Table 2.
Technology problems encountered during the trial
| Problem | Solution adopted | Impact on the use of the TiM | Recommendations for future TiM use |
| TiM Patient App software | |||
| Poor finger dexterity | Handheld stylus provided | 85% used TiM independently. | Provide stylus to all patients. |
| Carer help to use device | Interview data suggested that help from carers was acceptable. | Encourage carer support. | |
| Difficulties entering login password | Telephone support | Problem resolved with second TiM app release. | Provide face-to-face training. Provide telephone technical support. |
| Login page redesigned | No further problems reported. | Make local staff familiar with the software. | |
| Lack of confidence using the app or other features on the TiM | Face-to-face training Partner/family helped |
None: all participants could use the app. | Provide face-to-face training plus an additional contact after a few weeks to reinforce learning. Identify low confidence/experience users and provide extra training. |
| Patients not giving correct answers | Patient completing TiM with their family | Uncertain impact. | Capacity assessment at recruitment. Check TiM answers in training and in clinic. |
| Tablet | |||
| Tablet stored in place not accessible to patient | No solution available | Interviews suggested that adherence was reduced for two patients. | Use patients’ own equipment where possible. |
| Tablet battery drained, unable to switch on | Telephone advice | No impact. | Use patients’ own equipment. Familiarise local staff with hardware. |
| Unexpected screens/ software updates | Telephone advice | Reduced user confidence in tablet but no impact on use. | Use patients’ own equipment. Use a basic tablet that only displays the TiM app. |
| User fear of ‘breaking’ the tablet | Face-to-face training to improve user confidence | Patients/carers reluctant to use the additional features on the tablet. | Use patients’ own equipment. Face-to-face training. |
| Internet connection | |||
| Poor 3G phone signal | Used patients’ own broadband | None: solution found for all patients (3G or patients’ own broadband) | Use patients’ own broadband. Check internet availability prior to TiM enrolment. |
| Patients switched Wi-Fi off | Home visit required | Several TiM sessions failed to download. | Monitor adherence. Alert team if adherence is low. |
| Unreliable connection between scales and tablet/broadband | A separate 3G Wi-Fi route provided (‘Mifi’). No solution if using broadband | Additional home visits required and loss of weight data for several weeks. | Manual weight recording. Avoid using peripheral devices. |
| Clinician portal | |||
| Password/login problems | Support by external IT team | Delayed access during MDC visit. | Local systems access support. |
MDC, multidisciplinary clinic; TiM, telehealth in motor neuron disease.