PHASE I PILOT TRIAL OF A DUAL-FACING PATIENT NAVIGATION TOOL: A RELIABLE TOOL FOR PROVIDERS DELIVERING INDIVIDUALIZED CARE TO COMPLEX PATIENTS
Sami Shoucair*1,2, Gregory Downing2, jacqueline Orourke2, E. L. Greenberg2, Young-bai M. Yea3, Gunjan Vatas3, Paula Kim2, Thomas Fishbein2, Keith Unger2, Emily Winslow2
1Surgery, MedStar Franklin Square Medical Center, Baltimore, MD; 2Georgetown University, Washington, ; 3GMGArcdata, Washington,
Introduction: Patients diagnosed with hepatopancreaticobiliary conditions experience a complex journey through the healthcare system requiring a high level of coordination and communication with the clinical care team. Patient navigation reduces psychosocial burdens and potentially provider cognitive burden, improving efficiency and cost-effectiveness during cancer care. We developed and tested a prototype web-based dual facing (patient and provider) application ‘PatientNav' that serves as a central platform for patient education and facilitates communication between the patient and provider care team.
Methods: The phase I pilot trial enrolled individuals (≥18 years) with capacity to use a mobile app or desktop website over a 2-month period. In addition to routine care processes, PatientNav enabled the clinical care team to assign tasks tailored to patient's needs (educational material, videos, daily activities). Usability, functionality and reliability testing was conducted through biometric task completion data, in-app questionnaires and virtual interviews recording subjective qualitative responses from patient navigators and clinical care team members.
Results: A total of 22 patients consented to participate with a high app usability rate (95.4%) irrespective of age, race or occupation. After task assignment, care team members accessed a "provider platform" to track patient vitals, drain output logs, image uploads, and observe trends over a 3-day period with abnormal values requiring immediate attention highlighted in red. Preoperative education usage was most evident for patient education regarding hospital stay: Are you Packed? What to take to the Hospital"(77.2%); Tips for Family and Friends (63.6%). The rate of daily tasks assigned by care team members for postoperative monitoring was highest for weight (80.9 %) and walking input (90.4%). In-app surveys tailored to patient needs (Depression PHQ2, pain, SRS13 Fatigue survey) were filled at 100%, 94.1% and 90.4%. Patient interviews highlighted the value of uploading images for themselves and their caregivers:"I live 1.5 hours away. How else can they tell what's going on? Photos are helpful. My wife got data into the computer. I don't have to be savvy." In terms of efficiency and workload, care team navigators emphasized the app's role in reviewing data and images in an organized, timely manner allowing better communication.
Conclusion: PatientNav app is a highly customizable tool with a reliable modular design that allows flexibility for the care team to tailor tasks to individual patient needs. Our study was unique in portraying perspectives of both patients and providers highlighting an opportunity for hospital systems and stakeholders to implement user-centered tools embedded with electronic health record to address the unmet needs aimed at closing the gap between patients and their care team.
PatientNav patient navigator platform view showing daily tasks assigned by provider (left: vital signs and walking), and sample task completion (right: temperature and photo upload).
Usage rate in patient access to education material and assigned tasks on PatientNav.
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