Design for enhancing the trust of chronic patients in teleconsultation

Abstract

Under the influence of COVID-19, teleconsultation has been applied widely by hospitals and clinics. The value of teleconsultation for the management of chronic diseases is being explored as well. It is widely proved that building a trustworthy relationship between doctors and patients is the key point for long-term care. However, in the new context of teleconsultation, the interaction between patient and doctor has changed dramatically. The expansion of physical distance and the involvement of new technologies have affected the building of trust. Therefore, studying patient trust building in a digital context is crucial to implementing teleconsultation for the long-term management of chronic diseases in the future.

Through a contextual study of the challenges and opportunities in healthcare and technology, a future vision of teleconsultation was generated in the Understand stage (Chapter 2) as the background for implementing the trust design. A literature review was then conducted for an in-depth understanding of patient trust in teleconsultation, identifying the characteristics, consequences, and predictors of trust.

At the end of this chapter, a distinction was made between trust attitudes and trust behaviors. The pathways by which trust attitudes influence the three focused patient behaviors (ITU, Continuity, and Adherence) were demonstrated through a conceptual framework explaining the scenario in which trust attitudes and behaviors are consistent.

The reasons for the inconsistency of trust attitudes and behaviors were explored in the Explore stage (Chapter 3) through qualitative research. Four patient archetypes were first classified according to whether patients' attitudes and behaviors were consistent. The trust-related attitudinal and behavioral characteristics of each archetype and the respective needs were then elucidated through interviews to address the scenario of inconsistency.

In addition, combining the findings of the theoretical study in Chapter 2 and the user interview insights in Chapter 3, five categories of factors that promote patient trust were identified. Considering the design feasibility and value in teleconsultation, the focus scope for the design of this project was positioned.

In the Design stage (Chapter 4), the findings from the research resulted in six design strategies to help designers design for patient trust. The six strategies were further discussed and categorized along three dimensions: the covered influencing factors, the implementation stage corresponded with patient behavior phases, and the value priority for four patient archetypes.

In the Deliver stage of the project (Chapter 5), patients and designers were invited to evaluate both the research outcomes and the design strategies. Ultimately, all research outcomes and final design strategies on trust were presented on an online website to provide design guidance and inspiration for future trust designers.