A Social Networking Tool For Collaborative Care For Patients, Caregivers and Health Care Professionals
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Abstract
Background: Adolescents and young adults with cancer, as well as children with complex health needs are considered medically complex, requiring the care and skills of various healthcare professionals (HCP) who are often based in different places or settings. Effective communication between HCP across institutions is critical to achieving optimal health outcomes; however currently there is no organized system for this purpose, which places the burden of coordination of care on patients and their families.
Objective: To develop and test the usability of a secure, cross-setting, cross-institutional, and inter-professional online clinical collaboration system (Loop) for patients, caregivers and HCP to further refine the prototype.
Methods: A qualitative approach with semi-structured audio-taped individual and focus group interviews and observation by a trained observer was undertaken, with 3 iterative cycles (conducted until data saturation) to determine the usability of the user interface of the Loop tool. A purposive sample of English-speaking adolescents (n = 10; mean age = 17.5, standard deviation [SD] 3.0), young adults (n = 2; mean age = 22.8, SD 2.1), caregivers of young children (n = 7; mean age = 36.4, SD 3.6) and HCP (n = 22) were recruited from two Canadian tertiary care centers for individual interviews. In addition, a purposive sample of English-speaking HCP specializing in pediatric oncology (n = 7) and pediatric complex medical care (n = 5) were recruited for the 2 respective focus groups. Descriptive statistics and simple content analyses were used to organize data into categories that reflected emerging usability themes.
Results: All participants had access to a computer and Internet at home, however adolescents and young adults reported higher levels of comfort using computers and the Internet compared to caregivers and HCP. Identified usability themes centred on: (1) problematic navigation, (2) needed interface-related changes (format, layout and aesthetics), and (3) necessary additional functionalities. To address these issues the following design solutions were implemented: (1) the message stream was changed to present messages from all users (e.g., HCP, patients) in a single stream and enhance collaboration between parties, (2) new message notifications were made more obvious and user friendly, and (3) the capacity of the search function was enhanced. No new issues were identified following the third cycle of testing. Overall, participants liked the appearance of Loop, valued its purpose, and felt it was easy to navigate, use and understand. The vast majority of participants responded that they would use Loop if it was available, however there was concern regarding the implementation of the system into their daily workflow.
Conclusion: Usability testing was a crucial step in refining the clinical collaboration system to meet the various end-users needs. Development of the system has required thoughtful balancing of individual user needs and the need for a unifying tool with a clear purpose that may be applied widely across the healthcare system. Future work will focus on examining the impact of Loop on patient and health service utilization outcomes using a randomized controlled trial.
Objective: To develop and test the usability of a secure, cross-setting, cross-institutional, and inter-professional online clinical collaboration system (Loop) for patients, caregivers and HCP to further refine the prototype.
Methods: A qualitative approach with semi-structured audio-taped individual and focus group interviews and observation by a trained observer was undertaken, with 3 iterative cycles (conducted until data saturation) to determine the usability of the user interface of the Loop tool. A purposive sample of English-speaking adolescents (n = 10; mean age = 17.5, standard deviation [SD] 3.0), young adults (n = 2; mean age = 22.8, SD 2.1), caregivers of young children (n = 7; mean age = 36.4, SD 3.6) and HCP (n = 22) were recruited from two Canadian tertiary care centers for individual interviews. In addition, a purposive sample of English-speaking HCP specializing in pediatric oncology (n = 7) and pediatric complex medical care (n = 5) were recruited for the 2 respective focus groups. Descriptive statistics and simple content analyses were used to organize data into categories that reflected emerging usability themes.
Results: All participants had access to a computer and Internet at home, however adolescents and young adults reported higher levels of comfort using computers and the Internet compared to caregivers and HCP. Identified usability themes centred on: (1) problematic navigation, (2) needed interface-related changes (format, layout and aesthetics), and (3) necessary additional functionalities. To address these issues the following design solutions were implemented: (1) the message stream was changed to present messages from all users (e.g., HCP, patients) in a single stream and enhance collaboration between parties, (2) new message notifications were made more obvious and user friendly, and (3) the capacity of the search function was enhanced. No new issues were identified following the third cycle of testing. Overall, participants liked the appearance of Loop, valued its purpose, and felt it was easy to navigate, use and understand. The vast majority of participants responded that they would use Loop if it was available, however there was concern regarding the implementation of the system into their daily workflow.
Conclusion: Usability testing was a crucial step in refining the clinical collaboration system to meet the various end-users needs. Development of the system has required thoughtful balancing of individual user needs and the need for a unifying tool with a clear purpose that may be applied widely across the healthcare system. Future work will focus on examining the impact of Loop on patient and health service utilization outcomes using a randomized controlled trial.
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