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 limitations in online and offline health management, particularly in various situations including COVID-19. Additionally, proposing a patient-centered design strategy that utilizes Patient-Generated Health Data (PGHD) to facilitate optimal communication with caregivers and healthcare service providers is an essential area of investigation.

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 consists of five stages. Initially, a review was conducted on the previous application, Daily Healthcare 1.0, in collaboration with individuals with disabilities, caregivers, and healthcare providers. User needs were extracted using personas, scenarios, and user interface (UI) sketches for user-centered service design. The redesigned and updated app incorporating these requirements was then developed. Clinical and app experts performed heuristic evaluations of the improved app, resulting in the development of Daily Healthcare 2.0, which integrates IoT devices. Finally, a comprehensive usability evaluation was conducted over a two-month period, involving user groups consisting of 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 professionals. 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:

This study demonstrates that from the design phase, integrating the unique needs of individuals with disabilities, caregivers, and healthcare providers into a digital healthcare service platform can contribute to improving eHealth Literacy. Furthermore, we reveal the potential for forming partnerships between health consumers and providers, thus minimizing the vulnerability of marginalized populations even in crisis situations like COVID-19. it is crucial to continue efforts to enhance individuals with disabilities’ digital literacy and to foster collaborative co-creation to promote the shared values of health and digital health equity.