Feasibility and Implementation of an eHealth Dashboard for the Remote Monitoring of Dutch Patients With Chronic Myeloid Leukemia: Multimethods Approach

Abstract Background Chronic myeloid leukemia (CML) has evolved into a chronic condition as a consequence of effective tyrosine kinase inhibitor (TKI) therapy, leading to an expanding demographic of patients necessitating lifelong monitoring. The use of eHealth solutions has the potential to facilitate sustainable and patient-centered care by enabling remote monitoring and enhancing guideline adherence. The Dutch CMyLife digital care platform incorporates a CML Dashboard intended for health care professionals (HCPs). This dashboard is designed to provide insight into real-world CML care and enable remote monitoring. Objective This study aimed to evaluate the feasibility of the CML Dashboard for remote monitoring of CML care, to assess the usefulness of dashboard-derived data, and to identify barriers and facilitators for its implementation in routine clinical practice. Methods We conducted a multimethods early-stage evaluation, determining the feasibility of the CML Dashboard and its barriers and facilitators. Quantitative data were generated through the CMyLife app and displayed in the CML Dashboard. These data were collected over a 2.5-year period and analyzed descriptively. Concurrently, semistructured interviews were conducted with HCPs treating patients with CML to explore barriers and facilitators for implementation. The analysis of interview transcripts was conducted using framework analysis, using established implementation models. Results Of the 199 patients who were registered, 177 provided data to the dashboard. The dashboard provided insight into patient characteristics, TKI treatment, BCR::ABL1 values, and monitoring intervals. However, the completeness and reliability of the data were limited, as the majority of the data were manually entered by the patients. The absence of complete data and the presence of inconsistencies in monitoring time points reduced the immediate usability of the dashboard for clinical decision-making and quality monitoring. A total of 8 HCPs participated in the interviews. The facilitators included an enhanced overview of patient data, support for consultation preparation, and the potential for remote monitoring and quality improvement. Key barriers identified were the lack of integration with electronic medical records, the necessity for additional log-in procedures, the limited adoption of the app by patients, and the perception of its added value as being inferior to existing systems. Conclusions The prospect of implementing a remote monitoring system for CML care holds promise. Such a system, using a digital dashboard, has the potential to enhance oversight and contribute to the enhancement of quality assurance. Nonetheless, the implementation of automated data exchange with electronic medical records, enhanced data completeness, and the augmentation of integration into clinical workflows are imperative prior to the large-scale implementation and the transition toward home-based CML care.