Mobile Applications for Patient-centered Care Coordination: A Review of Human Factors Methods Applied to their Design, Development, and Evaluation

Summary

Objectives: To examine if human factors methods were applied in the design, development, and evaluation of mobile applications developed to facilitate aspects of patient-centered care coordination. Methods: We searched MEDLINE and EMBASE (2013-2014) for studies describing the design or the evaluation of a mobile health application that aimed to support patients’ active involvement in the coordination of their care.

Results: 34 papers met the inclusion criteria. Applications ranged from tools that supported self-management of specific conditions (e.g. asthma) to tools that provided coaching or education. Twelve of the 15 papers describing the design or development of an app reported the use of a human factors approach. The most frequently used methods were interviews and surveys, which often included an exploration of participants’ current use of information technology. Sixteen papers described the evaluation of a patient application in practice. All of them adopted a human factors approach, typically an examination of the use of app features and/or surveys or interviews which enquired about patients’ views of the effects of using the app on their behaviors (e.g. medication adherence), knowledge, and relationships with healthcare providers. No study in our review assessed the impact of mobile applications on health outcomes.

Conclusion: The potential of mobile health applications to assist patients to more actively engage in the management of their care has resulted in a large number of applications being developed. Our review showed that human factors approaches are nearly always adopted to some extent in the design, development, and evaluation of mobile applications.

Keywords

Human factors - mobile applications - mHealth - evaluation - patients

 

• References

• 1 Pew Research Internet Project.. Mobile technology fact sheet. 2014 http://www.pewinternet.org/fact-sheets-mobile-technology-fact-sheet/ (accessed 12th Nov 2014).
• 2 acma.. Communicatons report 2012-13. Australian Communications and Media Authority, Australian Government; 2013
• 3 Schindler S. Smartphones reach majority in all EU5 countries; 2013. http://www.comscore.com/Insights/Data-Mine/Smartphones-Reach-Majority-in-all-EU5-Countries accessed 12th Nov 2014).
• 4 research2guidance.. mHealth App Developer Economics 2014. Germany: research2guidance; 2014
• 5 Singh A, Wilkinson S, Braganza S. Smartphones and pediatric apps to mobilize the medical home. J Pediatr 2014; 165 (Suppl. 03) 606-10.
• 6 Torous J, Friedman R. Smartphone use among patients age greater than 60 with mental health conditions and willingness to use smartphone applications to monitor their mental health conditions. Am J Geriatr Psychiatry 2014; (Suppl. 01) S128-S9.
• 7 Pelletier S. Explosive growth in health care apps raises oversight questions. 2012 http://www.aamc.org/newsroom/reporter/october2012/308516/health-care-apps.html (accessed 20 November 2013).
• 8 Nilsen W, Kumar S, Shar A, Varoquiers C, Wiley T, Riley WT. et al. Advancing the science of mHealth. J Health Commun 2012;17 Suppl 1 5-10.
• 9 Stanton NA, Hedge A, Brookhuis K, Salas E, Hendrick H. editors. Handbook of Human Factors and Ergonomics Methods. Florida: CRC Press; 2005
• 10 Nguyen L, Bellucci E, Nguyen LT. Electronic health records implementation: An evaluation of information system impact and contingency factors. Int J Med Inform 2014; 83 (Suppl. 11) 779-96.
• 11 Hayakawa M, Uchimura Y, Omae K, Waki K, Fujita H, Ohe K. A smartphone-based medication self-management system with realtime medication monitoring. Appl Clin Inform 2013; 4 (Suppl. 01) 37-52.
• 12 Stopczynski A, Stahlhut C, Larsen JE, Petersen MK, Hansen LK. The smartphone brain scanner: a portable real-time neuroimaging system.[Erratum appears in PLoS One. 2014;9(4):e96652]. PLoS ONE [Electronic Resource] 2014; 9 (Suppl. 02) e86733.
• 13 Stinson JN, Lalloo C, Harris L, Isaac L, Campbell F, Brown S. et al. ICanCope with Pain^TM: User-centred design of a web- and mobile-based self-management program for youth with chronic pain based on identified health care needs. Pain Res Manag 2014; 19 (Suppl. 05) 257-65.
• 14 Ben-Zeev D, Kaiser SM, Brenner CJ, Begale M, Duffecy J, Mohr DC. Development and usability testing of FOCUS: a smartphone system for self-management of schizophrenia. Psychiatric Rehabil J 2013; 36 (Suppl. 04) 289-96.
• 15 Buller DB, Berwick M, Shane J, Kane I, Lantz K, Buller MK. User-centered development of a smart phone mobile application delivering personalized real-time advice on sun protection. Transl Behav Med 2013; 3 (Suppl. 03) 326-34.
• 16 Pulman A, Hill J, Taylor J, Galvin K, Masding MG. Innovative mobile technology alcohol education for young people with type 1 diabetes. Practical Diabetes 2013; 30 (Suppl. 09) 376-9a.
• 17 Shah N, Jonassaint J, De Castro L. Patients welcome the Sickle Cell Disease Mobile Application to Record Symptoms via Technology (SMART). Hemoglobin 2014; 38 (Suppl. 02) 99-103.
• 18 Hayakawa M, Uchimura Y, Omae K, Waki K, Fujita H, Ohe K. A smartphone-based medication self-management system with realtime medication monitoring. Appl Clin Inform 2013; 4 (Suppl. 01) 37-52.
• 19 Ben-Zeev D, Kaiser SM, Brenner CJ, Begale M, Duffecy J, Mohr DC. Development and usability testing of FOCUS: a smartphone system for self-management of schizophrenia. Psychiatric Rehabil J 2013; 36 (Suppl. 04) 289-96.
• 20 Cano Martin JA, Martinez-Perez B, de la TorreDiez I, Lopez-Coronado M. Economic impact assessment from the use of a mobile app for the self-management of heart diseases by patients with heart failure in a Spanish region. J Med Syst 2014; 38 (Suppl. 09) 96.
• 21 Sterling M, Rhee H, Bocko M. Automated cough assessment on a mobile platform. J Med Eng 2014 2014 (951621)
• 22 Burnay E, Cruz-Correia R, Jacinto T, Sousa AS, Fonseca J. Challenges of a mobile application for asthma and allergic rhinitis patient enablement-interface and synchronization. Telemed J E Health 2013; 19 (Suppl. 01) 13-8.
• 23 De La Vega R, Roset R, Castarlenas E, Sanchez-Rodriguez E, Sole E, Miro J. Development and testing of painometer: A smartphone app to assess pain intensity. J Pain 2014; 15 (Suppl. 10) 1001-7.
• 24 Klein M, Mogles N, van Wissen A. Intelligent mobile support for therapy adherence and behavior change. J Biomed Inform 2014; 51: 137-51.
• 25 Macpherson CF, Linder LA, Ameringer S, Erickson J, Stegenga K, Woods NF. Feasibility and acceptability of an iPad application to explore symptom clusters in adolescents and young adults with cancer. Pediatr Blood Cancer 2014; 61 (Suppl. 11) 1996-2003.
• 26 Radzuweit M, Lechner U. Introducing tablet computers into medical practice: Design of mobile apps for consultation services. Health Technol (Berl) 2014; 4 (Suppl. 01) 31-41.
• 27 Sanger PC, Hartzler A, Han SM, Armstrong CA, Stewart MR, Lordon RJ. et al. Patient perspectives on post-discharge surgical site infections: Towards a patient-centered mobile health solution. PloS One 2014; 9 (Suppl. 12) e114016.
• 28 Stopczynski A, Stahlhut C, Larsen JE, Petersen MK, Hansen LK. The smartphone brain scanner: A portable real-time neuroimaging system. PloS One 2014 9(2)
• 29 Becker S, Kribben A, Meister S, Diamantidis CJ, Unger N, Mitchell A. User Profiles of a Smart-phone Application to Support Drug Adherence - Experiences from the iNephro Project. PloS One 2013 8(10)
• 30 Padman R, Jaladi S, Kim S, Kumar S, Orbeta P, Rudolph K. et al. An evaluation framework and a pilot study of a mobile platform for diabetes self-management: insights from pediatric users. Stud Health Technol Inform 2013; 192: 333-7.
• 31 Haze KA, Lynaugh J. Building patient relationships: a smartphone application supporting communication between teenagers with asthma and the RN care coordinator. Comput Inform Nurs 2013; Jun 31 (Suppl. 06) 266-71 quiz 272-3.
• 32 Reid SC, Kauer SD, Hearps SJ, Crooke AH, Khor AS, Sanci LA. et al. A mobile phone application for the assessment and management of youth mental health problems in primary care: health service outcomes from a randomised controlled trial of mobiletype. BMC Fam Pract 2013; 14: 84.
• 33 Christensen S. Evaluation of a nurse-designed mobile health education application to enhance knowledge of Pap testing. Creat Nurs 2014; 20 (Suppl. 02) 137-43.
• 34 DeVito Dabbs A, Song MK, Myers B, Hawkins RP, Aubrecht J, Begey A. et al. Clinical trials of health information technology interventions intended for patient use: unique issues and considerations. Clin Trials 2013; 10 (Suppl. 06) 896-906.
• 35 Forman DE, LaFond K, Panch T, Allsup K, Manning K, Sattelmair J. Utility and efficacy of a smartphone application to enhance the learning and behavior goals of traditional cardiac rehabilitation: A feasibility study. J Cardiopulm Rehabil Prev 2014; 34 (Suppl. 05) 327-34.
• 36 Goldberg A, Arora S, Menchine M. Patient impression and satisfaction of a self-administered, automated medical history taking device in the emergency department. West J Emerg Med 2014 15(1)
• 37 Haze KA, Lynaugh J. Building patient relationships: A smartphone application supporting communication between teenagers with asthma and the rn care coordinator. Comput Inform Nurs 2013; 31 (Suppl. 06) 266-71.
• 38 Helander E, Kaipainen K, Korhonen I, Wansink B. Factors related to sustained use of a free mobile app for dietary self-monitoring with photography and peer feedback: retrospective cohort study. J Med Internet Res 2014; 16 (Suppl. 04) e109.
• 39 Kuhn E, Greene C, Hoffman J, Nguyen T, Wald L, Schmidt J. et al. Preliminary evaluation of PTSD Coach, a smartphone app for post-traumatic stress symptoms. Mil Med 2014; 179 (Suppl. 01) 12-8.
• 40 Layton AM, Whitworth J, Peacock J, Bartels MN, Jellen PA, Thomashow BM. Feasibility and acceptability of utilizing a smartphone based application to monitor outpatient discharge instruction compliance in cardiac disease patients around discharge from hospitalization. Int J Telemed Appl 2014; 2014: 415868.
• 41 Lin CY, Peng KL, Chen J, Tsai JY, Tseng YC, Yang JR. et al. Improvements in dental care using a new mobile app with cloud services. J Formos Med Assoc 2014; 113 (Suppl. 10) 742-9.
• 42 Min YH, Lee JW, Shin YW, Jo MW, Sohn G, Lee JH. et al. Daily collection of self-reporting sleep disturbance data via a smartphone app in breast cancer patients receiving chemotherapy: a feasibility study. J Medical Internet Res 2014; 16 (Suppl. 05) e135.
• 43 Tatara N, Arsand E, Bratteteig T, Hartvigsen G. Usage and perceptions of a mobile self-management application for people with type 2 diabetes: qualitative study of a five-month trial. Stud Health Technol Inform 2013; 192: 127-31.
• 44 Tseng MH, Wu HC. A cloud medication safety support system using QR code and Web services for elderly outpatients. Technol Health Care 2014; 22 (Suppl. 01) 99-113.
• 45 Tsui I, Drexler A, Stanton AL, Kageyama J, Ngo E, Straatsma BR. Pilot study using mobile health to coordinate the diabetic patient, diabetologist, and ophthalmologist. J Diabetes Sci Technol 2014; 8 (Suppl. 04) 845-9.
• 46 Mira JJ, Navarro I, Botella F, Borrás F, Nuño Solinís R, Orozco D. et al. A Spanish pillbox app for elderly patients taking multiple medications: randomized controlled trial. J Medical Internet Res 2014; 16 (Suppl. 04) e99.
• 47 Gilliam ML, Martins SL, Bartlett E, Mistretta SQ, Holl JL. Development and testing of an iOS waiting room “app” for contraceptive counseling in a Title X family planning clinic. Am J Obstet & Gynecol 2014; 211 (Suppl. 05) 481. e1-8.
• 48 Guo SH, Lin YH, Chen RR, Kao SF, Chang HK. Development and evaluation of theory-based diabetes support services. Comput Inform Nurs 2013; 31 (Suppl. 01) 17-26 quiz 7-8.
• 49 Phansalkar S, Zachariah M, Seidling HM, Mendes C, Volk L, Bates DW. Evaluation of medication alerts in electronic health records for compliance with human factors principles. J Am Med Inform Assoc 2014; Oct;21 e2 e332-40.
• 50 Patterson ES, Rogers ML, Chapman RJ, Render ML. Compliance With Intended Use of Bar Code Medication Administration in Acute and Long-Term Care: An Observational Study. Hum Factors 2006; 48 (Suppl. 01) 15-22.
• 51 Baroudi JJ, Olson MH, Ives B. An empirical study of the impact of user involvement on system usage and information satisfaction. Commun ACM 1986; 29 (Suppl. 03) 232-8.
• 52 Freid V, Bernstein A, Bush M. Multiple chronic conditions among adults aged 45 and over: Trends over the past 10 years. Hyattsville, MD: National Center for Health Statistics; 2012
• 53 Islam MM, Valderas JM, Yen L, Dawda P, Jowsey T, McRae IS. Multimorbidity and Comorbidity of Chronic Diseases among the Senior Australians: Prevalence and Patterns. PLoS One 2014; 9 (Suppl. 01) e83783.
• 54 Wagner EH, Groves T. Care for chronic diseases. BMJ 2002; 325 7370 913-4.
• 55 Balogh EP, Ganz PA, Murphy SB, Nass SJ, Ferrell BR, Stovall E. Patient-centered cancer treatment planning: improving the quality of oncology care. Summary of an Institute of Medicine workshop. The oncologist 2011; 16 (Suppl. 12) 1800-5.