JMIR Publications

ABSTRACT

Background:

Personal Health Record (PHR) is a healthcare technology that can be used to support workplace health promotion, and prevent social and economic losses related to workers’ health management. PHR services can not only ensure interoperability, security, privacy, and data quality, but also consider the user's perspective in their design.

Objective:

This study aimed to design and develop a PHR app using Fast Healthcare Interoperability Resources (FHIR) and national healthcare datasets to provide worker-centered, interconnected PHR services.

Methods:

This study considered the user's perspective using the Human-Centered Design (HCD) methodology to develop a PHR app suitable for occupational health. A prototype was developed by analyzing quantitative and qualitative data collected from workers and an expert group, following which a usability evaluation was performed. We structured the workers’ PHR items based on the analyzed data and then ensured structural and semantic interoperability using FHIR, Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT), and logical observation identifiers names and codes (LOINC). This study integrated workers’ health information that was scattered across different Korean institutions through a linkage method, and workers’ PHRs were managed through a cloud server using Azure API for FHIR.

Results:

In total, 562 workers participated in the quantitative study. The preferred data items for the PHR were medication, number of steps walked, diet, blood pressure, weight, and blood glucose. The preferred functions were accessing medical checkup results, content provision for health information, consultation record inquiry, and teleconsultation. The worker-centered PHR app collected data on topics such as life-logs, vital signs, and medical checkup results; offered healthcare services such as reservation and teleconsultation; and provided occupational safety and health information through material safety data sheet search and health questionnaires. The app reflected the improvements regarding user convenience and app usability that were proposed by 19 participants (7 experts and 12 end-users) who partook in the usability evaluation. The After Scenario Questionnaire (ASQ) was evaluated at 5.90 (± 0.34) out of 7, and the System Usability Scale (SUS) was evaluated at 88.7 (± 4.83) out of 100.

Conclusions:

The worker-centered PHR app integrates workers’ health information that is scattered across different institutions, providing a variety of healthcare services from linked institutions through workers’ shared PHR. This app is expected to allow workers to have autonomy over their health information and support medical personnel’s decision making regarding workers’ health in the workplace. Particularly, the PHR app we developed would provide solutions for the major challenges of PHR, and its design, which would consider the user's perspective, thereby satisfying the prerequisites for its utilization in occupational health.