Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
BMC Med Inform Decis Mak. 2020 Mar 4;20(1):46. doi: 10.1186/s12911-020-1065-8.
Chronic conditions present major health problems, affecting an increasing number of individuals who experience a variety of symptoms that impact their health related quality of life. Digital tools can be of support in chronic conditions, potentially improving patient-provider communication, promoting shared decision making for treatment and care, and possibly even improving patient outcomes. This study aimed to develop a digital tool for patient-provider communication in chronic health care settings and describes the data collection and subsequent content and software development of the InvolveMe tool. InvolveMe will provide patients with the opportunity to report symptoms and preferences to their health care providers (HCP), and to use secure messaging to interact with the HCPs.
The study employed a combination of interviews with patients with chronic conditions and focus groups with HCPs, examining experiences with chronic conditions and the potential use of a digital tool for support. Participants were recruited from two outpatient clinics at a university hospital. Data collected from interviews and focus groups were analysed using thematic analysis. Content and software development was informed by the data collection and by tool development workshops.
Analyses from interviews with patients (n = 14) and focus groups with HCPs (n = 11) generated three main themes: 1) Making symptoms and challenges visible, 2) Mastering a new life, and 3) Digital opportunities for follow-up. Each main theme generated separate subthemes. Theme 1 and 2 gave input for content development of the symptom and needs assessment part of the tool, while theme 3 provided ideas for the software development of the InvolveMe tool. Tool development workshops with patients (n = 6) and HCPs (n = 6) supplemented the development.
A digital tool such as InvolveMe has the potential to support shared decision making for patients with chronic health conditions. Through integration with an existing patient portal such a tool can provide opportunities for meaningful interactions and communication between patients and HCP's, particularly with regards to symptoms, needs and preferences for care.
慢性病带来了重大的健康问题，影响了越来越多的患者，他们经历着各种影响其健康相关生活质量的症状。数字工具在慢性病管理中能起到支持作用，可能改善医患沟通，促进治疗和护理的共同决策，并可能改善患者的预后。本研究旨在开发一种用于慢性病医疗保健环境的医患沟通数字工具，并描述了 InvolveMe 工具的数据收集以及随后的内容和软件开发。InvolveMe 将为患者提供向医疗保健提供者（HCP）报告症状和偏好的机会，并使用安全消息传递与 HCP 进行互动。
该研究采用了对慢性病患者的访谈和 HCP 的焦点小组相结合的方法，考察了慢性病的经历以及数字工具支持的潜在用途。参与者是从一家大学医院的两个门诊诊所招募的。从访谈和焦点小组中收集的数据采用主题分析进行分析。内容和软件开发是基于数据收集和工具开发研讨会进行的。
对患者（n=14）访谈和 HCP 焦点小组（n=11）的分析产生了三个主要主题：1）使症状和挑战可见，2）掌握新的生活，3）数字随访机会。每个主要主题都产生了单独的子主题。主题 1 和 2 为工具的症状和需求评估部分的内容开发提供了投入，而主题 3 为 InvolveMe 工具的软件开发提供了思路。与患者（n=6）和 HCP（n=6）的工具开发研讨会补充了开发工作。
像 InvolveMe 这样的数字工具有可能支持慢性病患者的共同决策。通过与现有的患者门户集成，此类工具可以为患者和 HCP 之间提供有意义的互动和沟通机会，特别是在症状、护理需求和偏好方面。
