gms | German Medical Science

Introduction: Patients with chronic conditions can be supported by mobile applications in their everyday life [1]. The adherence to a consistent daily structure and behavioural techniques are listed as recommended self-management measures [2]. To support adherence, we developed a modular platform approach for mobile applications adjustable for different chronical conditions and diseases. With each chronic condition having its own peculiarities there are still commonalities such as health diaries or monitoring symptoms and behaviour that can be supported by the platform.

Methods: During conducting two independent research projects covering self-management for COPD- and narcolepsy-patients similarities to support them in their everyday life were identified [3], [4]. The participative design process included medical experts and patients. Four different COPD self-help groups with a total of 50 participants were involved in the participatory design process. Based on their requirements and other concepts of generic platforms for self-management three main categories of user stories and functionalities were derived [5]. Modules already implemented in our apps were categorised and additionally declared as disease-overlapping or disease-specific.

Results: The three main categories are symptom monitoring, setting up guidelines and informative ressources. Examples for the disease-overlapping generalized functionality are the modules medication management, questionnaires and sleep documentation - initially intended for narcolepsy being reused for COPD [6].

The platform consists of a central, scalable API as backend, which is connected to an external drug database service. The mobile apps are developed for iOS and Android using cross-platform technology Xamarin and web-technology AngularJS for the physician’s interface. The backend was developed with Node.js and PostgreSQL.

The architecture for the mobile apps consists of three layers. The first layer builds the basis. It contains the disease-overlapping modules. The second layer contains disease-specific modules e.g. cataplexy-monitoring for narcolepsy. The underlying generic concept and data-models can be reused for different applications. The third layer combines both layers and is deployed as a disease-specific native mobile app on the device regarding the patients and physician's requirements e.g., for use in a trial. For the implementation the device specifications and operation-system dependencies are considered.

Discussion: Usability was enhanced based on feedback provided by narcolepsy-patients [7]. Methods included systems usability scale, a test phase over two weeks with five female narcolepsy patients and a follow up interview. Currently, one mobile app is regularly being used by ten narcolepsy patients. A further planned study will examine the long-term motivation by the integrated competitive achievement system. Due to the generic structure of the platform studies could use it simultaneously. We will share some preliminary results at the congress.

A further advantage of a generic platform is data integration. The central data-model for some modules will be based on the same FHIR resources to be uploaded to the coming electronic patient record by patients.

Conclusion Generic design and development of platforms are an interesting option to support patient self-management in different settings. Shared common core functionality can serve as a basis easier to maintain and be extended for different chronic conditions.

The authors declare that they have no competing interests.

The authors declare that an ethics committee vote is not required.