Matthew A Willis1, Leah Brand Hein1, Zhaoxian Hu2, Rajiv Saran3,4, Marissa Argentina5, Jennifer Bragg-Gresham3,4, Sarah L Krein6,7, Brenda Gillespie8, Kai Zheng2, Tiffany C Veinot1,9. 1. School of Information, University of Michigan, Ann Arbor, Michigan, USA. 2. School of Information and Computer Sciences, University of California, Irvine, California, USA. 3. Division of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA. 4. Kidney Epidemiology and Cost Center, University of Michigan, Ann Arbor, Michigan, USA. 5. National Kidney Foundation, New York City, New York, USA. 6. Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA. 7. Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, USA. 8. Department of Biostatistics, Consulting for Statistics, Computing and Analytics Research, University of Michigan, Ann Arbor, Michigan, USA. 9. School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Abstract
OBJECTIVE: Hemodialysis patients frequently experience dialysis therapy sessions complicated by intradialytic hypotension (IDH), a major patient safety concern. We investigate user-centered design requirements for a theory-informed, peer mentoring-based, informatics intervention to activate patients toward IDH prevention. METHODS: We conducted observations (156 hours) and interviews (n = 28) with patients in 3 hemodialysis clinics, followed by 9 focus groups (including participatory design activities) with patients (n = 17). Inductive and deductive analyses resulted in themes and design principles linked to constructs from social, cognitive, and self-determination theories. RESULTS: Hemodialysis patients want an informatics intervention for IDH prevention that collapses distance between patients, peers, and family; harnesses patients' strength of character and resolve in all parts of their life; respects and supports patients' individual needs, preferences, and choices; and links "feeling better on dialysis" to becoming more involved in IDH prevention. Related design principles included designing for: depth of interpersonal connections; positivity; individual choice and initiative; and comprehension of connections and possible actions. DISCUSSION: Findings advance the design of informatics interventions by presenting design requirements for outpatient safety and addressing key design opportunities for informatics to support patient involvement; these include incorporation of behavior change theories. Results also demonstrate the meaning of design choices for hemodialysis patients in the context of their experiences; this may have applicability to other populations with serious illnesses. CONCLUSION: The resulting patient-facing informatics intervention will be evaluated in a pragmatic cluster-randomized controlled trial in 28 hemodialysis facilities in 4 US regions.
OBJECTIVE: Hemodialysis patients frequently experience dialysis therapy sessions complicated by intradialytic hypotension (IDH), a major patient safety concern. We investigate user-centered design requirements for a theory-informed, peer mentoring-based, informatics intervention to activate patients toward IDH prevention. METHODS: We conducted observations (156 hours) and interviews (n = 28) with patients in 3 hemodialysis clinics, followed by 9 focus groups (including participatory design activities) with patients (n = 17). Inductive and deductive analyses resulted in themes and design principles linked to constructs from social, cognitive, and self-determination theories. RESULTS: Hemodialysis patients want an informatics intervention for IDH prevention that collapses distance between patients, peers, and family; harnesses patients' strength of character and resolve in all parts of their life; respects and supports patients' individual needs, preferences, and choices; and links "feeling better on dialysis" to becoming more involved in IDH prevention. Related design principles included designing for: depth of interpersonal connections; positivity; individual choice and initiative; and comprehension of connections and possible actions. DISCUSSION: Findings advance the design of informatics interventions by presenting design requirements for outpatient safety and addressing key design opportunities for informatics to support patient involvement; these include incorporation of behavior change theories. Results also demonstrate the meaning of design choices for hemodialysis patients in the context of their experiences; this may have applicability to other populations with serious illnesses. CONCLUSION: The resulting patient-facing informatics intervention will be evaluated in a pragmatic cluster-randomized controlled trial in 28 hemodialysis facilities in 4 US regions.
Authors: Kai Zheng; Mark W Newman; Tiffany C Veinot; Maureen Hanratty; Hyojeong Kim; Chrysta Meadowbrooke; Erica E Perry Journal: AMIA Annu Symp Proc Date: 2010-11-13
Authors: William H Sledge; Martha Lawless; David Sells; Melissa Wieland; Maria J O'Connell; Larry Davidson Journal: Psychiatr Serv Date: 2011-05 Impact factor: 3.084
Authors: Saul N Weingart; Maria Toth; Jonathan Eneman; Mark D Aronson; Daniel Z Sands; Amy N Ship; Roger B Davis; Russell S Phillips Journal: Int J Qual Health Care Date: 2004-12 Impact factor: 2.038
Authors: Bonnie S Dean; Michael J Decker; Diane Hupp; Andrew H Urbach; Elizabeth Lewis; Jocelyn Benes-Stickle Journal: J Healthc Qual Date: 2008 May-Jun Impact factor: 1.095
Authors: Jane K O'Hara; Rebecca J Lawton; Gerry Armitage; Laura Sheard; Claire Marsh; Kim Cocks; Rosie R C McEachan; Caroline Reynolds; Ian Watt; John Wright Journal: BMC Health Serv Res Date: 2016-11-28 Impact factor: 2.655
Authors: Jessica S Ancker; Natalie C Benda; Madhu Reddy; Kim M Unertl; Tiffany Veinot Journal: J Am Med Inform Assoc Date: 2021-11-25 Impact factor: 4.497
Authors: Traber D Giardina; Debra T Choi; Divvy K Upadhyay; Saritha Korukonda; Taylor M Scott; Christiane Spitzmueller; Conrad Schuerch; Dennis Torretti; Hardeep Singh Journal: J Am Med Inform Assoc Date: 2022-05-11 Impact factor: 7.942