Using cardiac implantable electronic device data to facilitate health decision making: A design study

For some individuals who live with chronic heart failure (CHF), cardiac implantable electronic devices (CIEDs) offer lifesaving therapy. Remote monitoring data from CIEDs are transmitted on a routine schedule for highly trained clinical staff to review. However, the remote monitoring data and clinic...

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Bibliographic Details
Published in:International journal of industrial ergonomics 2018-03, Vol.64, p.143-154
Main Authors: Rohani Ghahari, Romisa, Holden, Richard J., Flanagan, Mindy E., Wagner, Shauna, Martin, Elizabeth, Ahmed, Ryan, Daley, Carly N., Tambe, Rehab, Chen, Elizabeth, Allmandinger, Tina, Mirro, Michael J., Toscos, Tammy
Format: Article
Language:English
Subjects:
Adults
Cardiac resynchronization therapy-cardiac implantable electronic device (CRT-CIED)
Cardiovascular disease
Chronic heart failure (CHF)
Decision making
Decisions
Delivery scheduling
Design
Design requirements
Education
Electronic devices
Electronic equipment
Electronic health records
Electronic medical records
Focus group
Heart
Heart diseases
Heart failure
Medical records
Patient empowerment
Patients
Personal health
Personal health record (PHR)
Remote monitoring
Transplants & implants
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Summary:For some individuals who live with chronic heart failure (CHF), cardiac implantable electronic devices (CIEDs) offer lifesaving therapy. Remote monitoring data from CIEDs are transmitted on a routine schedule for highly trained clinical staff to review. However, the remote monitoring data and clinical interpretations are not directly accessible to patients. Hence, people living with CIEDs are not able to reflect on their health data, let alone take any health action based on relevant data buried in their electronic health record (EHR). Prior research has shown that properly timed and tailored health data through a personal health record (PHR) can enable individual decisions about health in novel ways. However, in order to be effective, patients’ needs must be well described before designing a tailored intervention. This study is an early investigation into ways in which complex CIED data can be harnessed to guide the health decisions of individuals living with CHF. To understand these information needs, we conducted four focus groups (N = 24) comprised of adults living with CHF (who were undergoing remote monitoring of their CIED data) and their informal caregivers (spouse or adult child). Focus group participants shared preferences for on-demand and personalized push message education. Through our analysis, we identified specific elements of device data and delivery design that can help promote reflection on changes in disease progression and CIED function over time. In this paper, we describe design ideas for the delivery of tailored CIED data and education that supports patient-level decision making. •Patients wanted the device data that supported reflection on changes over time.•Patients preferred to receive data within a normal range on-demand.•Patients preferred to be notified immediately if data is within abnormal range.•Patients preferred to have access to educational information at any time on-demand.
ISSN:0169-8141
1872-8219
DOI:10.1016/j.ergon.2017.11.002