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A Web-Based Application for Complex Health Care Populations: User-Centered Design Approach

BACKGROUND: Although eHealth technology makes it possible to improve the management of complex health care systems and follow up on chronic patients, it is not without challenges, thus requiring the development of efficient programs and graphic user interface (GUI) features. Similar information tech...

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Autores principales: Ferrucci, Francesca, Jorio, Manuele, Marci, Stefano, Bezenchek, Antonia, Diella, Giulia, Nulli, Cinzia, Miranda, Ferdinando, Castelli-Gattinara, Guido
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840279/
https://www.ncbi.nlm.nih.gov/pubmed/33439146
http://dx.doi.org/10.2196/18587
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author Ferrucci, Francesca
Jorio, Manuele
Marci, Stefano
Bezenchek, Antonia
Diella, Giulia
Nulli, Cinzia
Miranda, Ferdinando
Castelli-Gattinara, Guido
author_facet Ferrucci, Francesca
Jorio, Manuele
Marci, Stefano
Bezenchek, Antonia
Diella, Giulia
Nulli, Cinzia
Miranda, Ferdinando
Castelli-Gattinara, Guido
author_sort Ferrucci, Francesca
collection PubMed
description BACKGROUND: Although eHealth technology makes it possible to improve the management of complex health care systems and follow up on chronic patients, it is not without challenges, thus requiring the development of efficient programs and graphic user interface (GUI) features. Similar information technology tools are crucial, as health care populations are going to have to endure social distancing measures in the forthcoming months and years. OBJECTIVE: This study aims to provide adequate and personalized support to complex health care populations by developing a specific web-based mobile app. The app is designed around the patient and adapted to specific groups, for example, people with complex or rare diseases, autism, or disabilities (especially among children) as well as Alzheimer or senile dementia. The app’s core features include the collection, labeling, analysis, and sorting of clinical data. Furthermore, it authorizes a network of people around the patient to securely access the data contained in his or her electronic health record. METHODS: The application was designed according to the paradigms of patient-centered care and user-centered design (UCD). It considers the patient as the main empowered and motivating factor in the management of his or her well-being. Implementation was informed through a family needs and technology perception assessment. We used 3 interdisciplinary focus groups and 2 assessment surveys to study the contexts of app use, subpopulation management, and preferred functions. Finally, we developed an observational study involving 116 enrolled patients and 253 system users, followed by 2 feedback surveys to evaluate the performance and impact of the app. RESULTS: In the validated general GUI, we developed 10 user profiles with different privacy settings. We tested 81 functions and studied a modular structure based on disease or medical area. This allowed us to identify replicable methods to be applied to module design. The observational study not only showed good family and community engagement but also revealed some limitations that need to be addressed. In total, 42 of 51 (82%) patients described themselves as satisfied or very satisfied. Health care providers reported facilitated communication with colleagues and the need to support data quality. CONCLUSIONS: The experimented solution addressed some of the health system challenges mentioned by the World Health Organization: usability appears to be significantly improved when the GUI is designed according to patients’ UCD mental models and when new media and medical literacy are promoted. This makes it possible to maximize the impact of eHealth products, thereby overcoming some crucial gaps reported in the literature. Two main features seemed to have potential benefit compared with other eHealth products: the modeling, within the app, of both the formal and informal health care support networks and the modular structure allowing for comorbidity management, both of which require further implementation.
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spelling pubmed-78402792021-01-29 A Web-Based Application for Complex Health Care Populations: User-Centered Design Approach Ferrucci, Francesca Jorio, Manuele Marci, Stefano Bezenchek, Antonia Diella, Giulia Nulli, Cinzia Miranda, Ferdinando Castelli-Gattinara, Guido JMIR Hum Factors Original Paper BACKGROUND: Although eHealth technology makes it possible to improve the management of complex health care systems and follow up on chronic patients, it is not without challenges, thus requiring the development of efficient programs and graphic user interface (GUI) features. Similar information technology tools are crucial, as health care populations are going to have to endure social distancing measures in the forthcoming months and years. OBJECTIVE: This study aims to provide adequate and personalized support to complex health care populations by developing a specific web-based mobile app. The app is designed around the patient and adapted to specific groups, for example, people with complex or rare diseases, autism, or disabilities (especially among children) as well as Alzheimer or senile dementia. The app’s core features include the collection, labeling, analysis, and sorting of clinical data. Furthermore, it authorizes a network of people around the patient to securely access the data contained in his or her electronic health record. METHODS: The application was designed according to the paradigms of patient-centered care and user-centered design (UCD). It considers the patient as the main empowered and motivating factor in the management of his or her well-being. Implementation was informed through a family needs and technology perception assessment. We used 3 interdisciplinary focus groups and 2 assessment surveys to study the contexts of app use, subpopulation management, and preferred functions. Finally, we developed an observational study involving 116 enrolled patients and 253 system users, followed by 2 feedback surveys to evaluate the performance and impact of the app. RESULTS: In the validated general GUI, we developed 10 user profiles with different privacy settings. We tested 81 functions and studied a modular structure based on disease or medical area. This allowed us to identify replicable methods to be applied to module design. The observational study not only showed good family and community engagement but also revealed some limitations that need to be addressed. In total, 42 of 51 (82%) patients described themselves as satisfied or very satisfied. Health care providers reported facilitated communication with colleagues and the need to support data quality. CONCLUSIONS: The experimented solution addressed some of the health system challenges mentioned by the World Health Organization: usability appears to be significantly improved when the GUI is designed according to patients’ UCD mental models and when new media and medical literacy are promoted. This makes it possible to maximize the impact of eHealth products, thereby overcoming some crucial gaps reported in the literature. Two main features seemed to have potential benefit compared with other eHealth products: the modeling, within the app, of both the formal and informal health care support networks and the modular structure allowing for comorbidity management, both of which require further implementation. JMIR Publications 2021-01-13 /pmc/articles/PMC7840279/ /pubmed/33439146 http://dx.doi.org/10.2196/18587 Text en ©Francesca Ferrucci, Manuele Jorio, Stefano Marci, Antonia Bezenchek, Giulia Diella, Cinzia Nulli, Ferdinando Miranda, Guido Castelli-Gattinara. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 13.01.2021. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Human Factors, is properly cited. The complete bibliographic information, a link to the original publication on http://humanfactors.jmir.org, as well as this copyright and license information must be included.
spellingShingle Original Paper
Ferrucci, Francesca
Jorio, Manuele
Marci, Stefano
Bezenchek, Antonia
Diella, Giulia
Nulli, Cinzia
Miranda, Ferdinando
Castelli-Gattinara, Guido
A Web-Based Application for Complex Health Care Populations: User-Centered Design Approach
title A Web-Based Application for Complex Health Care Populations: User-Centered Design Approach
title_full A Web-Based Application for Complex Health Care Populations: User-Centered Design Approach
title_fullStr A Web-Based Application for Complex Health Care Populations: User-Centered Design Approach
title_full_unstemmed A Web-Based Application for Complex Health Care Populations: User-Centered Design Approach
title_short A Web-Based Application for Complex Health Care Populations: User-Centered Design Approach
title_sort web-based application for complex health care populations: user-centered design approach
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840279/
https://www.ncbi.nlm.nih.gov/pubmed/33439146
http://dx.doi.org/10.2196/18587
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