Enhancing a Home Care eHealth Application for Stroke Survivors with Multiple Chronic Conditions – Bringing Primary Care into the Circle of Care

Abstract

The Canadian elderly population living with multiple chronic conditions (MCCs) is increasing. Multiple health care settings need to be involved in patients’ care management with this vulnerable group. Therefore, meaningful collaboration and communication among health care providers in different sectors, especially at transition points, is highly desirable. This study focuses on the co-design of an expansion of an existing eHealth App (MyST) to include primary care providers who are in the stroke survivors’ circle of care. MyST was originally developed for the home care sector and is currently accessible by home care providers, patients and their caregivers. Primary care providers, another group of users of the proposed enhanced version of MyST, were not engaged in the design process. The objective of this study is to identify this user group’s requirements and develop specifications for the design and development of MyST 2 to be implemented in real practice settings. Persona-scenario co-design methodology was used for data collection. Two persona scenario discussion sessions were conducted with 5 health care professionals from different primary care practices. Three nurses participated in one session, and a dietitian and a social worker participated in another session. Participants in groups created personas and scenarios where their persona interacted with members of the circle of care using MyST 2. Eight themes were identified in the data analysis process: Inter-professional team communication, Patient safety approach, Access to non-medical information, Facilitation of referral to community services and resources, Patient-centred care, System integration, Clinic EMR as a complementary tool, and Implementation considerations. Related to each theme, a list of design specifications was created, including required modules and features, and implementation specifications such as hardware requirements, team members’ responsibilities, MyST 2 use policies, patient privacy, and provider training. The identified requirements will also inform the design and development of future Apps that support patients with MCCs who require home care.