Rethinking Lifestyle Telemonitoring Design Through the Lens of Patient Life Contexts

Telemonitoring systems for lifestyle change have become a cornerstone of remote healthcare, promising continuous physiological surveillance and personalized care. Yet despite their technological sophistication, these systems remain inconsistently adopted in real-world
practice. This paper argues that the issue lies not in a lack of innovation, but in a failure to account for the contextual, social, and emotional realities of the people they aim to serve. Drawing on work in cancer surgery prehabilitation and cardiac rehabilitation – habilitation
programs focused on proactive health behaviour – I argue that decisions about sensors, data types, and system interfaces are often driven by clinical assumptions and technological convenience, overlooking patients’ values, environments, and care relationships. I call for a redesign of telemonitoring practices that centres patient experience, supports caregiver involvement, and integrates context into both design and evaluation. I outline five shifts toward more context-aware telemonitoring and offer provocations to spur systemic change across policy, design, and research.