Exploring patient-centered design solutions of a telehealth app for HIV − A qualitative study

Jannik Schaaf, Timm Weber, Michael Von Wagner, Christoph Stephan, Susanne Köhler, Alexander Voigt, Richard Noll, Holger Storf, Angelina Müller

Keywords: user-centered-design, telehealth, patient-centered, collaboration

Background:

The COMTRAC-HIV (Communication-and-Tracing-App-for-HIV) project is focused on the development of an innovative mobile health (mHealth) application aimed at facilitating integrated care for individuals living with HIV in Germany. Given the intricate nature of HIV treatment and the necessity for continuous, patient-centered care. This qualitative study investigates potential design approaches and evaluates a prototype to optimize the app's functionality and improve its overall effectiveness for both patients and healthcare providers.

Research questions:

How does a telehealth app for HIV have to be designed in terms of functionalities and usability to meet the expectations and needs of patients?

Method:

A cohort of eight individuals, including HIV patients and users of pre-exposure prophylaxis, recruited from the HIVCenter, to participate in focus groups and think-aloud (TA) usability tests. An interactive prototype was developed based on the results of focus groups. The usability of this prototype was subsequently assessed through TA tests. Data collection involved video and audio recordings for comprehensive analysis. A qualitative analysis was performed using a deductive category system.

Results:

The app was praised for its straightforward and user-friendly design, particularly its features for medication reminders and health tracking.
In the think-aloud (TA) usability test, a total of 25 usability issues were identified, majority in the categories of layout (n = 6), navigation (n = 5), interaction (n = 5), and terminology (n = 5). Examples of these issues included non-intuitive controls and poorly placed buttons. Despite these challenges, participants provided positive feedback in the satisfaction category (n = 5), reflecting an overall favorable impression of the app.

Conclusions:

The study underscores the importance of patient-centered design in mobile solutions for HIV care, emphasizing the app's user-friendliness and its potential to improve patient care and engagement. However, further research is needed to refine its functionality and ensure alignment with both clinical requirements and patients' privacy concerns.

Points for discussion:

In which phase of the development of telehealth apps should we involve patients?

How can we address for example comorbidities and different social backgrounds in development of telehealth systems?

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