Assessment of usability and viability in clinical practice of the Nabelia mHealthCare Platform to support integrated care management of patients with pulmonary hypertension

Abstract

Introduction : Pulmonary hypertension (PH) is a rare, life-threating disease that requires complex long term management, often involving coordination of actions across different agencies and jurisdictions. This is a challenging scenario to the effective delivery of care. Adoption of an integrated care (IC) approach with a sensible use of enabling technology can be a way of successfully dealing with this complexity. Aims : a) To assess the usability and potential feasibility in clinical practice of the Nabelia mHealthCare Platform, in the IC management of patients with Pulmonary Hypertension and; b) to identify areas in need of improvement in collaboration with patients and professionals Material and method : This qualitative research study involved two distinct groups chosen for convenience: 1) Patients’ group, patients with a pulmonary arterial hypertension (HAP) diagnose and/or chronic thromboembolic hypertension (HPTEC); and, 2) Health professionals’ group. In both groups, we carried out : 1) user tests followed by administration of a questionnaire (adaptation of the SUMI questionnaire items); 2) Focus groups sessions (1 patients, 1 professionals). A total of 23 people participated in this study (12 patients, 7 practitioners and 4 nurses). Informed consent was obtained from all participants. The study was completed by a heuristic assessment of the platform that was undertaken by a specially trained researcher. Results : Professionals highlighted that the Platform facilitated: 1) the sharing of information (notably in the case of treatment prescribed), 2) coordination of actions (remote monitoring data) and 3) communication with patients. Patients’ appraisals of the platform differed. Globally, it was viewed as an interesting tool and patients especially valued the accessibility to the information about their condition and the easiness to share this information with the different health professionals. Perceptions on the benefits of using the mobile application to manage everyday life depended on patients’ age and treatments’ complexity. Thus, younger patients were more favorable towards its use while elders were more reluctant. Heuristic evaluation. The aspects that were best ranked where those related with the clarity of the interface (adequate management of spaces and text, visual structure of the information, easily recognizable links), consistency in its design (elements, actions, language, navigation), and architecture (organizational system, elements and terms used in the navigation menu). Usability elements in need of attention were those related with system status, information flow, aid in its actions, clarity of information, control by user, readability and configuration. The application is easy to learn and uses standard tags and a language close to professionals with helpful graphics though in some parts readability could be improved. Control of the application by the user was acceptable at the current status of development. Conclusions : At its current stage of development the Nabelia mHealthCare Platform has a good usability and can be potentially applied in the management of patients with pulmonary hypertension. Professionals and patients think that the application facilitates the management of the disease, allows closer follow-up and monitoring and improves coordination across levels of health care. Attention to acceptance and usability issues in the group of older patients is, however, required.