A Web-Based Application for Complex Health Care Populations: User-Centered Design Approach

Ferrucci, Francesca; Jorio, Manuele; Marci, Stefano; Bezenchek, Antonia; Diella, Giulia; Nulli, Cinzia; Miranda, Ferdinando; Gattinara, Guido Castelli

doi:10.2196/18587

Cited by 14 publications

(7 citation statements)

References 19 publications

(17 reference statements)

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“…In our review, a significant portion of projects leveraged technology. Examples include apps [ 28 , 50 ], online web portals [ 27 , 29 ] and other digital media [ 36 ]. Those with multimorbidity tend to be older adults, and it is not uncommon for this group to be less accepting or less able to use technology [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

Co-designing care for multimorbidity: a systematic review

Sumner,

Ng,

Teo

et al. 2024

BMC Med

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Background The co-design of health care enables patient-centredness by partnering patients, clinicians and other stakeholders together to create services. Methods We conducted a systematic review of co-designed health interventions for people living with multimorbidity and assessed (a) their effectiveness in improving health outcomes, (b) the co-design approaches used and (c) barriers and facilitators to the co-design process with people living with multimorbidity. We searched MEDLINE, EMBASE, CINAHL, Scopus and PsycINFO between 2000 and March 2022. Included experimental studies were quality assessed using the Cochrane risk of bias tool (ROB-2 and ROBINS-I). Results We screened 14,376 reports, with 13 reports meeting the eligibility criteria. Two reported health and well-being outcomes: one randomised clinical trial (n = 134) and one controlled cohort (n = 1933). Outcome measures included quality of life, self-efficacy, well-being, anxiety, depression, functional status, healthcare utilisation and mortality. Outcomes favouring the co-design interventions compared to control were minimal, with only 4 of 17 outcomes considered beneficial. Co-design approaches included needs assessment/ideation (12 of 13), prototype (11 of 13), pilot testing (5 of 13) (i.e. focus on usability) and health and well-being evaluations (2 of 13). Common challenges to the co-design process include poor stakeholder interest, passive participation, power imbalances and a lack of representativeness in the design group. Enablers include flexibility in approach, smaller group work, advocating for stakeholders’ views and commitment to the process or decisions made. Conclusions In this systematic review of co-design health interventions, we found that few projects assessed health and well-being outcomes, and the observed health and well-being benefits were minimal. The intensity and variability in the co-design approaches were substantial, and challenges were evident. Co-design aided the design of novel services and interventions for those with multimorbidity, improving their relevance, usability and acceptability. However, the clinical benefits of co-designed interventions for those with multimorbidity are unclear.

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Section: Discussionmentioning

confidence: 99%

Co-designing care for multimorbidity: a systematic review

Sumner,

Ng,

Teo

et al. 2024

BMC Med

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“…The focus group findings highlight the complex and dynamic implications of providing care for persons living with dementia in their homes. More importantly, this study contributes to the growing literature on how technology can support care for people with dementia living in the community [ 18 , 19 ] and the importance of a user-centered design approach [ 20 ]. Overall, the stakeholder group participants share a widespread belief about the benefits of technology in general and about the Generation Connect platform, specifically with regard to the platform’s support efforts for caring for individuals with dementia in their homes.…”

Section: Discussionmentioning

confidence: 99%

Refining a Digital Therapeutic Platform for Home Care Agencies in Dementia Care to Elicit Stakeholder Feedback: Focus Group Study With Stakeholders

Gilson¹,

Gassman²,

Dodds³

et al. 2022

JMIR Aging

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Background Persons living with dementia require increasing levels of care, and the care model has evolved. The Centers for Medicare and Medicaid Services is transitioning long-term care services from institutional care to home- or community-based services, including reimbursement for nonclinical services. Although home care companies are positioned to handle this transition, they need innovative solutions to address the special challenges posed by caring for persons living with dementia. To live at home longer, these persons require support from formal caregivers (FCGs; ie, paid professionals), who often lack knowledge of their personal histories and have high turnover, or informal caregivers (eg, family or friends), who may have difficulty coping with behavioral and psychological symptoms of dementia. The Generation Connect platform was developed to support these individuals and their formal and informal caregivers. In preliminary studies, the platform improved mood and influenced caregiver satisfaction. To enhance platform effectiveness, Generation Connect received a grant from the National Institutes of Health Small Business Innovation Research to improve clinical outcomes, reduce health care costs, and lower out-of-pocket costs for persons living with dementia who receive care through home care agencies. Objective This study aims to evaluate information elicited from a series of stakeholder focus groups to understand existing processes, needs, barriers, and goals for the use of the Generation Connect platform by home care agencies and formal and informal caregivers. Methods A series of focus groups were conducted with home care agency corporate leadership, home care agency franchise owners, home care agency FCGs, and informal caregivers of persons living with dementia. The qualitative approach allowed for unrestricted idea generation that best informed the platform development to enable home care providers to differentiate their dementia care services, involve informal caregivers, improve FCG well-being, and extend the ability of persons living with dementia to age in place. Using the Technology-Enabled Caregiving in the Home framework, an inductive and iterative content analysis was conducted to identify thematic categories from the transcripts. Results Overall, 39 participants participated across the 6 stakeholder focus groups. The following five overarching themes were identified: technology related; care services; data, documentation, and outcomes; cost, finance, and resources; and resources for caregivers. Within each theme, the most frequent subthemes were identified. Exemplar stakeholder group statements provided support for each of the identified themes. Conclusions The focus group results will inform the further development of the Generation Connect platform to reduce the burden of caregiving for persons living with dementia, evaluate changes in cognition, preserve functional independence, and promote caregiver engagement between these individuals. The next step is to evaluate the effectiveness of the revised platform in the National Institutes of Health Small Business Innovation Research phase 2 clinical trial to assess the efficacy of its evidence-based interventions and market viability.

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“… Ferrucci et al (2021) mentioned the importance of healthcare professionals sharing information with their colleagues through a mobile app. This aspect was also highlighted by all therapists who participated in this research, who explained that the app should provide them with seamless and constant communication with both colleagues and patients when assessing changes and behaviors regarding oxygen supply use.…”

Section: Discussionmentioning

confidence: 99%