Developing an Intranet-Based Lymphedema Dashboard for Breast Cancer Multidisciplinary Teams: Design Research Study.


Journal

Journal of medical Internet research
ISSN: 1438-8871
Titre abrégé: J Med Internet Res
Pays: Canada
ID NLM: 100959882

Informations de publication

Date de publication:
21 04 2020
Historique:
received: 19 12 2018
accepted: 30 08 2019
revised: 06 05 2019
entrez: 22 4 2020
pubmed: 22 4 2020
medline: 28 10 2020
Statut: epublish

Résumé

A large quantity of data is collected during the delivery of cancer care. However, once collected, these data are difficult for health professionals to access to support clinical decision making and performance review. There is a need for innovative tools that make clinical data more accessible to support health professionals in these activities. One approach for providing health professionals with access to clinical data is to create the infrastructure and interface for a clinical dashboard to make data accessible in a timely and relevant manner. This study aimed to develop and evaluate 2 prototype dashboards for displaying data on the identification and management of lymphedema. The study used a co-design framework to develop 2 prototype dashboards for use by health professionals delivering breast cancer care. The key feature of these dashboards was an approach for visualizing lymphedema patient cohort and individual patient data. This project began with 2 focus group sessions conducted with members of a breast cancer multidisciplinary team (n=33) and a breast cancer consumer (n=1) to establish clinically relevant and appropriate data for presentation and the visualization requirements for a dashboard. A series of fortnightly meetings over 6 months with an Advisory Committee (n=10) occurred to inform and refine the development of a static mock-up dashboard. This mock-up was then presented to representatives of the multidisciplinary team (n=3) to get preliminary feedback about the design and use of such dashboards. Feedback from these presentations was reviewed and used to inform the development of the interactive prototypes. A structured evaluation was conducted on the prototypes, using Think Aloud Protocol and semistructured interviews with representatives of the multidisciplinary team (n=5). Lymphedema was selected as a clinically relevant area for the prototype dashboards. A qualitative evaluation is reported for 5 health professionals. These participants were selected from 3 specialties: surgery (n=1), radiation oncology (n=2), and occupational therapy (n=2). Participants were able to complete the majority of tasks on the dashboard. Semistructured interview themes were categorized into engagement or enthusiasm for the dashboard, user experience, and data quality and completeness. Findings from this study constitute the first report of a co-design process for creating a lymphedema dashboard for breast cancer health professionals. Health professionals are interested in the use of data visualization tools to make routinely collected clinical data more accessible. To be used effectively, dashboards need to be reliable and sourced from accurate and comprehensive data sets. While the co-design process used to develop the visualization tool proved effective for designing an individual patient dashboard, the complexity and accessibility of the data required for a cohort dashboard remained a challenge.

Sections du résumé

BACKGROUND
A large quantity of data is collected during the delivery of cancer care. However, once collected, these data are difficult for health professionals to access to support clinical decision making and performance review. There is a need for innovative tools that make clinical data more accessible to support health professionals in these activities. One approach for providing health professionals with access to clinical data is to create the infrastructure and interface for a clinical dashboard to make data accessible in a timely and relevant manner.
OBJECTIVE
This study aimed to develop and evaluate 2 prototype dashboards for displaying data on the identification and management of lymphedema.
METHODS
The study used a co-design framework to develop 2 prototype dashboards for use by health professionals delivering breast cancer care. The key feature of these dashboards was an approach for visualizing lymphedema patient cohort and individual patient data. This project began with 2 focus group sessions conducted with members of a breast cancer multidisciplinary team (n=33) and a breast cancer consumer (n=1) to establish clinically relevant and appropriate data for presentation and the visualization requirements for a dashboard. A series of fortnightly meetings over 6 months with an Advisory Committee (n=10) occurred to inform and refine the development of a static mock-up dashboard. This mock-up was then presented to representatives of the multidisciplinary team (n=3) to get preliminary feedback about the design and use of such dashboards. Feedback from these presentations was reviewed and used to inform the development of the interactive prototypes. A structured evaluation was conducted on the prototypes, using Think Aloud Protocol and semistructured interviews with representatives of the multidisciplinary team (n=5).
RESULTS
Lymphedema was selected as a clinically relevant area for the prototype dashboards. A qualitative evaluation is reported for 5 health professionals. These participants were selected from 3 specialties: surgery (n=1), radiation oncology (n=2), and occupational therapy (n=2). Participants were able to complete the majority of tasks on the dashboard. Semistructured interview themes were categorized into engagement or enthusiasm for the dashboard, user experience, and data quality and completeness.
CONCLUSIONS
Findings from this study constitute the first report of a co-design process for creating a lymphedema dashboard for breast cancer health professionals. Health professionals are interested in the use of data visualization tools to make routinely collected clinical data more accessible. To be used effectively, dashboards need to be reliable and sourced from accurate and comprehensive data sets. While the co-design process used to develop the visualization tool proved effective for designing an individual patient dashboard, the complexity and accessibility of the data required for a cohort dashboard remained a challenge.

Identifiants

pubmed: 32314968
pii: v22i4e13188
doi: 10.2196/13188
pmc: PMC7201315
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e13188

Informations de copyright

©Anna Janssen, Candice Donnelly, Judy Kay, Peter Thiem, Aldo Saavedra, Nirmala Pathmanathan, Elisabeth Elder, Phuong Dinh, Masrura Kabir, Kirsten Jackson, Paul Harnett, Tim Shaw. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 21.04.2020.

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Auteurs

Anna Janssen (A)

Research in Implementation Science and eHealth Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
Sydney West Translational Cancer Research Centre, Sydney, Australia.
Charles Perkins Centre, The University of Sydney, Sydney, Australia.

Candice Donnelly (C)

Research in Implementation Science and eHealth Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
Sydney West Translational Cancer Research Centre, Sydney, Australia.
Charles Perkins Centre, The University of Sydney, Sydney, Australia.

Judy Kay (J)

Faculty of Engineering, The University of Sydney, Sydney, Australia.

Peter Thiem (P)

Sydney Informatics Hub, The University of Sydney, Sydney, Australia.

Aldo Saavedra (A)

Sydney Informatics Hub, The University of Sydney, Sydney, Australia.
Faculty of Health Sciences, The University of Sydney, Sydney, Australia.

Nirmala Pathmanathan (N)

Westmead Breast Cancer Institute, Sydney, Australia.
Sydney Medical School, The University of Sydney, Sydney, Australia.

Elisabeth Elder (E)

Westmead Breast Cancer Institute, Sydney, Australia.
Sydney Medical School, The University of Sydney, Sydney, Australia.

Phuong Dinh (P)

Sydney Medical School, The University of Sydney, Sydney, Australia.
Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia.

Masrura Kabir (M)

Westmead Breast Cancer Institute, Sydney, Australia.
Sydney Medical School, The University of Sydney, Sydney, Australia.

Kirsten Jackson (K)

Research in Implementation Science and eHealth Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
Sydney West Translational Cancer Research Centre, Sydney, Australia.
Charles Perkins Centre, The University of Sydney, Sydney, Australia.

Paul Harnett (P)

Sydney West Translational Cancer Research Centre, Sydney, Australia.
Sydney Medical School, The University of Sydney, Sydney, Australia.
Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia.

Tim Shaw (T)

Research in Implementation Science and eHealth Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
Charles Perkins Centre, The University of Sydney, Sydney, Australia.

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Classifications MeSH