JMIR Publications

ABSTRACT

Background:

The diffusion of information and communication technologies (ICTs) in Type 1 Diabetes (T1D) management has generated a debate on the ways in which ICTs can support patient-provider relationship. Several studies have focused on the use of text messaging, paying attention to its impact on the clinical conditions of patients and measuring their satisfaction with the technology.

Objective:

Considering the case of the TreC-DS, a digital platform with a built-in messaging system that supports communication between healthcare organisations and T1D patients, we focused on: the perceived usefulness of the messaging system by both patients and healthcare professionals; the content and communication styles of healthcare professional–patient interactions; and, finally, the effects of the TreC-DS on the workflows of the healthcare organisations.

Methods:

We used qualitative techniques to analyse the use of a messaging system by both diabetic patients and healthcare professionals. The study focused on the use of the messaging system in two hospital departments, integrating analyses of messages with interviews with patients and healthcare professionals. Each department focused on a particular patient profile: the first department (Diabetes Centre-Pregnancy), focused on pregnant woman with T1D; the second one ( Diabetes Centre-Adults), focused on patients with poorly controlled diabetes.

Results:

The main results of the study have been the following: • Healthcare professionals and patients perceived the messaging system as useful for sharing knowledge (for women in pregnancy in form of prescriptions, for adults with poor controlled diabetes in form of advices) between the two groups. • The content and communication styles of the two hospital departments differed radically: in the Diabetes Centre-Pregnancy, Interactions in Text messaging were markedly prescriptive, while in the Diabetes Centre-Adults they were conceived as open dialogues. • Conversations were initiated mainly by the hospital departments, and from both patients’ and professionals’ perspectives, the system reduced the number of face-to-face visits while increasing their quality.

Conclusions:

The study focused on some underinvestigated topics such as the perceptions of professionals of the usefulness of the messaging system, its consequences on organisational workflows and, finally, the communication styles of the exchanged messages. The results show how the perceived usefulness and the features of interactions changed based on the patient profile. Moreover, the system had a positive impact on workflows.