The Paradox of Disease Self-Management Technology

October 3, 2014 | Hamilton, Ontario
Contributed by Heston Tobias, Advancement Intern

173742881_smConstant improvement of personal technology like mobile phones, apps, wearables, and personal computers are giving chronically ill patients more options for managing their own health.

Online tools, called self-management interventions (SMIs) are encouraging patients to make dramatic lifestyle changes. However, using SMIs is a relatively new approach to patient self-management. More research is needed to understand the long term effects they will have on the people using them.

Norm Archer (Professor Emeritus of Information Systems), Karim Keshavjee (Health Informatics Consultant at Infoclin), Catherine Demers (Associate Professor of Cardiology at McMaster University), and Ryan Lee (from the Department of Medicine at McMaster University) have teamed up to research SMIs. They look at the current state of disease self-management and try to understand its benefits, the barriers it faces, and possible integrated solutions that could make SMIs more effective.



With the proliferation of mobile devices, it’s easier for patients with chronic diseases to access online tools for managing their conditions.


SMIs give patients access to disease management tools at home. This saves time normally spent driving to the hospital, or waiting for a caregiver to visit.


SMI online applications and websites are built to be consistent, more than many other disease management tools. Patients also have immediate access to SMIs. That makes it easier to consistently monitor their diet, physical health, and other daily lifestyle habits.

Proliferation of the Cell Phone

The widespread use of mobile phones is a major factor behind SMI effectiveness. Disease self-management can be very demanding on both patients and caregivers. Mobile solutions give both groups more options when it comes to managing the disease.

A Significant Barrier

SMIs are usually effective, but there is one factor that can debilitate a patient’s ability to self-manage: cognitive impairment.

Based on a literature review, the researchers found that chronically ill patients are likely to develop some form of cognitive impairment as a result of their illness. This is important because patients with cognitive impairment tend to have difficulty operating the complex designs of self-management applications.

Integrated Solutions

The researchers suggest considering the following when looking for solutions to the problems cognitively impaired patients might face when using SMIs.

iHealth_Homepage_BPsmDyadic Caregiver Support

Dyadic support involves the patient collaborating with a spouse, child, or close friend.

This kind of approach is likely to motivate and sustain the patient’s participation in their own disease management.

However, the researchers caution that it could also put psychological strain on the relationship between the caregiver and patient. There may also be privacy issues concerning the caregiver’s access to the patient’s medical records.

Online Interfaced System Design

How well the online tool is designed is important. If the user interface is well-designed, patients will be more comfortable using it, and will be more likely to use it consistently.

Adoption and Sustainability

Even with a well-designed tool, the patient’s adoption of the SMI, and their motivation to continue using it, are significant factors that need to be addressed.

Support from family, friends, and online communities can be encouraging and insightful, motivating patients to use the tool.

Smart Home Technologies

“Smart homes” are equipped with technology that monitors the health, safety, and living conditions of a person who lives there.

Like mobile devices, the proliferation of smart home technologies gives chronically ill patients opportunities to manage their disease at home. Less time needs to be spent visiting hospitals or booking appointments with professional caregivers.

More Than Tech

This research reminds health practitioners that it takes more than technological advancements to overcome the challenges of disease self-management. New self-management tools are useful, but do not resolve all the important issues.

There also needs to be cooperation to deal with the multiple technological and personal difficulties patients and caregivers encounter during the self-management process.

Read the original article:
Online self-management interventions for chronically ill patients: Cognitive impairment and technology issues

norm archerNorm Archer‘s research interests centre on electronic health applications and systems; electronic business; identity theft; supply chain management; project management; change management in eGovernment; and mobile commerce. He has a major responsibility in the collaborative MSc eHealth program that is a joint undertaking by the DeGroote School of Business, Faculty of Health Sciences, and the Computing and Software Department at McMaster University.


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