Getting Ready for Adult Healthcare: Designing a Chatbot to Coach Adolescents with Special Health Needs Through the Transitions of Care

Beaudry, Jeremy; Consigli, Alyssa; Clark, Colleen; Robinson, Keith J.

doi:10.1016/j.pedn.2019.09.004

Cited by 64 publications

(56 citation statements)

References 11 publications

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“…In addition, the methodology by Spinuzzi [2] was referenced in 4 papers [25,26,31,32]. References to other design theories were also used, such as experience-based design [55] in studies by Wherton et al [39] and Crosby [56], design thinking [57,58] in various studies [37,56,[59][60][61], human-centered design [62] in the study by Das and Svanaes [63], and prototyping [64] in the study by Hetrick et al [65].…”

Section: Overall Findingsmentioning

confidence: 99%

Generative Participatory Design Methodology to Develop Electronic Health Interventions: Systematic Literature Review

Vandekerckhove¹,

Mul²,

Bramer³

et al. 2020

J Med Internet Res

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Background Generative participatory design (PD) may help in developing electronic health (eHealth) interventions. PD is characterized by the involvement of all stakeholders in creative activities. This is different from the traditional user-centered design, where users are less involved. When looking at PD from a research through design perspective, it is important to summarize the reasons for choosing a certain form of generative PD to further develop its methodology. However, the scientific literature is currently unclear about which forms of PD are used to develop eHealth and which arguments are used to substantiate the decision to use a certain form of generative PD. Objective This study aimed to explore the reporting and substantiation of generative PD methodologies in empirical eHealth studies published in scientific journals to further develop PD methodology in the field of eHealth. Methods A systematic literature review following the Cochrane guidelines was conducted in several databases (EMBASE, MEDLINE Ovid, Web of Science, and CINAHL EBSCOhost). Data were extracted on the recruitment and management of stakeholders, the use of tools, and the use of outcome measures. Results Of the 3131 studies initially identified, 69 were selected for qualitative synthesis. The reporting was very variable, depending to a large extent on whether the study stated that reporting on the PD process was a major aim. The different levels of reporting and substantiation of the choices of a recruitment strategy, stakeholder management, and tools and outcome measures are presented. Only a few authors explicitly used arguments directly related to PD guiding principles such as democratic, mutual learning, tacit and latent knowledge, and collective creativity. Even though PD principles were not always explicitly discussed in the method descriptions of the studies, they were implicitly present, mostly in the descriptions of the use of PD tools. The arguments used to substantiate the choices made in stakeholder management, PD tools, and the type of outcome measures adopted point to the involvement of PD principles. Conclusions Studies that have used a PD research methodology to develop eHealth primarily substantiate the choice of tools made and much less the use of stakeholders and outcome measures.

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Section: Overall Findingsmentioning

confidence: 99%

Generative Participatory Design Methodology to Develop Electronic Health Interventions: Systematic Literature Review

Vandekerckhove¹,

Mul²,

Bramer³

et al. 2020

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Recent advances in medical education for patients and clinicians have focused on using immersive virtual and augmented reality (AR/VR), app-based interactive training, virtual assistants to answer questions in real-time, 3D modeling, and online real-time education [8,46,47]. In particular, virtual assistants or chatbots have been identified as a technology suitable for supporting patient groups with focused information available in real time [48][49][50]. One of the challenges in using novel technology-based education is ensuring that hard-to-reach and vulnerable groups have appropriate access to and understanding of these tools [51,52].…”

Section: Principal Findingsmentioning

confidence: 99%

An eHealth Framework for Managing Pediatric Growth Disorders and Growth Hormone Therapy

Dimitri¹,

Fernández-Luque²,

Banerjee³

et al. 2021

J Med Internet Res

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Background The use of technology to support health and health care has grown rapidly in the last decade across all ages and medical specialties. Newly developed eHealth tools are being implemented in long-term management of growth failure in children, a low prevalence pediatric endocrine disorder. Objective Our objective was to create a framework that can guide future implementation and research on the use of eHealth tools to support patients with growth disorders who require growth hormone therapy. Methods A total of 12 pediatric endocrinologists with experience in eHealth, from a wide geographical distribution, participated in a series of online discussions. We summarized the discussions of 3 workshops, conducted during 2020, on the use of eHealth in the management of growth disorders, which were structured to provide insights on existing challenges, opportunities, and solutions for the implementation of eHealth tools across the patient journey, from referral to the end of pediatric therapy. Results A total of 815 responses were collected from 2 questionnaire-based activities covering referral and diagnosis of growth disorders, and subsequent growth hormone therapy stages of the patient pathway, relating to physicians, nurses, and patients, parents, or caregivers. We mapped the feedback from those discussions into a framework that we developed as a guide to integration of eHealth tools across the patient journey. Responses focused on improved clinical management, such as growth monitoring and automation of referral for early detection of growth disorders, which could trigger rapid evaluation and diagnosis. Patient support included the use of eHealth for enhanced patient and caregiver communication, better access to educational opportunities, and enhanced medical and psychological support during growth hormone therapy management. Given the potential availability of patient data from connected devices, artificial intelligence can be used to predict adherence and personalize patient support. Providing evidence to demonstrate the value and utility of eHealth tools will ensure that these tools are widely accepted, trusted, and used in clinical practice, but implementation issues (eg, adaptation to specific clinical settings) must be addressed. Conclusions The use of eHealth in growth hormone therapy has major potential to improve the management of growth disorders along the patient journey. Combining objective clinical information and patient adherence data is vital in supporting decision-making and the development of new eHealth tools. Involvement of clinicians and patients in the process of integrating such technologies into clinical practice is essential for implementation and developing evidence that eHealth tools can provide value across the patient pathway.

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“…Owing to their limited interactivity, traditional data entry forms are not very effective in engaging users, especially when a large amount of information is collected. Guided by prior research on the effectiveness of chatbots in improving patient engagement [34,35] and care experience [36], we decided to develop a rule-based AI chatbot for enhanced engagement and better patient interaction.…”

Section: Exploration Of the Problem Context And Activities Using Activity Theorymentioning

confidence: 99%

Design, Development, and Evaluation of a Telemedicine Platform for Patients With Sleep Apnea (Ognomy): Design Science Research Approach

Mulgund¹,

Sharman²,

Rifkin³

et al. 2021

JMIR Form Res

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Background With an aging population and the escalating cost of care, telemedicine has become a societal imperative. Telemedicine alternatives are especially relevant to patients seeking care for sleep apnea, with its prevalence approaching one billion cases worldwide. Increasing awareness has led to a surge in demand for sleep apnea care; however, there is a shortage of the resources and expertise necessary to cater to the rising demand. Objective The aim of this study is to design, develop, and evaluate a telemedicine platform, called Ognomy, for the consultation, diagnosis, and treatment of patients with sleep apnea. Methods Using the design science research methodology, we developed a telemedicine platform for patients with sleep apnea. To explore the problem, in the analysis phase, we conducted two brainstorming workshops and structured interviews with 6 subject matter experts to gather requirements. Following that, we conducted three design and architectural review sessions to define and evaluate the system architecture. Subsequently, we conducted 14 formative usability assessments to improve the user interface of the system. In addition, 3 trained test engineers performed end-to-end system testing to comprehensively evaluate the platform. Results Patient registration and data collection, physician appointments, video consultation, and patient progress tracking have emerged as critical functional requirements. A telemedicine platform comprising four artifacts—a mobile app for patients, a web app for providers, a dashboard for reporting, and an artificial intelligence–based chatbot for customer onboarding and support—was developed to meet these requirements. Design reviews emphasized the need for a highly cohesive but loosely coupled interaction among the platform’s components, which was achieved through a layered modular architecture using third-party application programming interfaces. In contrast, critical findings from formative usability assessments focused on the need for a more straightforward onboarding process for patients, better status indicators during patient registration, and reorganization of the appointment calendar. Feedback from the design reviews and usability assessments was translated into technical improvements and design enhancements that were implemented in subsequent iterations. Conclusions Sleep apnea is an underdiagnosed and undertreated condition. However, with increasing awareness, the demand for quality sleep apnea care is likely to surge, and creative alternatives are needed. The results of this study demonstrate the successful application of a framework using a design science research paradigm to design, develop, and evaluate a telemedicine platform for patients with sleep apnea and their providers.

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Getting Ready for Adult Healthcare: Designing a Chatbot to Coach Adolescents with Special Health Needs Through the Transitions of Care

Cited by 64 publications

References 11 publications

Generative Participatory Design Methodology to Develop Electronic Health Interventions: Systematic Literature Review

Generative Participatory Design Methodology to Develop Electronic Health Interventions: Systematic Literature Review

An eHealth Framework for Managing Pediatric Growth Disorders and Growth Hormone Therapy

Design, Development, and Evaluation of a Telemedicine Platform for Patients With Sleep Apnea (Ognomy): Design Science Research Approach

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