"Am I OK?" using human centered design to empower rheumatoid arthritis patients through patient reported outcomes

Patient Educ Couns. 2019 Mar;102(3):503-510. doi: 10.1016/j.pec.2018.10.016. Epub 2018 Oct 28.

Abstract

Objective: Use of patient reported outcomes (PROs) in the routine care of rheumatoid arthritis (RA) has been shown to improve health outcomes, However, integration of PROs into the clinical visit is inconsistent. We aimed to develop a "dashboard" for RA patients to display relevant PRO measures for discussion during a routine RA clinical visit.

Methods: Patients (N = 45) and providers (N = 12) were recruited from rheumatology clinics at a university center and a safety net hospital. Using a human-centered design process involving patients, clinicians, designers, and health-IT experts, we performed interviews, clinic observations, and focus groups, which subsequently guided an iterative phase of prototype testing.

Results: RA patients and their providers shared the goals of assessing wellbeing and developing a personalized treatment plan. We found conflicting views of which data were most important for guiding decision-making and for answering the patient's overarching question of "Am I OK?"

Conclusion: The final dashboard simplified the display of PRO data and correlated it longitudinally to the patient's medication regimen. It also included laboratory values relevant for RA care.

Practice implications: By presenting data graphically, the dashboard may provide a platform for patients and providers to communicate around PROs and shared goals.

Keywords: Dashboard; Human-centered design; Low-literacy; Patient reported outcomes; Rheumatoid arthritis; Shared decision-making.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / psychology*
  • Arthritis, Rheumatoid / therapy
  • Clinical Decision-Making
  • Communication*
  • Decision Making
  • Female
  • Focus Groups
  • Health Literacy
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Patient Participation*
  • Patient Reported Outcome Measures*
  • Patient-Centered Care / methods*
  • Patients / psychology*
  • Professional-Patient Relations*
  • Qualitative Research
  • Quality of Life