Closing the patient-provider gap along the surgical journey one click at a time: results of a phase I pilot trial of a patient navigation tool

Abstract

BackgroundPatients diagnosed with complex hepato-pancreaticobiliary (HPB) conditions experience a challenging journey through the healthcare system. Patient navigation is commonly offered to patients and their caregivers throughout this process. Here, we report on the development and phase I testing of a prototype web-based dual (patient and provider) navigation application ‘PatientNav.’MethodsEvidence-based recommendations were determined through a needs assessment. The PatientNav app was designed to be a highly customizable tool based on the needs of the patients, the care team, and the characteristics of the institution. Our phase I pilot trial targeted adult patients who reported the capacity to use a mobile app or desktop website presenting to our HPB transplant clinic at MedStar Georgetown University Hospital/Lombardi Comprehensive Cancer Center over two months. Usability, functionality, and reliability testing were conducted by applying multiple strategies, including biometric data analysis, task completion, questionnaires, and interviews.ResultsOut of 22 patients, 18 (81.8%) completed the in-app survey whose responses were included in the analysis. The usability rate of PatientNav among patient app users was 95.4%. Among patient app users who completed the in-app survey questionnaire, 66.6% reported that the content in the PatientNav app was relevant. In terms of the app's reliability, none of the patient app users reported technical issues with accessing PatientNav throughout the study period. To further elucidate the characteristics of individuals who exhibited high usage of the PatientNav assigned task functions, we divided our cohort based on the median number of tasks used (N = 75 total tasks). The univariable comparison showed that high function users were older, with a median (IQR) age of 61.5 (57.8, 71.3) compared to 52.2 (34.5, 65.7) years among low function users. No differences were observed based on gender, racial distribution, living condition, or occupation. However, 41.7% of low function users had Medicare/Medicaid insurance, whereas all high function users had private or combined insurance.ConclusionOur phase I pilot study showed that PatientNav is a feasible, usable, and functional technological tool that enables patients with complex HPB diagnoses and their care team to interface in real-time using patient-reported outcome measures (PROMs). PatientNav is a reliable tool that can be used by clinical and support staff to help navigate patients through surgery and aftercare and by patients to assist in navigation and self-management.Trial registrationThe trial was registered at ClinicalTrials.gov; Registration number: NCT04892927; date of registration: 5/19/2021.