JMIR Publications

ABSTRACT

Background:

Electronic patient-reported outcome measures (ePROMs) are standardized online instruments integrated into clinical care to collect subjective data regarding patients’ health-related quality of life, functional status, and symptoms. In documenting patient-reported progress, ePROMs can guide treatment decisions and encourage measurement-based care practices. Voxe is a pediatric and user-centred ePROM platform for patients with chronic health conditions.

Objective:

The objective of this paper is to describe the user-centred creation of Voxe and the mixed method usability testing with end-users before implementation in a pediatric healthcare setting.

Methods:

Purposive sampling was used to recruit patients aged 8 to 17 from two chronic illness populations in two pediatric hospitals in Canada. Members of the patients’ healthcare teams were also purposively recruited. One-on-one iterative testing sessions were conducted virtually by research team members with participants to obtain feedback on the appearance and functionalities of the Voxe platform prototype. Patients and healthcare providers (HCPs) completed task-based activities pertaining to the Voxe platform. International Organization for Standardization key performance indicators were tracked during HCP task-based activities. HCPs also completed the System Usability Scale. To test platform usability, the think-aloud technique was used by participants during the completion of structured tasks. After completing all task-based activities, patient participants selected five words from the Microsoft Desirability Toolkit to describe their overall impression and experience with the Voxe platform. Qualitative data about likes, dislikes, and ease of use were collected through semi-structured interviews. Feedback testing sessions were conducted with patients and HCPs until Voxe was acceptable to participating end-users, with no further refinements identified. Quantitative and qualitative data analysis were completed using descriptive statistics and content analysis.

Results:

A total of 49 patients and 38 HCPs were recruited. Patients were positive about Voxe’s child-centred design characteristics and notification settings. HCPs rated Voxe as user-friendly and efficient, with the time to complete tasks decreasing over time. HCPs were satisfied with the Voxe platform functionalities and identified the value of Voxe’s system notifications, summarized display of PROM results, and its capacity to integrate with Electronic Medical Records (EMRs). Patients’ and HCPs’ high satisfaction rates with the Voxe prototype highlight the importance of being responsive to user suggestions from the inception of eHealth platform developments to ensure their efficient and effective design.

Conclusions:

This paper describes the user-centred design and usability testing of Voxe as an ePROM platform for implementation into clinical care for pediatric patients with chronic health conditions. As a patient-facing platform that can be integrated into EMRs, Voxe aligns with measurement-based care practices to foster quality patient-centered approaches to care. End-users’ positive feedback and evaluation of the platform’s user-friendliness and efficiency suggest that Voxe represents a valuable and promising solution to systematically integrate PRO data in complex and dynamic clinical healthcare settings.