivation of this thesis, concluding that the engagement and compliance of patients with RPM is low. Study 2, explored the needs and requirements of patients in various aspects of RPM through a series of three Patient and Public Involvement (PPI) workshops and concluded that reassurance can play a central role in the design of RPM technologies. Study 3, based on the identified key finding of reassurance, employed user-centred design methods to translate patient needs into actionable design recommendations through a novel user-centred tool, the Reassurance Journey Map (RJM). This thesis contributes to the realisation that RPM engagement barriers extend beyond clinical or technical factors into the realm of user experience and user interface design. The RJM, along with a set of best-practice guidelines, is capable of positively influencing the application of user-centred principles in RPM design, subsequently fostering patient engagement. Improved patient engagement enables clinicians to care more effectively for their patients, making patients alleviate concerns, anxiety and uncertainty, ultimately leading to improved health outcomes.