Requirements engineering–based mixed-methods needs assessment for a telemedicine breast cancer follow-up system

INTRODUCTION: Breast cancer is one of the leading causes of mortality among women worldwide. Telemedicine presents a promising pathway to improve cancer care delivery; however, structured approaches to systematically eliciting and integrating stakeholder requirements remain scarce. This study aimed to conduct a comprehensive needs assessment using requirements engineering principles to inform the design of a telemedicine-based follow-up system for breast cancer patients. METHODS: An exploratory sequential mixed-methods design was employed, encompassing five stages: requirements elicitation, data collection, data analysis, requirements validation, and use-case development. Data were collected from 41 stakeholders-including healthcare professionals, administrative staff, patients, and caregivers-using semi-structured interviews and focus group discussions. Quantitative data were analyzed descriptively, while qualitative data underwent thematic analysis. RESULTS: The analysis identified three key domains of requirements-organizational, system, and stakeholder. Organizational requirements underscored the importance of leadership support, sustainable funding, and comprehensive training. System requirements emphasized security, scalability, interoperability, and user-centered design. Stakeholder needs highlighted privacy protection, accessibility, and effective communication channels. CONCLUSION: Applying a structured, stakeholder-driven requirements engineering approach enabled the identification of organizational, technical, and user needs essential for designing a telemedicine follow-up system for breast cancer. The developed framework provides a replicable model for implementing secure, scalable, and user-centered telemedicine solutions not only in oncology but also across other healthcare domains.