Table 5.
Main contrasts in perceptions of eHealth between groups.
| eHealth as something undesirable and worthless | eHealth as something that makes things easier | |
|---|---|---|
| Remote consultation | Remote consultations were perceived as unpleasing and superficial, and participants highlighted a preference for face-to-face consultations: “I don’t mind going to the hospital. I don’t! Because it sort of gives me an aim to go for. I think it’s quite good to take those small trips. Yesterday I also went to the hospital with my husband.” (Female, 71 years, ID: 1) “When I look at that picture, I literally find it pleasant to sit and wait in the department and talk to a real human being. I get that you are able to do almost the same thing this way […] I have no reasoned objections; I just find it emotionally unpleasant.” (Male, 71 years, ID: 5) “I prefer talking to the person who has to help me with something. It can easily get too impersonal. I don’t find it interesting at all! I would think: ‘God, they really don’t care about me.’”(Male, 65 years, ID: 9) |
Remote consultations were perceived as useful for some healthcare appointments. Due to frequent appointments and experienced challenges such as access barriers and burdensome transportation, participants perceived remote consultations as an easier alternative to face-to-face consultations: “In many situations, it would be fine to talk to the nurse on the phone – when there is no need to be face-to-face.” (Male, 55 years, ID: 3) “I think it’s great that you are able to see the person you’re talking to, and the doctor is able to see what it is all about. […] It would be great if I could show him my swollen leg, and it’s positive because it’s difficult for me to get ready and leave the house and get to the other side of the city.” (Male, 72 years, ID: 8) “First of all, a good thing is that you don’t have to use 77 different means of transportation, and you’re in your own home, which is more relaxing. [...] I think it’s fantastic. […] Also, it would be useful when you have doubts about the pills. Then you could get an answer much faster.” (Female, 69 years, ID: 10) “For some purposes, it would be great. It would be difficult with the rheumatologist, I think, but my diabetes could easily be handled on a screen. Typically, I just have to talk with the doctor about a blood test, and that can easily be done via a screen. […] It would also be great if it was more easy to call the doctor if you’re worried about something.”(Female, 55 years, ID: 7) |
| Remote monitoring | Remote monitoring was perceived as unnecessary due to stable and well-managed conditions, and good self-management abilities: “My conditions are quite stable and my blood pressure is more or less always the same. […] I know what to do when I have to measure my blood pressure, and if it is too high, I also know what to do. I just take some diuretics. I mean, I have had these conditions for a very long time now, so I doubt that I could benefit from something like that. I would prefer an easier access to the specialists. But I don’t think they have the time to sit behind the screen the whole day, so the limitations would probably be the same as today.” (Male, 71 years, ID: 5) Remote monitoring was perceived as impersonal, superficial and unnatural, and participants expressed no intention to use it when in their current state of health: “I really don’t like it. I would feel like an idiot if I had to sit there and use it. I think it is creepy. I would not use it, whatsoever. Of course, I would use it if I really had to, but then I would be thinking all the time that it wasn’t normal.” (Male, 65 years, ID: 9) |
Remote monitoring was perceived as useful for monitoring different body parameters. In addition, it was perceived as a time-saving alternative to clinic visits, and as a way to keep better track of own health status: “A lot of small things, like blood pressure and other tests, could easily be done this way. That would save both the doctors’ and my own time. If you could just call the doctor and he could make out a prescription, that would be great.” (Female, 55 years, ID: 6) “I would find it useful for my blood pressure. I mean, you cannot always feel and tell if something is wrong. […] As I told you, I’ve been feeling kind of strange the last couple of days, and what am I supposed to do, if I suddenly collapse? […] When I haven’t walked for a long time, I have trouble just getting to the bathroom, and sometimes my legs cannot carry me and I fall. So I would use it in those periods where I feel a need to measure my blood pressure.” (Female, 69 years, ID: 10) |
| Remote rehabilitation | Remote rehabilitation was perceived as undesirable, and participants highlighted a preference for social interaction with other people, and expressed no intention to use it when in their current state of health: “I have been in two heart rehabilitation programs, and I would say that a positive thing is that you are together with a lot of people who are in the same situation as yourself. It was great fun! Making rehabilitation alone, I don’t think I would do it… I would forget to connect myself. I couldn’t take it seriously.” (Male, 48 years, ID: 4) “I would really not like that. […] I don’t think it would make me more active. Well, I can see that it put some kind of moral pressure on you when the screen is lighting up and it’s beeping and saying ‘Now it’s time’. But, no thanks! […] I also think it’s a lonesome affair.” (Male, 71 years, ID: 5) “It’s very impersonal. I would fall with laughter. […] I prefer spending time with happy people. I feel most comfortable that way.” (Male, 65 years, ID: 9) “Maybe it can be necessary. If you have troubles leaving the house. I had that the first time. I had to catch two buses and walk to get to the rehabilitation center. That was too much.” (Male, 72 years, ID: 2) |
Remote rehabilitation was perceived as an easier alternative to standard rehabilitation in a rehabilitation center due to physical restrictions and burdensome transportation: “I think it would be wonderful! That somebody sort of comes to you and says: ‘It’s workout time’. It’s a positive thing that you’re able to communicate with another person in front of you. And that person can tell you if you’re not doing the exercises the right way. She can correct you immediately.” (Female, 58 years, ID: 6) “I think it would be easy for many people. […] It can be difficult to do exercises alone at home. I mean, if you can see it on a screen, I think it would be easier. I mean, I think it’s like standing just in front of the physiotherapist who tells you what to do – instead of just getting a piece of paper with the exercises. That can be difficult, I think. […] You also avoid transportation troubles and long waiting times. […] I could see myself using it.” (Female, 55 years, ID: 7) “Yes, I could imagine myself using it. A positive thing is that you can use it even when you have almost no energy. You don’t have to get ready and get out of the door and get to the other part of the city. You just have to push a button.” (Male, 72, ID: 8) “I’m convinced that it is something that will get you active. I cannot imagine anything else. If I knew how to use it, I would. […] I have no muscles at all, and I’m in pain all over my body. I think it’s brilliant.” (Female, 69 years, ID: 10) |
| Self-management tools | Self-management monitoring tools were perceived as unnecessary as participants were already managing their conditions well: “I don’t really need it because I know what to do. When I’m taking it, and my blood glucose is too high I say: ‘Alright, I need some insulin’, and if it’s too low I say: ‘Alright, I better get some sugar’. […] I measure my blood pressure at home, but I don’t keep track of the results anymore. […] If you have had the same chronic conditions for 10–25 years, then you know when you’re not well, and I know when I need to see a doctor. I would prefer that, if I were not well. I think that’s most safe.” (Male, 72 years, ID: 2) Drug-reminder applications were perceived as unnecessary and worthless, as participants experienced no difficulties with medication management: “I don’t need it. It’s stored in here” [pointing at his head]. (Male, 72 years, ID: 2) “It would only make sense if I were taking even more pills than I am doing now.” (Male, 48 years, ID: 4) |
Self-management monitoring tools were perceived as an easier way to monitor conditions: “That would be quite nice to have. Because, for example, my blood pressure – I take it every day, but I actually don’t…I mean, I don’t really have a realistic and useful picture of the variation over time.” (Female, 58, ID: 6) Participants were interested in improving their health by obtaining health-related information via self-management tools: “It would be great if you could make a system that patients could enter to see if any new drugs were on the market, and to get proposals on possible drug adjustments.” (Male, 55 years, ID: 3) To improve patient-centered care, participants expressed a desire for a pre-visit reporting tool: “I think it would be great if I could type in questions in the system. Sometimes you feel bad, and suddenly you have questions. It would be great if the questions could just lie in the system and be used in the next consultation or something like that.” (Female, 58 years, ID: 6) |