Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States of America.
Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States of America.
PLoS One. 2023 May 2;18(5):e0285044. doi: 10.1371/journal.pone.0285044. eCollection 2023.
The Veterans Health Administration (VA) is the largest integrated healthcare organization in the US and cares for the largest cohort of individuals with hepatitis C (HCV). A national HCV population management dashboard enabled rapid identification and treatment uptake with direct acting antiviral agents across VA hospitals. We describe the HCV dashboard (HCVDB) and evaluate its use and user experience.
A user-centered design approach created the HCVDB to include reports based on the HCV care continuum: 1) 1945-1965 birth cohort high-risk screening, 2) linkage to care and treatment of chronic HCV, 3) treatment monitoring, 4) post-treatment to confirm cure (i.e., sustained virologic response), and 5) special populations of unstably housed Veterans. We evaluated frequency of usage and user experience with the System Usability Score (SUS) and Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) instruments.
Between November 2016 and July 2021, 1302 unique users accessed the HCVDB a total of 163,836 times. The linkage report was used most frequently (71%), followed by screening (13%), sustained virologic response (11%), on-treatment (4%), and special populations (<1%). Based on user feedback (n = 105), the mean SUS score was 73±16, indicating a good user experience. Overall acceptability was high with the following UTAUT2 rated from highest to least: Price Value, Performance Expectancy, Social Influence, and Facilitating Conditions.
The HCVDB had rapid and widespread uptake, met provider needs, and scored highly on user experience measures. Collaboration between clinicians, clinical informatics, and population health experts was essential for dashboard design and sustained use. Population health management tools have the potential for large-scale impacts on care timeliness and efficiency.
退伍军人健康管理局（VA）是美国最大的综合性医疗机构，负责照顾最大的丙型肝炎（HCV）患者群体。一个全国性的 HCV 人群管理仪表板使 VA 医院能够通过直接作用抗病毒药物快速识别和接受治疗。我们描述了 HCV 仪表板（HCVDB），并评估了其使用情况和用户体验。
采用以用户为中心的设计方法创建了 HCVDB，其中包括基于 HCV 护理连续体的报告：1）1945-1965 年出生队列的高危筛查，2）与护理和慢性 HCV 治疗的联系，3）治疗监测，4）治疗后的确认治愈（即持续病毒学应答），以及 5）居住不稳定的退伍军人的特殊人群。我们使用系统可用性得分（SUS）和统一接受和使用技术理论 2（UTAUT2）工具评估了使用频率和用户体验。
在 2016 年 11 月至 2021 年 7 月期间，共有 1302 位用户总共访问了 HCVDB 163836 次。链接报告的使用频率最高（71%），其次是筛查（13%）、持续病毒学应答（11%）、治疗中（4%）和特殊人群（<1%）。根据用户反馈（n=105），平均 SUS 得分为 73±16，表明用户体验良好。总体接受度较高，以下 UTAUT2 评分从高到低分别为：价格价值、绩效预期、社会影响和便利条件。
HCVDB 得到了快速广泛的采用，满足了提供者的需求，在用户体验方面得分很高。临床医生、临床信息学和人群健康专家之间的合作对于仪表板设计和持续使用至关重要。人群健康管理工具有可能对护理及时性和效率产生重大影响。
