MHealth for breast cancer patient navigation: What patients want—What clinicians need.

Abstract

e19244 Background: mHealth interventions support patient behavior change, promote adherence to treatment provide patient education, and clinical decision support. Research on mHealth interventions has focused on unidirectional communication from providers to patients. mHealth to support patient navigation through multidisciplinary breast cancer care (MBCC) has not been realized. Our team explored the information needs and perceived benefits and barriers to the design and adoption of mHealth solutions to support patient-centered MBCC. Methods: We conducted a prospective cohort study with patients and family members of patients with breast cancer (Stage 0-III), clinicians and practice staff participated semi-structured interviews/focus group to explore stakeholder perceptions of mHealth across the domains of: information needs, communication, technology preferences, and barriers and facilitators to adoption and implementation. Transcripts were analyzed using concurrent content analysis and recruitment continued until saturation of themes was achieved within each stakeholder group. Results: We conducted 22 interviews and 5 focus groups with 49 participants generating 466 individual responses. Patients, clinicians, and staff found existing communication pathways (e.g., calls to office, patient portal) sufficient in meeting patient’s needs. Family members and caregivers saw the potential of mHealth as beneficial to decision-making and treatment adherence. Patient access to health information on a smartphone between visits was perceived positive to support care organization. Clinicians and staff recognized the need for patient engagement to optimize treatment outcomes. Concerns about workload, privacy and security, and misinterpretation of information shared in mHealth apps were perceived as barriers to adoption. Recommendations included EHR integration, existing “in-box” management workflow, and team engagement in information management processes. Conclusions: mHealth can play a pivotal role in supporting patient-clinician-family dynamics for MBCC. Designers of mHealth should carefully consider the relative value of applications to the clinical workflow, patient and family needs, and identify team-based approaches to supporting adoption and implementation.