Co-design of a remote monitoring application for the first month following colorectal cancer surgery


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Morven Miller1,John Connaghan1,Lisa McCann1,Hester Van-Wyk2,Campbell Roxburgh2,Roma Maguire1
1University of Strathclyde,2University of Glasgow

Abstract

Background

Prompt identification of post-operative complications is associated with better outcomes. This study aimed to co-design a remote monitoring application with patients and clinicians to support care in the month following colorectal cancer surgery.

Method

Co-design enables ‘users’ to make creative contributions to the formulation and solution of problems, based on the premise that they are ‘experts’ of their own experience and central to the design process. Four co-design, multi-method sequential phases were used to produce a high-fidelity remote monitoring application prototype for people with colorectal cancer following surgery:

Discover – evaluating the role of digital health interventions and identifying recommendations for future design through literature review

Define – interviews/focus groups with patients and clinicians gathered perspectives about post-operative experiences and attitudes towards remote monitoring

Develop – exploring user experience through a paper-based prototype of the app using ‘keep, change, lose’ and ‘think aloud’ techniques with patients while focus groups gathered clincians’ perspectives

Deliver – conducting user interface design/acceptance testing of the electronic prototype with patients; prioritisation of app content/functionality by clinicians using the MoSCoW method.

Results

Focus groups/interviews with patients and clinicians identified similar elements (physical, emotional and social) for inclusion in the app plus positive attitudes towards the concept of remote monitoring, supporting the evidence from literature review.

Patient experience with the paper-based prototype was positive and clinicians expressed promising attitudes towards further development. Patients identified supportive information, interactivity, camera function and personalisation as important key features of app development.

User-interface testing found that patients navigated the app easily, believed its content was relevant and most would have used it had it been available. Clinicians prioritised acute symptom assessment, self-care advice, real-time reporting and alerting functions for future app development.

Conclusion

Sequential co-design methods successfully resulted in the development of a first prototype application for remote monitoring of patients following colorectal cancer surgery, sensitive to issues identified by patients and clinicians.