Table 1.

Results of phases 1 and 2 of the Center for eHealth Research road map in the development of the PETRA (Personalized Treatment by Real-time Assessment) application.

Theme		Description
Problems clients and clinicians identified in the status quo of mental health treatment
	Reliability or efficiency of current monitoring instruments	Often paper-and-pencil based and deemed less reliable and efficient Often focus too much on symptoms and fail to take important contextual factors and strengths into account Usually only administered 1 to 2 times per month; missing relevant information about clients’ daily lives throughout the day Usually not person-specific enough to be directly relevant to clients
	Insights	Limited insight into overall progress and treatment outcomes Limited insight into the effects of treatment or lifestyle adaptations Limited insight into the frequency and severity of symptoms and when they occur Limited insight into triggers and relapse signals Recall of well-being in between sessions is biased by current mood or otherwise difficult to recall for clients (recall bias)
	Therapeutic alliance	Knowledge imbalance between client and clinician, weakening the therapeutic alliance Current monitoring instruments are often not discussed in treatment, weakening the therapeutic alliance Limited contact between client and clinician in between sessions Client does not believe in the current treatment approach as the effects are not clearly visible
Perceived advantages of personalized electronic diaries
	Reliability or efficiency	More reliable and efficient as assessments take place multiple times per day via smartphone and are less easily forgotten or ignored
	Insight	Offers insights into progress, treatment effects, and the flow of symptoms throughout daily life, thereby increasing client self-management Offers insights into contextual factors and personal strengths
	Therapeutic alliance	Client and clinicians share the same information and can, therefore, collaborate more easily Relevant diary feedback can more easily be integrated in treatment, strengthening the therapeutic alliance and clients’ trust in their clinician
Perceived challenges in constructing personalized electronic diaries
	Diary construction	What kind of clinical questions can be answered with electronic diaries? How to formulate or select relevant and valid diary items? How to determine the number of assessments per day, balancing client burden and the number needed to answer a clinical question? How to determine the necessary diary schedule (eg, time-contingent or event-contingent) for a clinical question? How to make sure the diary maximizes its advantages and minimizes disadvantages?
	Diary feedback	How to automatically analyze and visualize the diary data without the need for statistical knowledge of the clinician? How to interpret the diary feedback in a clinical context?