Connect technology to patients' daily lives to boost engagement

Just as technology vendors have learned the importance of integrating systems such as computerized physician order entry into healthcare employees' workflow, new research advocates similar attention to patients' needs in gaining--and maintaining--their engagement in self-care technology.

The research, published at the Journal of the American Medical Informatics Association, refers to the effort patients and family members exert for health maintenance as "patient work." That work might be visible, physical tasks or it might be invisible tasks, such as thinking about what needs to be done.

It urges tech developers to better align technology with patients' abilities, relationships, community factors and daily activities. Taking this approach, the researchers say, offers rich design opportunities.

They point to five key components: the people involved; the tasks to be completed; the tools they'll use; the physical environment; and the social-organizational environment. A good fit with these factors increases likelihood that the task will be performed effectively, while breakdowns occur from a bad fit. A poor fit also might lead the patient to abandon the task all together, according to the researchers.

Treatment adherence might be affected in disadvantaged neighborhoods, for instance, while providers might see the problem as lack of compliance. For expample, a woman might not use an online application if she has to walk to the library through an unsafe neighborhood to use a computer or if the computer is located where she has little privacy.

The researchers call for more research on the nature of this patient work and how that can best be translated into application design.

With patient engagement becoming ever more the focus in healthcare, NewYork-Presbyterian Hospital's Ambulatory Care Network found that low-income immigrant patients with diabetes experienced a dramatic drop in blood sugar, blood pressure and cholesterol levels after participating in a holistic self-management program.

Mobile technology programs in the United Kingdom have freed community health nurses from routine calls so they can spend more time on higher-risk patients, and remote monitoring has boosted the self-management of patients with chronic heart failure or obstructive pulmonary disease.

To learn more:
- read the abstract