The design of patient-centred e-health services embodies an inherent tension between the concerns of clinicians and those of patients. Clinicians’ concerns are related to professional issues to do with diagnosing and curing disease in accordance with accepted medical standards. In contrast, patients’ concerns typically relate to personal experience and quality of life issues. It is about their identity, their hopes, their fears and their need to maintain a meaningful life. This divergence of concerns presents a fundamental challenge for designers of patient-centred e-health services. We explore this challenge in the context of chronic illness and telecare. Based on insights from medical phenomenology as well as our own experience with designing an e-health service for patients with chronic heart disease, we emphasise the importance – and difficulty – of aligning the concerns of patients and clinicians. To deal with this, we propose a set of concepts for analysing concerns related to the design of e-health services: A concern is (1) meaningful if it is relevant and makes sense to both patients and clinicians, (2) actionable if clinicians or patients – at least in principle – are able to take appropriate action to deal with it, and (3) feasible if it is easy and convenient to do so within the organisational and social context. We conclude with a call for a more participatory and iterative approach to the design of patient-centred e-health services.

中文翻译：

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调整远程医疗的关注点：指导以患者为中心的电子医疗保健设计的三个概念

以患者为中心的电子医疗服务的设计体现了临床医生和患者关注之间的内在矛盾。临床医生的担忧与根据公认的医学标准诊断和治愈疾病有关的专业问题有关。相反，患者的顾虑通常与个人经历和生活质量问题有关。这与他们的身份，他们的希望，他们的恐惧以及他们维持有意义的生活的需要有关。对于以患者为中心的电子卫生服务的设计者，这种关注的分歧提出了根本性的挑战。我们在慢性病和远程护理的背景下探索这一挑战。根据医学现象学的见识以及我们在为慢性心脏病患者设计电子医疗服务方面的经验，我们强调协调患者和临床医生关注的重要性和困难。为了解决这个问题，我们提出了一套用于分析与电子医疗服务设计有关的关注点的概念：关注点是（1）有意义的，如果它是相关的，有意义的病人和医生，（2）采取行动，如果临床医生或病人-至少在原则上-都能够采取适当的行动来对付它，和（3）是可行的，如果它是简单方便在组织和社会背景下做到这一点。最后，我们呼吁以更具参与性和迭代的方式设计以患者为中心的电子医疗服务。