JMIR Publications

ABSTRACT

Background:

Emergency departments (EDs) are high-pressure environments where diagnoses must be made under significant constraints, including limited access to patients' medical histories, severe time pressures, and frequent interruptions. While patient involvement is crucial for accurate diagnosis and care delivery in these challenging settings, current ED care practices often fall short of supporting meaningful patient participation. Most interventions in emergency care settings are predominantly clinician-focused or system-focused, prioritizing workflow efficiency and provider communication while inadvertently overlooking patients' needs. Furthermore, although patient-facing technologies are increasingly deployed in EDs, they rarely incorporate patient input during the design process. This results in solutions that may not effectively address patients' specific needs and concerns in emergency care settings. To enhance both patient-centered care practices and diagnosis process in EDs, patient involvement in technology design is essential to ensure their needs during emergency care are understood and addressed.

Objective:

This study aims to invite ED patients to participatory design sessions, identify their needs during ED visits, and present potential design guidelines for technological interventions to address these needs.

Methods:

We conducted a participatory design study with ED patients to validate their needs and identify considerations for designing patient-centered interventions to improve diagnostic safety. We used ten technological intervention ideas as probes for needs evaluation of the study participants. We had participants discuss the use cases of each intervention idea to assess their needs during the ED care process and facilitated co-design activities with the participants to improve the technological intervention designs. We audio- and video-recorded the design sessions. We then analyzed session transcripts, field notes, and design sketches. In total, 36 ED patients or caregivers participated in eight design sessions.

Results:

Based on ED patients’ feedback and evaluation of our intervention designs, we found the three most preferred intervention ideas that address the common challenges ED patients experience. We also identified four themes of ED patients' needs: feeling of inclusion in the ED care process, access to sources for patient comprehension of medical information, need to address patient anxiety related to information overload and privacy concerns, and ensuring continuity in care and information. We interpreted them as insights for designing technological interventions for ED patients. Hence, based on the findings, we present five considerations for designing better patient-centered interventions in the ED care process: 1) technology-based interventions should address patients’ dynamic needs to promote continuity in care, 2) interventions should consider the amount and timing of information that patients receive, 3) interventions should empower patients to be more active for better patient safety and care quality, 4) interventions should optimize human resources, depending on patient’s needs, and 5) interventions should be designed with the consideration of patients’ perspectives on implementation.

Conclusions:

This study provides unique insights for designing technological interventions to support ED diagnostic processes. By inviting ED patients into the design process, we present unique insights into the diagnostic process and design considerations for designing novel technological interventions to enhance patient safety.