Patient Trust and Usability Challenges in Remote Patient Monitoring Platforms for Chronic Disease

Abstract

Remote patient monitoring platforms are increasingly deployed to support self-management among patients with chronic conditions such as heart failure and diabetes, yet sustained engagement with these tools varies considerably across patient populations. This study investigates how patient trust and perceived usability jointly influence continued platform use among older adults managing chronic disease at home. We conducted a mixed-methods evaluation combining usage log analysis with semi-structured interviews across two remote monitoring programs, examining how interface design, alert frequency, and clinician responsiveness shaped participants' willingness to rely on the technology for daily health decisions. Findings show that trust was less dependent on technical accuracy of readings than on participants' confidence that clinical staff would act promptly on concerning data, suggesting that workflow integration matters as much as sensor performance. Usability concerns clustered around alert fatigue and ambiguous error messages, which participants associated with declining engagement over time. We propose design and workflow recommendations, including tiered alert thresholds and explicit feedback loops confirming clinician review, aimed at sustaining long-term adherence. These findings inform the design of remote monitoring programs intended to support chronic disease management beyond initial adoption periods.