A Cloud-Based Virtual Outpatient Clinic for Patient-Centered Care: Proof-of-Concept Study

• Published in: Journal of medical Internet research Vol. 20; no. 9; p. e10135
• Main Authors: de Jong, Jelske Marije, Ogink, Paula Am, van Bunningen, Carin Gm, Driessen, Rieke Jb, Engelen, Lucien Jlpg, Heeren, Barend, Bredie, Sebastian Jh, van de Belt, Tom H
• Format: Journal Article
• Language: English
• Published: Canada Journal of Medical Internet Research 01.09.2018; JMIR Publications
• Subjects: Care and treatment; Chronic diseases; Clinics; Hospital patients; Medical records; Medical research; Medicine, Experimental; Original Paper; Patient compliance; Patients; Netherlands; digital health; cloud service; mobile phone; mHealth; outpatient clinic; patient-centeredness; eHealth
• ISSN: 1438-8871; 1439-4456; 1438-8871
• DOI: 10.2196/10135

Most electronic health (eHealth) interventions offered to patients serve a single purpose and lack integration with other tools or systems. This is problematic because the majority of patients experience comorbidity and chronic disease, see multiple specialists, and therefore have different needs regarding access to patient data, communication with peers or providers, and self-monitoring of vital signs. A multicomponent digital health cloud service that integrates data sharing, collection, and communication could facilitate patient-centered care in combination with a hospital patient portal and care professionals. This study aimed to assess the feasibility and functionality of a new cloud-based and multicomponent outpatient clinic, the "Virtual Outpatient Clinic" (VOC). The VOC consists of 6 digital tools that facilitate self-monitoring (blood pressure, weight, and pain) and communication with peers and providers (chat and videoconferencing) connected to a cloud-based platform and the hospital patient portal to facilitate access to (self-collected) medical data. In this proof-of-concept study, 10 patients from both Departments of Internal Medicine and Dermatology (N=20) used all options of the VOC for 6 weeks. An eNurse offered support to participants during the study. We assessed the feasibility, usage statistics, content, adherence, and identified technical issues. Moreover, we conducted qualitative interviews with all participants by following a standard interview guide to identify user experiences, including barriers, facilitators, and potential effects. Most participants successfully used all options of the VOC and were positive about different tools and apps and the integral availability of their information. The adherence was 37% (7/19) for weight scale, 58% (11/19) for blood pressure monitor, and 70% (14/20) and 85% (17/20) for pain score and daily questions, respectively. The adherence for personal health record was 65% (13/20) and 60% (12/20) for the patient portal system. Qualitative data showed that performance and effort expectancy scored high among participants, indicating that using the VOC is convenient, easy, and time-saving. The VOC is a promising integrated Web-based technology that combines self-management, data sharing, and communication between patients and professionals. The system can be personalized by connecting various numbers of components, which could make it a relevant tool for other patient groups. Before a system, such as the VOC, can be implemented in daily practice, prospective studies focused on evaluating outcomes, costs, and patient-centeredness are needed.