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Original research
Mobile health in cardiac patients: an overview on experiences and challenges of stakeholders involved in daily use and development
  1. Dirkjan Kauw1,2,
  2. Piter R Huisma1,
  3. Stephanie K Medlock3,
  4. Maarten A C Koole4,5,
  5. Eric Wierda6,
  6. Ameen Abu-Hanna3,
  7. Marlies P Schijven7,
  8. Barbara J M Mulder1,
  9. Berto J Bouma1,
  10. Michiel M Winter1,4,
  11. Mark J Schuuring1,8
  1. 1 Cardiology, Amsterdam UMC–Locatie AMC, Amsterdam, Netherlands
  2. 2 ICIN–Netherlands Heart Institute, Utrecht, Netherlands
  3. 3 Medical Informatics, Amsterdam UMC–Locatie AMC, Amsterdam, Netherlands
  4. 4 Cardiology Centers of the Netherlands, Amsterdam, Netherlands
  5. 5 Cardiology, Red Cross Hospital, Beverwijk, Noord-Holland, Netherlands
  6. 6 Cardiology, Dijklander Ziekenhuis, Hoorn, Netherlands
  7. 7 Surgery, Amsterdam UMC–Locatie AMC, Amsterdam, North Holland, Netherlands
  8. 8 Cardiology, HagaZiekenhuis, Den Haag, Zuid-Holland, Netherlands
  1. Correspondence to Dr Mark J Schuuring, Cardiology, Amsterdam UMC–Locatie AMC, 1105 AZ Amsterdam, Netherlands; m.j.schuuring{at}


Background Mobile health (mHealth) can improve quality of care and empower cardiac patients. However, large-scale adoption is still lacking, as several challenges continue to be encountered in daily practice. We aimed to explore the mHealth experiences and challenges in cardiac patients, healthcare professionals, healthcare managers and information and communications technology (ICT) developers.

Methods A qualitative research was employed where semistructured interviews were conducted in patients, healthcare professionals, managers and ICT developers. We aimed to enrol participants of every stakeholder group, with diversity in sex, age group and occupation. Thematic analysis was used to identify themes reflecting experiences and challenges in mHealth in cardiac patients.

Results In total, 24 interviews were conducted in six patients, eight healthcare professionals, five managers and five ICT developers. Monitoring/care at home was reported as important advantage of mHealth (n=20, 83%). Patients valued increase of self-care (n=6, 100%) and remote reassurance (n=6, 100%), but reported medicalisation as important concern (n=4, 67%). Healthcare professionals warned for increased data burden (n=4, 50%). Managers agreed on the importance of device reliability (n=5, 100%) and ICT developers emphasised that the goal of mHealth is to replace care, rather than being supplementary (n=4, 80%). The majority of all participants (n=22, 92%) considered future use of mHealth as promising.

Conclusions All stakeholders foresee benefit of mHealth in cardiac patients, especially for remote care and reassurance. Frequently mentioned challenges included the need to replace care with mHealth, rather than adding more workload, and employing reliable devices and applications. If collaboration can be improved and group-specific challenges overcome, success of mHealth in cardiac patients can improve significantly.

  • remote monitoring
  • mHealth
  • cardiology

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  • DK and PRH contributed equally.

  • Contributors DK, PRH, SKM, MACK, AAH, MPS, BJMM, BJB, MMW and MJS planned the study. PRH conducted the interviews. DK and PRH analysed the data. DK, PRH, SKM, EW, BJMM, BJB, MMW and MJS helped to report the study. DK submitted the study and is responsible for the overall content as guarantor.

  • Funding This work was supported by the Dutch Heart Foundation (grant number 2017 T2) and the Dutch Federation of University Medical Centers (NFU). The work described in this study was carried out in the context of the e‑Health Citrien programme. The e‑Health Citrien programme is part of and funded by the Dutch Federation of University Medical Centers (NFU).

  • Disclaimer The providers of the funding had no role in the study design, collection of the data, analysis or interpretation.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The local ethical committee issued a waiver that committee approval was not required for this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.