gms | German Medical Science

Introduction: eHealth technologies have the potential for tackling some of the major barriers in healthcare. With the rise of digital transformation, health mobile applications are proliferating. However, health providers are struggling with the adoption of digital health initiatives which often fail to be used to their fullest functionality [1], [2].

The current “one size fits all” approach of healthcare IT applications does not cover the individual needs of patients and clinicians as they are not part of the design process. The importance of people-centricity, defined as placing both patients, and physicians, at the heart of the development process [3], is acknowledged but rarely applied to healthcare applications [4].

The objective of this study was to use the Patient Journey Mapping model for the development of an app that monitors pediatric cancer patients at home as a user-centered telehealth solution. A Patient Journey Map (PJM) is a visual presentation of the complete route a patient follows during all stages of care [5].

Methods: An interdisciplinary team consisting of experts in the areas of pediatric oncology, medical informatics, and epidemiology, and patients, participated in the implementation. Stakeholders who did not directly participate provided input through interviews.

Firstly, the most important aspects of the patient experience were defined. Using empathy-based methods e.g. beginner’s mindset and asking 5 whys, we conducted interviews that helped define the design challenge. The gathered data was analyzed and organized in affinity clusters in a matrix. Each of the clusters was arranged chronologically in columns representing each step of the process e.g. from the moment the patient is enrolled in the study until the moment they exit.

Next, a persona representing the patient was created. The actions to be accomplished were identified and interconnected. Afterward, all touchpoints including who and what influences each were identified. This task involved multiple people belonging to different organizations, backgrounds, and interests in the project.

The involved parties and support processes were organized into rows. Finally, based on interviews, we identified what makes for a good or bad experience each step of the way. This step was iterated to adapt to changes that happened over time.

Results: The application of the PJM model added clarity as to which requirements needed to be re-evaluated. For instance, the setting of reminders is now tailored to the patient’s schedule encouraging them to record their vitals. This, in turn, improved the collection of data enabling physicians to make clinical decisions based on data. Other opportunities included the early discovery of problems that required elicitation of requirements that were missing in the first approach.

Discussion: Multiple perspectives have been identified as a major issue in participatory collaborative system design [6]. However, in our experience, the use of PJM improved team communication helping to tackle this challenge significantly.

Conclusion: The PJM method was useful in identifying processes, interfaces, and challenges enabling our interdisciplinary team to effectively tailor the user experience and obtain a deeper understanding of the user needs. A PJM offers a method to understand the interactions of stakeholders and facilitates team alignment.

The authors declare that they have no competing interests.

The authors declare that an ethics committee vote is not required.