Visualization of Cardiac Implantable Electronic Device Data for Older Adults Using Participatory Design
Visualization of Cardiac Implantable Electronic Device Data for Older Adults Using Participatory Design
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DOI：
10.1055/s-0039-1695794
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发表时间：
2019-08-01
影响因子：
2.9
通讯作者：
Mirro, Michael
中科院分区：
文献类型：
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作者：
Ahmed, Ryan;Toscos, Tammy;Mirro, Michael
心力衰竭（HF）患者通常植入心脏起搏治疗（CRT）器械作为其治疗的一部分。目前，他们无法直接访问这些设备生成的远程监控（RM）数据，这意味着错失了增加护理知识和参与度的机会。然而，电子健康数据共享可能会给临床医生和患者带来信息过载问题，并且一些老年患者可能不愿意使用该技术（即，计算机和智能手机）访问这些数据所必需的。为了缓解这些问题，患者可以直接参与创建根据其偏好和需求量身定制的数据可视化，使他们能够成功地解释和处理他们的健康数据。我们与7名HF和CRT器械植入的成人患者进行了参与式设计（PD）会议，这些患者目前正在接受RM，沿着有两名非正式护理人员。参与者分成三个团队，使用绘图用品和设计卡片设计一个面向患者的仪表板原型，他们可以使用该仪表板处理设备数据。患者在“主仪表板”屏面中被评为高优先级的信息包括起搏异常警报的平均百分比、其他器械信息（如电池寿命和记录的事件）以及关于数据相关问题联系人的信息。包含在“附加信息”显示中的首选项包括每日起搏图表、健康提示、中止电击、症状列表和日志。这些结果为创建实际的仪表板原型提供了信息，该原型随后由患者和临床医生进行评估。此外，收集了关于老年患者参与PD的重要见解。
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.