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Design and development of an eHealth service for collaborative self-management among older adults with chronic diseases: A theory-driven user-centered design (Preprint)


 BACKGROUND
 The increasing prevalence of chronic conditions and multimorbidity poses great challenges to healthcare systems. Therefore, patients’ engagement in self-managing their illness becomes increasingly important. eHealth interventions are a promising resource for the provision of adequate and timely support, but there is inconclusive evidence about how to design eHealth services to meet the complex needs of patients with multimorbidity.
 
 
 OBJECTIVE
 To apply an evidence-based and theory-informed user-centered design approach for a) identifying the needs of older adults and healthcare professionals in the collaborative management of multimorbidity, b) developing an eHealth service to address these needs, and c) testing the feasibility and acceptance of the eHealth service in a clinical setting.
 
 
 METHODS
 A theory-driven user-centered design approach was carried out in three interconnected phases: 1) exploration of user needs with patients and healthcare professionals; 2) design and development of content and software; 3) feasibility study of the software prototype and redesign.
 
 
 RESULTS
 Phase 1 resulted in the specification of twenty-two user needs, which were grouped into five themes: diagnosis-specific information, medication management support, self-management support, care coordination support, psychosocial support. A web-based application – ePATH (electronic Patient Activation in Treatment at Home) – with separate user interfaces for patients and healthcare professionals was developed to address these needs. Two nurses and five patients tested the ePATH service in clinical practice, resulting in a refined web interface and a mobile application (mPATH) to support self-tracking and make it possible to get reminders through push notifications. The feasibility study highlighted the importance of adequately addressing not only varying user needs, but also the complex nature of healthcare organizations when implementing new services and processes in chronic care management.
 
 
 CONCLUSIONS
 We conclude that user engagement in design and development should not be limited to the elicitation of user needs and creation of new services but should focus more holistically on improving current practices to shape better care, which requires adequate strategies and resources to implement changes in people’s lives and complex organizations.
 
 
 INTERNATIONAL REGISTERED REPORT
 RR2-10.2196/11625
