Designing an mHealth App for Stroke Rehabilitation in Indonesia: Mixed Methods Design Science Research Study

Background: Indonesia has the second-highest prevalence of stroke in Southeast Asia, with 4,918,487 people (1.7% of the population) living with this condition as of 2025. This is attributable to the living conditions in Indonesia, where limited health care workers and facilities are available to assist with stroke rehabilitation via mobile health (mHealth) interventions. Objective: This study designed an mHealth app to facilitate stroke rehabilitation in Indonesia. Methods: In this mixed methods study, interviews were conducted with 10 experts (doctors, therapists, and medical students) and 8 patients who have experienced a stroke to explore the need for stroke rehabilitation management apps. Using a design science research approach, we conducted 3 iterative design cycles, each comprising design, development, and evaluation, to construct an mHealth app for stroke rehabilitation. The first iteration produced a low-fidelity app prototype informed by intervention theory. The prototype, which comprised 13 features for patients and 12 for medical personnel, was evaluated through interviews with medical personnel. The second iteration produced a design for a high-fidelity app prototype based on feedback from the first iteration. The third iteration yielded an improved app based on feedback from the second iteration. Results: This study identified app features that support patient rehabilitation, including patient training programs with progress monitoring in functional, speech, and occupational therapy, along with consultations and home visits to connect rehabilitating patients with medical personnel. Other features of the app include onboarding, gamification, users' authentication, user profile management, schedule reminders, activity targets, therapeutic progress reports, and educational materials and videos. The prototypes received a System Usability Scale score of 71.83 ("good") and average scores of 2.32 (system usefulness), 2.39 (information quality), 2.42 (interface quality), and 2.35 (overall). Conclusions: This study provides guidance for health care facilities and regulators to improve the quality of rehabilitation services for patients with stroke in Indonesia.