Abstract

Patients with heart failure (HF) are commonly implanted with cardiac resynchronization therapy (CRT) devices as part of their treatment. Presently, they cannot directly access the remote monitoring (RM) data generated from these devices, representing a missed opportunity for increased knowledge and engagement in care. However, electronic health data sharing can create information overload issues for both clinicians and patients, and some older patients may not be comfortable using the technology (i.e., computers and smartphones) necessary to access this data. To mitigate these problems, patients can be directly involved in the creation of data visualization tailored to their preferences and needs, allowing them to successfully interpret and act upon their health data. We held a participatory design (PD) session with seven adult patients with HF and CRT device implants, who were presently undergoing RM, along with two informal caregivers. Working in three teams, participants used drawing supplies and design cards to design a prototype for a patient-facing dashboard with which they could engage with their device data. Information that patients rated as a high priority for the "Main Dashboard" screen included average percent pacing with alerts for abnormal pacing, other device information such as battery life and recorded events, and information about who to contact with for data-related questions. Preferences for inclusion in an "Additional Information" display included a daily pacing chart, health tips, aborted shocks, a symptom list, and a journal. These results informed the creation of an actual dashboard prototype which was later evaluated by both patients and clinicians. Additionally, important insights were gleaned regarding the involvement of older patients in PD for health technology.

Document Type

Article

Publication Date

8-1-2019

Publication Title

Applied Clinical Informatics

First Page

707

Last Page

718

Comments

Conflict of interest statement

T.T. declares the following: Research grants, Medtronic, Inc., Biotronik, Janssen Pharmaceuticals, and iRhythm Technologies, Inc. M.M. declares the following: Compensation for services, Zoll Medical Corporation; Equity interests/stock options—Non-public, Murj Inc./Viscardia; Equity interests/stock options—Public, iRhythm Technologies; Research grants, Medtronic, Inc., Biotronik, Janssen Pharmaceuticals; and Indiana University Trustee. R.A., R.R.G., C.D., R.H., S.W., A.C., and E.M. declare no conflicts of interest. Dr. Mirro reports grants from Biotronik, Inc, during the conduct of the study; grants from Agency for Healthcare Research and Quality (AHRQ), Medtronic plc, Janssen Scientific Affairs, consulting fees / honoraria from iRhythm Technologies, Inc., Zoll Medical Corporation, and nonpublic equity/stock interest in Murj, Inc./Viscardia outside the submitted work. Dr. Mirro's relationships with academia include serving as trustee of Indiana University. Dr. Toscos reports grants from Biotronik, Inc, during the conduct of the study; grants from Medtronic plc, Janssen Scientific Affairs, and iRhythm Technologies, Inc, outside the submitted work.

Download

Share

COinS