Towards end-user development for chronic disease management

Although developments in modern medicine continue to reduce premature death from acute illnesses, chronic diseases are now pervading the resultant aging population at a growing rate. Such diseases cannot be cured with drug-based treatment, but can be controlled with patients' regular monitoring of their symptoms and consequent lifestyle changes. However, this level of sustained engagement outside face-to-face appointments places a considerable burden upon patients. Smartphones are suitable platforms to support both patients in engaging with self-management plans, and clinicians in directly monitoring the influence of these plans. Bespoke applications exist for such purposes, yet the diversity in patients' lifestyles and levels of engagement necessitates many new or personalised applications. One approach, to solve these problems at scale, is with end-user development. This paper reports the findings from interviews with clinicians, and ethnographic observation in chronic disease management clinics, to derive requirements of end-user development technology to support clinicians and patients in tailored management of their diseases. Time and quality are key factors towards stakeholders' acceptance of chronic disease management with end-user development.