JMIR Publications

ABSTRACT

Background:

Breast cancer is the most common cancer among Canadian women, bringing complex demands for timely decision-making, coordination of multidisciplinary care, and efficient communication between patients and providers. The increasing reliance on fragmented and non-interoperable health information systems exacerbates workflow and documentation burdens, leading to inefficiencies and gaps in continuity of care. While nurse navigation programs partially bridge these gaps, most digital platforms remain poorly integrated into provider workflows, requiring manual tracking, which results in duplicated effort and reduced efficiency. Our team developed ‘MyJourney’ at North York General Hospital in Ontario. It is a digital navigation platform that supports breast cancer care throughout the entire continuum, from diagnosis to survivorship.

Objective:

This study aimed to (1) map the breast cancer journey and workflow to inform the design and adaptation of MyJourney at two oncology settings at NYGH; (2) identify barriers and guide local implementation; and (3) evaluate the implementation, usability, and perceived utility of MyJourney's Clinical Navigation Tool for breast cancer care teams.

Methods:

A multi-method, three-phase study was conducted at NYGH’s Breast Diagnostic Centre (BDC) and Chemotherapy Clinic in Toronto, Canada. Phase 1 involved qualitative interviews with breast cancer patients to map their care journey and inform user-centered platform design. Phase 2 included pre-implementation interviews with nurses, pharmacists, and administrative staff to map workflows and customize MyJourney for the chemotherapy clinic. Phase 3 evaluated MyJourney’s implementation and usability over six weeks using the System Usability Scale, Technology Acceptance Model surveys, and follow-up interviews with platform users. Data were analyzed via interpretive description and descriptive statistics. Ethics approval was obtained.

Results:

13 patient interviews revealed distinct challenges and communication needs across pre-diagnosis, diagnosis, treatment, and survivorship phases, emphasizing the need for personalized, integrated resources. Eight providers and clinic staff highlighted pain points in fragmented information systems, inefficient manual processes, and limited team coordination. MyJourney’s phased implementation led to high user acceptance, with mean System Usability Scale scores rated “excellent” (BDC: 81.3; Chemotherapy Clinic: 86.3 at six-week follow-up). Users described the platform as intuitive, efficient, and well-organized, citing consolidated patient records, streamlined appointment management, and improved workflow as major benefits. Recommendations included improved interoperability, enhanced notifications, role-specific customization, and integration with electronic medical records for broader scalability.

Conclusions:

The iterative, stakeholder-engaged design and phased implementation of MyJourney facilitated rapid uptake and high usability among breast cancer provider teams. The Clinical Navigation Tool component of the MyJourney platform reduced documentation burden, improved workflow efficiency, and facilitated care coordination across oncology settings.