Adherence to care plans is a major issue in health care systems. According to the World Health Organization, adherence to long-term therapies for chronic illnesses in developed countries is 50%, and rates in developing countries are even lower [1]. In Canada, fewer than 51% of patients follow their prescribed treatment regimen for many chronic diseases, affecting a large portion of a population that requires strict adherence to minimize the risk of health deterioration or comorbidities [2]. Nonadherence not only leads to preventable worsening of disease [3] but also generates additional costs for the health care system and for employers due to absenteeism [4,5]. Although the responsibility for adherence has traditionally been attributed solely to patients, it is now acknowledged that some of the responsibility is shared by the professionals delivering care, with patient-professional interactions having a significant impact [6]. Therefore, adherence to medical treatment must be analyzed from a communication perspective taking into account how patients and health professionals interact and exchange health information.

Exponential growth in the number of various apps available to consumers has directly influenced the health information environment. As early as 2012, 19% of smartphone owners in the United States had previously used a health app, a usage rate that is only increasing as the population becomes more accustomed to the daily use of technology. The popularization of smartphones is changing the way users record, store, and exchange their health information and has a direct effect on patients, including improving self-management of their condition [7]. The connectivity and interactivity of health apps must be further developed to support treatment adherence in such a way that the effort required of the users to obtain or manage their health information is minimized.

Concerns have been reported about the fact that technologies are not yet designed to support data collaboration between patients and health professionals [8]. In connected health, which refers to a health care system connected with smart medical devices, communication gaps hinder progress toward higher quality health care and improvements remain to be seen [9], although projects on connected health are rapidly emerging worldwide, particularly in North America [10]. To identify needs and plan solutions, the perspective of patients has proven to be particularly relevant and valuable [11]. It is, therefore, critical to properly evaluate the user experience when developing and implementing apps to facilitate interactions between health care professionals and patients. Among the methodological approaches identified to assess users’ needs in emerging projects on connected health, design thinking has been recognized for innovative and often technological aspects that meet health care requirements [12].

Design thinking comes from the design industry and is a method designers use to “match people’s needs with what is technologically feasible and what a viable business strategy can convert into customer value and market opportunity” [13]. According to this approach, for an innovation to be successful, it should meet 3 challenges: answer the needs of users, be technically feasible, and be economically viable [14]. The design process is always confronted with the importance of the user experience: if a product does not please users, it will not be used. In this approach, a key to success is using the designer’s sensibilities; otherwise the first step—understanding the needs of future users—cannot be achieved. The designer must then rely on integrative thinking to find solutions that respond to both the needs identified and their context. During the implementation phase, potential solutions are tested using an iterative process until they are considered satisfactory. Thus, while the approach does come from the field of technological design, design thinking is characterized by a human-centered approach to problem solving [15]. It also allows for the involvement of participants with no design experience but whose expertise is necessary (such as professionals or patients) to achieve a product that corresponds to their needs through simple and engaging activities [16].

This creative process also aims to stimulate critical discussions through practical methods to bring about structural change in any type of organization [17]. In their recent review, Altman et al [18] identified 24 health care studies that used design thinking, a large majority of which were successful in achieving their objectives. Moreover, all 4 studies that compared interventions showed greater satisfaction, usability, and effectiveness using a design thinking approach than using a traditional approach [18].

Acknowledging the health issues associated with nonadherence to treatment, a health technology start-up first developed an app for patient medication adherence without any patient-health care professional connectivity or interaction features. As more end users started using the app to manage their medications, the team observed that patients who used the app at the request of a health care professional (physician or pharmacist) demonstrated a higher level of engagement and adherence to their care plan. The team concluded that a web-based app designed to enable health care professionals to easily create and transfer digital care plans to patients would be an effective approach from an operational perspective for professionals and from an engagement perspective for patients. As a result, they developed a digital platform offering a patient-health care professional interaction model that seamlessly links the development, sharing, and monitoring of care plans. The platform provides postdiagnostic support to patients taking medication or following a care plan. This innovative digital health solution combines unprecedented connectivity to clinical services with a web-mobile digital platform for execution. The platform is offered as a SaaS solution and consists of 3 fully integrated components that close the loop of the entire care plan journey: (1) The web platform allows professionals or individuals to create a care plan that can consist of medications, health data measurements, and other therapies. Custom care plan activities can also be created to meet the needs of the most complex care plans. (2) Individuals can quickly activate their account and access their care plan via the mobile app. Reminders and alarms are predefined in advance by the health care professional and ready for execution by the patient. (3) Once the care plan has been accepted, patients are given access to a suite of tools to execute and report on their care plan. Some key features include push notification reminders, persistent alarms, access to medication leaflets and images, notes, a dashboard, and a report with adherence results. The report can be securely shared with a health care professional via a code so the professional can view results using the web platform.

This research project aims to:

The project will follow a multimethod evaluative design focused on the needs expressed by users (patients and health professionals) and is divided into 2 phases. The first phase includes a design thinking approach and consists of cyclic phases to understand user needs, identify solutions, and integrate them into a prototype. The second phase will use a pre-post design with qualitative and quantitative data analysis to document optimal use of the platform. The project will develop and test the platform in collaboration with a teaching family medicine group in Quebec that includes a broad representation of primary care practitioners.

Figure 1 presents the events and their dependencies of the 2 project phases.

The protocol presented in this manuscript, as well as the informed consent forms and semistructured interview guides, was reviewed and approved by the Research Ethics Committee of the Integrated Health and Social Services Centre of Montérégie-Centre (an administrative region of Quebec; study ID 2022-677) on December 7, 2021.

Data sharing is not applicable to this article as no complete data sets were generated or analyzed at this stage of the study.

This engaging digital platform aims to provide a new tool for health care professionals involved in managing chronic diseases. The platform will enable patient-health care professional exchanges that will facilitate chronic disease management, including the timing of medication use. During follow-ups, professionals will be able to obtain patient data in a secure manner and modify treatments or treatment plans as needed. The results of this project will be relevant to clinicians and managers seeking contemporary solutions to support patient adherence to treatment. These results will enable optimal use of the platform and identify avenues for improvement in the use of interactive patient-health care professional apps. As part of this applied research project, new functionalities will be deployed by participating health care professionals via the web portal. These new functionalities will be accessible for use in actual consultation situations via the existing web browser, distinct and separate from the operational tools currently used by professionals, such as the EMR. Efforts will be made to facilitate integration of the new functionalities into the EMR, thereby reducing required computer use and simplifying the process, once evaluation of the platform is completed and following the recommendations made in the final report. Integration of the web portal into the EMR is a critical success factor for broader rollout.

The adaptation of the platform based on the identified needs of patients living with a chronic condition and their health professionals will be acceptable to both professionals and patients.

Although the impact of mobile technologies for chronic disease management may have appeared inconsistent at first [33], as the technology was adapted and improved, it became clear that mobile health can truly support better management of chronic diseases. Studies focused on diabetes first demonstrated positive physiological and behavioral outcomes with mobile health technologies [34-37]. In 2018, a systematic review by Lee et al [38] confirmed that mobile health can also support effective behavior intervention strategies for the management of other chronic diseases, such as cancer, fibromyalgia, spina bifida, or cardiovascular diseases. One of the factors identified as enhancing self-management in patients with chronic conditions in mobile health approaches was improved communication between patients and health care providers, which is one of the key features of the platform developed in this project.

It has been shown that adherence to treatment decreases rapidly and proportionally as the number of activities included in a care plan increases [39]. Unfortunately, this is a typical situation in chronic diseases, where adherence is less than 50% when the prescribed treatments include 4 or more events per day, significantly increasing the risk of patients’ health status gradually deteriorating [40]. The emergence of chronicity affects the physical and mental well-being of patients and family caregivers. By focusing on adherence, the digital platform aims to help patients and health care professionals stabilize health status and avoid the development of chronic conditions and comorbidities. Better adherence to care plans can also improve employee productivity and reduce absenteeism, an issue that has significant economic repercussions for employers [4].

This project will allow for experimentation with a digital platform promoting patient empowerment and the individualization of care and allow for an unprecedented level of patient-health care professional interactions as well as access to guidance and other information shared by health care professionals (medications, nonmedicated therapies, biometric data). Data collected by the patient, such as medication use, adherence rates, notes, and side effects, will be accessible to health professionals via the web portal. This research project aims to demonstrate that the higher level of patient empowerment expected or to be achieved through this interactive and integrated (web and mobile) digital platform will improve adherence to prescribed care plans.

Information quality gains are expected for health care professionals when users of the digital platform return to the clinic. Professionals will be able to access a web portal interface specifically designed to view patient care and biometric data in real time using a secure code generated by the patient via the digital platform. This new approach will allow physicians and nurses to view medications, other care plan elements, biometric measures, and patient adherence rates in less than a minute via a standardized web interface. Direct productivity gains are also expected for professionals relative to the traditional approach, which is based on verbal exchanges with patients.

The study will also test new ways of performing traditionally manual tasks that can now be done via the new platform, such as distributing notes and patient instructions. This new way of communicating treatment-related information will not only allow the patient to obtain instructions effortlessly via the digital platform, but also, as a bonus, eliminate the risk of instructions being misplaced. Therefore, this project plans to observe the impact of the platform on patient follow-up on information provided and potential lightening of the task load of health professionals, a factor that may promote their adoption of the platform. In addition, the project will allow us to observe, from an intrinsic perspective, impacts for professionals, a nonnegligible notion in a context that is sometimes difficult for human resources (particularly during the pandemic, when patient-health care professional interactions were constantly adapting).

As shown by Ahmed et al [41], there are now multiple technological options aimed at improving adherence to treatment, at least medication adherence. However, the lack of studies that included health care professionals during app development is concerning. In their review, only 57 of the 420 free apps identified were developed with the involvement of health care professionals. One of the strengths of our study is the inclusion of both patients and health professionals, from exploration of their needs at the beginning, to their active participation during elaboration of the prototype, to testing of the platform in their practices. Furthermore, the efforts that will be made to allow communication between the platform and the EMR will be a significant benefit over other existing apps. As a feasibility research study, this project does not involve a control group nor does it have an effective sample size. However, our aim is not to demonstrate a generalizable effect of the platform on the management of chronic diseases but intends to create a tailored and relevant tool to be implemented in an authentic clinical setting.

This research project will explore in-depth the use of an adapted interprofessional digital platform to maximize treatment adherence in an authentic clinical environment. By creating a model of patient-primary health care professional interactions, this platform will ease the process of developing, sharing, and monitoring care. The adoption of an interactive digital platform to facilitate effective exchanges between patients and health care professionals in primary care settings could improve adherence to treatment. The platform tested in this project takes a first step in this direction by ensuring that the technological product is developed according to the needs of patients as well as the health professionals who are likely to use it.