Accepted for/Published in: JMIR Human Factors
Date Submitted: Sep 20, 2022
Open Peer Review Period: Sep 19, 2022 - Nov 14, 2022
Date Accepted: May 25, 2023
(closed for review but you can still tweet)
User-Centered Design of a Digitally Enabled Care Pathway in a Large Health System: A Qualitative Study
ABSTRACT
Background:
Major depressive disorder (MDD) is a leading cause of disability worldwide and is associated with a significant economic burden. Management of chronic conditions like MDD can be improved by enhanced patient engagement, measurement-based care (MBC), and shared decision-making (SDM). Digital technology platforms, such as mobile apps, have the potential to expand health interventions. However, adoption of these platforms by both people living with MDD and their care teams has been limited by their perceived utility, as most of them are patient-facing only and do not have a care team interface. A user-centered design approach can improve understanding of the patient journey and care team workflows and thus aid the development of healthcare innovations that are optimized for the needs of both people living with MDD and their primary care teams.
Objective:
This study describes the user-focused development process for a digitally enabled MDD care platform, Pathway Platform, designed to enhance patient engagement, MBC, and SDM.
Methods:
Insights were gathered through 2 stages of qualitative interviews by a study team with expertise in qualitative research and user-centered design methods. In stage 1, interviews were conducted with 20 people living with MDD and 15 healthcare providers (HCPs) from September 2018–January 2019 to understand experiences and perceptions of the initial functionality of the Pathway App while also exploring perceptions of potential additional features and functionality. Follow-up feedback was collected in stage 2 interviews with 36 HCPs at 8 primary care sites to understand care team workflows and treatment approaches. Thematic analysis of interviews was supported by Dedoose, a qualitative data analysis software tool that enables systematized coding. Findings and insights were presented based on code frequency, salience, and relevance to the research project.
Results:
The insights from stage 1 included the need for rapid communication of updated patient data with the care team along with integration of app data with electronic health records. Also, based on user feedback, educational programs for people living with MDD and their care teams were developed to provide information about app features and utility, MBC, SDM, and collaborative goal-setting. Key insights from stage 2 interviews led to further development of the patient- and care team–facing visit preparation features. Additional user feedback in stage 2 informed improvements to collaborative goal-setting and tracking features, patient-reported outcome summaries, and trend visualizations.
Conclusions:
Ongoing communication with people living with MDD and their care teams provided an opportunity for user-centric developmental iterations of the Pathway Platform. The result is an enhanced digital platform with the potential to improve treatment outcomes by supporting an expanded understanding of MDD treatment, enhancing treatment adherence, assisting care team workflows, and providing people living with MDD additional support throughout their treatment journey. Clinical Trial: N/A
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.