Background: The development of the Internet has created new opportunities for health care provision, including its use as a
tool to aid the self-management of chronic conditions. We studied stakeholder reactions to an Internet-based “virtual clinic,”
which would allow people with diabetes to communicate with their health care providers, find information about their condition,
and share information and support with other users.
Objective: The aim of the study was to present the results of a detailed consultation with a variety of stakeholder groups in
order to identify what they regard as the desirable, important, and feasible characteristics of an Internet-based intervention to aid
diabetes self-management.
Methods: Three focus groups were conducted with 12 people with type 1 diabetes who used insulin pumps. Participants were
recruited through a local diabetes clinic. One-on-one interviews were conducted with 5 health care professionals from the same
clinic (2 doctors, 2 nurses, 1 dietitian) and with 1 representative of an insulin pump company. We gathered patient consensus via
email on the important and useful features of Internet-based systems used for other chronic conditions (asthma, epilepsy, myalgic
encephalopathy, mental health problems). A workshop to gather expert consensus on the use of information technology to improve
the care of young people with diabetes was organized.
Results: Stakeholder groups identified the following important characteristics of an Internet-based virtual clinic: being grounded
on personal needs rather than only providing general information; having the facility to communicate with, and learn from, peers;
providing information on the latest developments and news in diabetes; being quick and easy to use. This paper discusses these
characteristics in light of a review of the relevant literature. The development of a virtual clinic for diabetes that embodies these
principles, and that is based on self-efficacy theory, is described.
Conclusions: Involvement of stakeholders is vital early in the development of a complex intervention. Stakeholders have clear
and relevant views on what a virtual clinic system should provide, and these views can be captured and synthesized with relative
ease. This work has led to the design of a system that is able to meet user needs and is currently being evaluated in a pilot study
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