Table 12.

ALAMEDA data collection journey challenges and mitigation actions.

Challenge	Technical Mitigation	Process Level Mitigation
Patients find it challenging to fill in PROs	The ALAMEDA Digital Companion issues notifications and instructions on how to fill in each questionnaire	Medical professionals perform a dry-run of receiving a notification and completing a PRO while the patient is hospitalized/on the first days after enrollment
Patients find it challenging to follow the schedule for PRO submission	Notifications in the ALAMEDA Digital Companion can be postponed; Questionnaires can be split into multiple completion sessions	A light PRO schedule is provisioned: no more than 1 questionnaire a week or 1–2 relevant questions a day
Patients find it challenging to wear and operate many devices (e.g., smart insoles, smart belt) during the intensive monitoring period	An early morning checklist (comprising video tutorials of how to wear and use the devices) is delivered through the ALAMEDA Digital Companion every day of the intense monitoring period	Collect usability feedback at each pilot milestone and iterate over support documentation; Enable option for admission into clinic during the intense monitoring period (e.g., for stroke patients)
Patients find it challenging to understand their role and contribution in the study leading to reduced engagement and possible dropout	Patients can see their own data in the ALAMEDA Digital Companion; Social Media groups can be created to facilitate inter-patient support	Medical professionals keep a close contact with the patient; Medical professionals explain the pioneering role that patients play in the study: for themselves, as well as for future patients