Making the most of the waiting room: Electronic patient engagement, a mixed methods study

Developing digital applications for tailored communication in orthopaedics using a Research through Design approach

OBJECTIVE

Tailored communication and information provision is expected to contribute to patient-centred care (PCC) in total hip arthroplasty (THA). In previous research, three subgroups of THA patients were identified that are similar in their clinical, psychological and communication characteristics. Preliminary subgroup-specific design guidelines were also formulated. Using these insights as a starting point, a theoretical framework was developed for tailored information provision and communication using digital applications. This study aims to refine the framework as well as subgroup-specific design guidelines for digital applications.

METHODS

This study uses a Research through Design (RtD) approach, generating insights both from the development and evaluation of prototypes in the early design stage. Paper-based prototypes will be made for each subgroup and evaluated with patients and care providers. Semi-structured interviews are held with participants exploring their experiences with the prototype. A quasi-experiment with a non-random control cohort is used to validate the qualitative findings. Post-surgery consultations with and without prototype are videotaped and scored using a structured instrument.

RESULTS

A design diary will be used to summarize design decisions and considerations. Feedback from participants is analysed inductively. Adaptations in subgroup-specific guidelines will be based on comparison of verbal feedback and descriptive statistics from consultations with and without prototype.

CONCLUSIONS

Although mixed-method feasibility studies of digital health interventions are common, this protocol also considers the utility of the early design process and the designer's perspective for realizing PCC and tailored care.

Equitable Participation in Biobanks: The Risks and Benefits of a "Dynamic Consent" Approach

Participation in biobanks tends to favor certain groups—white, middle-class, more highly-educated—often to the exclusion of others, such as indigenous people, the socially-disadvantaged and the culturally and linguistically diverse. Barriers to participation, which include age, location, cultural sensitivities around human tissue, and issues of literacy and language, can influence the diversity of samples found in biobanks. This has implications for the generalizability of research findings from biobanks being able to be translated into the clinic. Dynamic Consent, which is a digital decision-support tool, could improve participants' recruitment to, and engagement with, biobanks over time and help to overcome some of the barriers to participation. However, there are also risks that it may deepen the “digital divide” by favoring those with knowledge and access to digital technologies, with the potential to decrease participant engagement in research. When applying a Dynamic Consent approach in biobanking, researchers should give particular attention to adaptations that can improve participant inclusivity, and evaluate the tool empirically, with a focus on equity-relevant outcome measures. This may help biobanks to fulfill their promise of enabling translational research that is relevant to all.

Digitization of the health sector in Pakistan: challenges and opportunities to online health communication: A case study of MARHAM social and mobile media

OBJECTIVE

Social and mobile media are playing a significant role in the digitization of health sectors globally. New technology provides an opportunity for stakeholders (i.e., patients and healthcare professionals) to engage with each other in virtual environments to discuss health-related issues. This study examines the role of social and mobile media in digitizing the health sector in Pakistan through MARHAM, the platform which is the subject of this case study.

METHOD

A thematic content analysis of MARHAM's social media (Facebook group, Facebook page, and Twitter account) and mobile media application ("app" and website) were chosen for sampling. Some 6083 group posts, 1724 tweets and 1123 Facebook posts populated our sample.

RESULTS

Analysis results indicate that MARHAM's Facebook group most often fields patient inquiries. The most discussed health issues were: women's health issues (43.23%), children's diseases (16.63%), psychological issues (15.45%), dental issues (9.50%), skin problems (5.93%), others (5.04%), and obesity (4.19%). MARHAM's Facebook page and Twitter account were mainly used for health education and awareness. Their mobile application and website were used by healthcare professionals and for patient registration.

CONCLUSION

The study's results suggest that MARHAM is playing a significant role in the health sector of Pakistan, addressing primarily women and children's issues through their Facebook group. Like many who have an online presence, MARHAM faces certain challenges, including the public's low literacy rates and scant Internet access.