Core Components for a Clinically Integrated mHealth App for Asthma Symptom Monitoring
| Autor: | Maria Orlando Edelen, Eyal Zimlichman, Adam B. Landman, Kevin W. Kron, Zachary Predmore, David W. Bates, Robert S. Rudin, Christopher H. Fanta |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male 020205 medical informatics Psychological intervention MEDLINE Health Informatics 02 engineering and technology 03 medical and health sciences Young Adult 0302 clinical medicine Health Information Management mental disorders 0202 electrical engineering electronic engineering information engineering medicine Electronic Health Records Humans 030212 general & internal medicine mHealth Asthma Aged Notice business.industry Middle Aged medicine.disease Mobile Applications Telemedicine Computer Science Applications Workflow Systematic review Female Medical emergency Self Report business Qualitative research |
| Zdroj: | Applied clinical informatics. 8(4) |
| ISSN: | 1869-0327 |
| Popis: | Background mHealth apps may be useful tools for supporting chronic disease management. Objective Our aim was to apply user-centered design principles to efficiently identify core components for an mHealth-based asthma symptom–monitoring intervention using patient-reported outcomes (PROs). Methods We iteratively combined principles of qualitative research, user-centered design, and “gamification” to understand patients' and providers' needs, develop and refine intervention components, develop prototypes, and create a usable mobile app to integrate with clinical workflows. We identified anticipated benefits and burdens for stakeholders. Results We conducted 19 individual design sessions with nine adult patients and seven clinicians from an academic medical center (some were included multiple times). We identified four core intervention components: (1) Invitation—patients are invited by their physicians. (2) Symptom checks—patients receive weekly five-item questionnaires via the app with 48 hours to respond. Depending on symptoms, patients may be given the option to request a call from a nurse or receive one automatically. (3) Patient review—in the app, patients can view their self-reported data graphically. (4) In-person visit—physicians have access to patient-reported symptoms in the electronic health record (EHR) where they can review them before in-person visits. As there is currently no location in the EHR where physicians would consistently notice these data, recording a recent note was the best option. Benefits to patients may include helping decide when to call their provider and facilitating shared decision making. Benefits to providers may include saving time discussing symptoms. Provider organizations may need to pay nurses extra, but those costs may be offset by reduced visits and hospitalizations. Conclusion Recent systematic reviews show inconsistent outcomes and little insight into functionalities required for mHealth asthma interventions, highlighting the need for systematic intervention design. We identified specific features for adoption and engagement that meet the stated needs of users for asthma symptom monitoring. |
| Databáze: | OpenAIRE |
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