Introduction
This page explores a system that allows for the expression of personal preferences for virtual healthcare and responding to these preferences in a meaningful way that reduces barriers. This system is informed by the emerging work on the principles, practices, and approaches from the Guide for Reducing Barriers to Virtual Healthcare (including co-design, subject matter expert interviews, and literature review).
Current State of Software Tools for Patient-Centred Care and Personalized Therapy
Based on some of the current healthcare personalization software tools, the following are the two main categories of tools currently being used to provide personalized care.
Assessment Based Customization
The recipient of care answers a questionnaire (like an intake form) or assessment which the tool uses to determine next steps based on the responses. Based on their responses, the subsequent questions may change and adapt. Ultimately the assessment results are used by a practitioner or by the system to provide more personalized care.
Challenges with assessment based customization
- Individuals may not understand the questions being asked (healthcare literacy).
- The interpretation of questions and responses may be ambiguous or subjective which may make personalization challenging.
- There may be bias in the questions and answers themselves which may lead to skewed assessments.
- It may be unclear what information is relevant to include in responses.
Customization from personal data and observation
The recipient of care provides information directly through a wearable device, logging information, or direct observation from a clinician or practitioner. Treatment is then adjusted based on the recorded data or observations.
Challenges with customization from personal data and observation
- In some cases, individuals are required to track personal information and they may not be able to do so properly.
- Quality of data depends on the participant to use and record the information properly.
- The storage and use of the personal data raises questions about security and privacy.
- Data may not track other relevant factors and qualitative information that may be unique and important to the individual.
- There may be an assumption that the data is complete or provides an accurate picture of the situation.
Inclusively Designed Software Tools for Patient-Centred Care and Personalized Therapy
The current software tools used for healthcare customization can be useful as long as the individual can perform the functions in their intended contexts. For example, in order to use a particular wearable device, the individual requires sufficient digital literacy to configure it, is able to comprehend what is being requested, is comfortable with the privacy and security issues, etc. However, for many people it may not be possible to perform the required functions in a particular context. In these circumstances these customization tools and software platforms create barriers. To improve the usability of virtual healthcare software, these tools and platforms should broaden their adaptability by considering a more dynamic individual who is situated in perpetually changing contexts.
Principles
- Design for diversity: Focusing on the hypothetical average propagates and strengthens inequalities. The more diverse one's needs, the further one finds them self from the hypothetical average. Shifting the baseline to address these diverse needs, provides a system that can expand to cover the needs of all. Systems that adapt and flex to varying needs and preferences are more achievable when this is taken into account in its core design.
- Contextualization can individualize healthcare experiences: Contexts are not singular, there may be multiple contexts that layer and overlap, change rapidly or remain static, and include history, patterns, preferences and needs. Understanding context can remove ambiguity and assumptions, and support enhanced patient-centred care.
- Understandability is fundamental to quality care: Patients and practitioners require meaningful exchanges; lack of understanding and comprehension is a common reason for anxiety and confusion.
Inclusive Practices and tools
The design of these solutions, tools, and processes should include all key stakeholders including, practitioners, patients and patients' circle of care.
Practitioners need tools that enable them to provide services that are more effective and have broader reach. Areas that can be explored:
- Providing opportunities for expressing needs and preferences, and using this information to reduce barriers to healthcare
- How to communicate functional requirements
- Enable understanding of the healthcare process
Developers (vendors) and procurers need to be equipped with tools and guidelines to verify or validate inclusive and accessible features of software tools and platforms.
The Personal Preferences Approach
The Personal Preferences Approach is one way of constructing an Inclusively designed software system. Broadly, it is a collection of scalable and interchangeable tools, processes, and workflows that help create the foundation for discovering and expressing an individual's needs and preferences, and the contexts in which those preferences work best. Virtual healthcare systems may use these needs and preferences to create experiences that are personalized to the individual.