When I started working on the mPOWEr project, my goal was straightforward–to build a wound assessment app and test it out to see if it would improve care. I really didn’t think very much about the users—patients and providers—when considering how the app should work. As I’ve since learned, health IT is littered with examples of well-meaning software that was foisted on users without involving them along the way. Thankfully, as I was coming up with a plan of research for my dissertation, I took a class on user-centered design and gained several mentors with experience in the field. My research plan became more complicated… and qualitative (eek!).
We began by conducting a needs assessment among two key user groups: patients who had experienced post-discharge surgical site infections (SSIs) and providers who commonly manage those infections. The insights we gained through these interviews and surveys would turn out to be invaluable. Through a rigorous qualitative analysis of the words of patients, we were able to identify gaps in current post-discharge care and describe some key qualities of a post-discharge wound monitoring app. Through surveys of providers, we better understood the frustrations and challenges that providers face in managing patients after discharge, and were able to prioritize features for inclusion in the provider dashboard. As we built new iterations of the app, we continued to solicit feedback from surgical patients, patient advisors, and providers.
As I think back on my initial design for mPOWEr, uninformed by user input, I realize how critical user engagement was in shaping and improving the app. As Donald Rumsfeld memorably said, there are “unknown unknowns”—things that we don’t know that we don’t know. The only way to explore these unknown is to get out from behind the screen and into the real world to talk to as many stakeholders as possible.
To read more about our findings look out for these peer-reviewed manuscripts and abstracts:
- Sanger P, Hartzler A, Han SM, Armstrong AC, Stewart M, Lordon R, Lober WB, Evans HL Patient Perspectives on Post-Discharge Surgical Site Infections: Towards a Patient-Centered Mobile Health Solution. PLoS ONE 9(12): e114016. doi:10.1371/journal.pone.0114016
- Sanger P, Hartzler A, Lober B, Evans H, Pratt W. Design Considerations for Post-Acute Care mHealth: Patient Perspectives. AMIA Annu Symp Proc. 2014; 2014: 1920–1929.
- Sanger P, Hartzler A, Lober B, Evans H. Provider Needs Assessment for mPOWEr: a Mobile tool for Post-Operative Wound Evaluation. AMIA Annu Symp Proc 2013. Washington DC [presented Nov 2013]; 2013. p. 1236.