Purpose: Revolutionizing the partnership with end users during the system development lifecycle by developing innovative patient engagement tools that have meaningful impact on workflows and patient experiences.

Description: Patient engagement is essential to promoting optimal outcomes and meaningful patient centered care in the oncology setting. At an NCI-designated comprehensive cancer center, inpatient services were expanded with the construction of a new smart hospital that included patient engagement tools. When designed correctly, tools supporting patient engagement promote involvement in treatment and support patient-centered care. This requires thoughtful development of the technologies within the smart hospital.

Historically in the system development lifecycle, end users are consulted after conception of the initial design. Nursing informaticists at the cancer center supported the design of novel technologies by restructuring concepts of the system development lifecycle. Key stakeholders were pursued from the infancy of the project as opposed to obtaining feedback after initial technology feasibility was reviewed. This was accomplished by coordinating weekly sessions with end users to create a foundation of their expectations of the technology. Thereafter, weekly meetings transitioned to design sessions that focused on the foundation and allowed for the development of innovative products. Most importantly, engagement was not limited to clinical teams but also included patients and families. Patients are a valuable member of the multidisciplinary team as they are experts on how oncology treatments impact their quality of life. To ensure the tools impacted the continuum of care, stakeholders were empowered to design the products and utilize the informaticists as partners in the system design lifecycle.

This partnership ensured the implemented technologies integrated with the electronic medical record and supporting systems, nurse call platform, and staff announcement tool. Nurses and patients designed engagement tools, including digital whiteboards and door signs, patient education videos, clinical notifications, and daily patient tasks. One essential tool for both the patients and the clinicians was the ability to automate patient-facing displays based on modifications to the treatment plan. Formerly, nurses were responsible for a manual process that included writing updates on a whiteboard or posting a sign. The inclusive design approach leveraged digital integrations and allowed a manual workflow to become automated.

Outcome: The process of designing the patient engagement solutions was dynamic and required the stakeholders to serve as the primary experts throughout the system design lifecycle. This was particularly important when reviewing automation workflows. Workflow automation should be developed to promote patient experience and remove administrative duties from the clinical workflow. As a result of the partnership developed, patient satisfaction surveys have been positive with feedback supporting the use of the tools created. Furthermore, clinical leadership and representation from the patients have expressed their support of continued early engagement when developing tools that impact experience. This suggests that stakeholders should be approached as early-on collaborative partners in the system design lifecycle to ensure product development meet the needs of patient-centered care.

Marissa Wafford discloses that she is a project manager of healthcare services for physIQ.

Timothy Demid BSN, RN, NI-BC

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