Medical Interviews
Themes	Codes	Verbatim
Device	Patient equipment	“It’s either patients who already have Apple Watches.” “I think it depends on how patients are equipped.” “It depends on the phone the patient has.”
	Price	“Choose a model that’s not too expensive.”
	Quality	“What we prefer is good quality.”
	Watch references	“It’s not bad from Withings® and also we see a bit of Samsung ®.” “If they don’t have an Apple Watch® I give them the references for the Whitings® or the Fitbit ®.” “I prefer Withings® because it goes with all phones.” “There’s one brand that I use the most, and that my patients buy quite extensively, and that’s Withings®.” “I recommend one watch in particular that is compatible with all phone models: Whitings®.”
Patient use	Recordings	“Often it’s they actually try to record and sometimes they can send by e-mail by contacting our office the tracings record.” “These are patients who have palpitations that they are recording at the time.” “We ask them to send us PDF of the ECGs they have recorded by e-mail, explaining their symptoms.” “So the instructions, in quotation marks, are for them to do tracings for me when they’re feeling well, to have a reference of their normal tracings, and to record a tracing when they have a symptom, and then once they’ve done that they send it to me, I tell them they can send it to me by e-mail.”
	Ease of use	“Yes, it’s quite easy to use.” “Yes, well, curiously enough, these tools are quite easy for the patient to use and don’t really require much learning.”
	Patient typology	“I use it for patients with rare but fairly frequent symptoms.” “When patients come to us complaining of palpitations, sensations of rhythm disturbances that have never been recorded.”
Use by the doctors	Diagnosis	“It gives us a positive diagnosis.” “Either we see that there’s no arrhythmia and there are no abnormalities in that case, well, that’s pretty reassuring, and if not, sometimes it can be dubious, but often we still see that it’s either normal or pathological.” “It allows us to know more precisely what the patient has, to make a diagnosis.” “This will enable us to diagnose and correctly manage the right arrhythmia, because managing atrial fibrillation is not the same as managing tachycardia or other conditions, which are not at all the same treatments.” “Most of the time we use them during the diagnostic phase.”
	Treatment	“This can lead directly to a strategy of ablation or drug treatment.” “And if need be initiate a treatment or an intervention behind.”
	Follow-up	“Diagnostics! After all, they bought it, so it belongs to them and we can use it to monitor the effectiveness of our treatments.” “It’s for diagnosis at the moment, afterwards, for follow-up, let’s say no more symptoms, he’ll let go of the recordings a little and if there’s a resurgence of symptoms afterwards, they’ll use the device again.” “But it can also be used to evaluate the effectiveness of a treatment.”
	Patient typology	“I use it for patients with rare but fairly frequent symptoms.” “When patients come to us complaining of palpitations, sensations of rhythm disturbances that have never been recorded.”
Added value	Qualitative	“Good quality tracks.” “Tracks are still of fairly good quality.”
	Efficient diagnostics	“Diagnostic means for palpitations are pretty poor because it’s either an ECG holter.”
	Long recording	“Longer recordings but then it’s over a week or they have to wear one of the holters, which is quite restrictive and fragile.”
	Ease of use	“It’s really quite simple to use.”
Financing	Budget	“We can’t give them too much of a model to equip themselves with, it’s also a matter of their budget.” “But for those who have an iPhone or the means to get a slightly higher-end watch.”
	Financial brake	“After all, there is a filter linked to financial investment.” “There are departments that have chosen to invest in the purchase of tools at the hospital, but we have chosen not to do this because it creates additional constraints in terms of equipment, and it also allows us to filter patient motivation to a certain extent.” “Because, on the other hand, it’s a purely personal opinion, but I absolutely don’t want watches to be reimbursed. Patients have to make the investment themselves, otherwise they’ll be left to their own devices.”
Support from the doctor	Solicitation	“Well, I’d say quite simply, so maybe the other rhythmos will tell you something else, but frankly I don’t think so.” “I don’t get a lot of requests afterwards, because I don’t have many patients with watches, so it’s still filtered, but I’d say like conventional patients.” “In general, we don’t have any questions about the pure use of the watch, that’s more likely to come from the stores.”
	Recording	“I ask them to buy the watch, so it’s often the Withings® during a first consultation, for example, and then the instruction is to make tracings as soon as they have symptoms and send them to me by e-mail.” “In fact, we ask them to come and see us again once they have registered symptoms, i.e., it depends a little on the frequency of the symptoms.”
	Sending tracks	“Personally, I don’t ever ask for it to be sent to my e-mail address, because otherwise it would mean being available 24 h a day, which is a bit complicated. And what’s more, when you send it to us by e-mail, there’s a medico-legal responsibility.”
	Meeting	“That way, at least you’re sure to have tracings at the time of the consultation, because if I see them again in 6 months and they haven’t had anything in 6 months, there’s no point in setting up the appointment in advance.” “But I can’t always reply by e-mail, and if they have a route, we’ll meet again to analyze it together.” “So they come to see us or we can give them a generic mailbox, especially from our telecardiology nurses, but not on personal mail.”
The pharmacist’s role	Complex patients	“These are patients who require complex care.”
	No need to	“I don’t really see what the pharmacist could contribute.” “I’ve never had any feedback from a patient who’s had problems using it.” “I’ve always had the impression that it worked well on its own, spontaneously.” “I’ve never had any feedback from a patient at this level, so I have the impression that it works well.”
	Technical support	“An operating aid.” “A handling aid.” “The patient could come to the pharmacy to get a recording with his equipment.” “On a slightly more practical note, to help him properly record his rhythm disorder, palpitations, check that he’s also using it the right way.”
	Large population	“It may be possible to extend this to people who are more fragile and have more difficulty understanding. I can see what’s involved in remote monitoring of implantable medical prostheses, and we need more support to reassure people. I think that if we want to extend this kind of device to older people, it could be interesting to have pharmacists involved in this project.” “Reach a wider population to compare with something comparable that is between the doctor and the pharmacist, that is the patient who has just taken their blood pressure at the pharmacy.”
	Communication	“He’d have to have more or less secure messaging and things like that. And then the development of networks to enable advanced practices. For example, in our company, we could have privileged contacts, I think paramedics, who could have managed this kind of alert and then redirected patients to doctors according to their profiles, and so on.” “Mail is the easiest way, or via MonSisra®, the secure messaging system, but processes need to be put in place, especially if the number of patients increases.”
	Relationship	“Yes, I think so, because patients often have a lot of contact with their dispensing pharmacist if they take medication every month or if they go there for other reasons.”
	Board	“On an advisory role because it can also have a role if we teach it to validate anomalies.”
	Training	“We need to teach the pharmacist how to diagnose atrial fibrillation, for example, which is the most common rhythm disorder.”
	Limits	“But I don’t quite see what the pharmacist would get out of it, unless these devices are sold in pharmacies and not reimbursed, in which case why not.” “But only a cardiologist can interpret the trace.”