User-centered design of a patient-generated health data mobile application for primary care visits for older adults with chronic pain

Objectives To design the provider-facing side of an application that collects and displays contextual patient-generated health data (PGHD) as a means of facilitating patient-centered care for older adults with chronic pain in the Veterans Health Administration (VHA). Materials and Methods We conducted one-on-one user-centered design (UCD) sessions with VHA clinicians who care for veterans age 65 years and older with chronic pain. We elicited information about clinical practices, barriers and facilitators to working with patients with chronic pain, and types of patient information that could provide utility in the delivery of care. We displayed a wireframe prototype of the PGHD application to elicit feedback and preferences about information to collect, desired functionality, visual design, and possible workflows. Results From 21 UCD sessions with clinicians, we identified 3 overarching themes: (1) specific contextual information could facilitate patient-centered care for older adults with chronic pain (information needs); (2) clinicians have specific desired uses for PGHD (functional requirements); and (3) clinicians have specific beliefs about how PGHD can and should be integrated into clinical practice (implementation strategies). Discussion PGHD integration in clinical care for older adults with chronic pain was perceived favorably among VHA clinicians, with specific utility for this technology anticipated. The ways in which PGHD is accessed, integrated, and shared were perceived as critically important to its future implementation and potential for improving patient-centered care. Conclusion Display of contextual PGHD from older adults with chronic pain is promising to VHA clinicians, but barriers to implementation in clinical practice need to be addressed.