JMIR Publications

ABSTRACT

Background:

As digital health services advance, it has become a significant concern to enhance digital health equity by enabling all users to access these services. However, individuals with disabilities and the elderly still face online and offline health management limitations, particularly in various situations, including COVID-19. Additionally, an essential area of investigation is proposing a patient-centered design strategy that utilizes Patient-Generated Health Data (PGHD) to facilitate optimal communication with caregivers and healthcare service providers.

Objective:

This study aims to conceptualize, develop, and validate a digitally integrated healthcare service platform for individuals with disabilities, caregivers, and healthcare providers, utilizing IoT devices and PGHD to contribute to the improvement of digital health equity.

Methods:

The methodology unfolds in five distinct stages. Firstly, a collaborative review of the previous application, Daily Healthcare 1.0, was undertaken with individuals with disabilities, caregivers, and healthcare providers. In the second stage, user needs were identified via personas, scenarios, and user interface (UI) sketches to shape a user-centered service design. The third stage involved the creation of an enhanced app that integrated these specifications. In the fourth stage, heuristic evaluations by clinical and app experts paved the way for Daily Healthcare 2.0, now featuring IoT device integration. Conclusively, in the fifth stage, an extensive two-month usability evaluation was executed with user groups, comprising individuals with disabilities using the app and their caregivers.

Results:

Among the participants, "Disability welfare information and related institutional linkage" was the highest priority. Three of the 14 UI sketches the participants created were related to "providing educational content." The 11 heuristic evaluation experts identified "focusing on a single task" as a crucial issue and advocated redesigning the home menu to simplify it and integrate detailed menus. Subsequently, the app Daily Healthcare 2.0 was developed, incorporating wearable devices for collecting PGHD and connecting individuals with disabilities, caregivers, and healthcare providers. After the two-month usability evaluation with 27 participants, all showed an increase in eHealth Literacy, particularly those who used the caregiver app with relatively older users demonstrated improved scores in Health IT usability and smartphone self-efficacy. Overall satisfaction and willingness to recommend increased among all users, although the willingness to pay decreased.

Conclusions:

In this study, we underscore the significance of incorporating the distinct needs of individuals with disabilities, caregivers, and healthcare providers from the design phase of a digital healthcare service platform, highlighting its potential to advance digital health equity. Our findings also elucidate the potential benefits of fostering partnerships between health consumers and providers, thereby attenuating the vulnerability of marginalized groups, even amidst crises such as COVID-19. Emphasizing the imperative, we advocate for sustained endeavors to bolster the digital literacy of individuals with disabilities and champion collaborative co-creation, aiming to uphold the collective ethos of health and digital health equity.