Table 3 Summary of areas for improvement (design of machines and surrounding care provision)

Enhancing learning, safety and usability

• Better clamping mechanism (easier to do, easier to remember)

• Better support for learning, troubleshooting and remembering all steps

• Providing prompts to alert the patient when dialysis is about to finish

• Designing interfaces for use by patient or carer

• Easy intervention by untrained person in emergency

• Minimize risk of incorrect connections (through colour coding or connector types)

• Provide guidance on troubleshooting out-of-hours for home machines

• Streamlining the extra processes before and after dialysis

• Providing reminders for periodic activities (e.g. changing filters, making up batch of dialysate)

• Provide access to in-centre dialysis at short notice

Remote monitoring

• Real-time remote monitoring of current machine state advocated by technicians

• Remote intervention in case of emergency

• Nephrologist wanted to be able to send messages to patients

• Patients wanted to be able to send readings to clinic