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Developing a Digital Health Advisor for Patients with Complex Needs

The Issue

More than 165,000 digital health apps are currently available, most narrow in focus and aimed at relatively healthy individuals. There is no comprehensive set of digital tools to help the frail elderly or individuals with multiple chronic conditions manage their complex health needs. Writing in the Journal of Medical Internet Research, Commonwealth Fund–supported researchers used human-centered design methods to identify the ideal features of a “digital health advisor” that would address the wide-ranging needs of these patients.

What the Study Found

Patients and caregivers interviewed for the study stressed that their medical and functional needs intersect with personal and emotional requirements (see graphic).

A comprehensive digital health advisor could prove valuable to providers by reducing the amount of information they need to collect during visits.

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Based on these insights, the researchers developed a rudimentary prototype of a digital health advisor with four functions aimed at addressing patient and caregiver needs:

  • Track and display key patient health data, like blood pressure and oxygen levels, and functional status over time, while alerting the care team to worrisome changes in health status. Data could be entered manually or collected via sensors and connected devices.
  • Obtain personalized advice about health-related questions, either from a digital assistant or from a care team member via text, phone, or video.
  • Create a holistic picture by communicating the patient's context and his or her goals and preferences with the care team.
  • Create a shared calendar that tracks appointments, as well as a task manager that helps the patient, caregiver, and care team improve communication and coordination.

Experts and health care stakeholders who reviewed the prototype agreed it was technically feasible. But they raised concerns that providing adequate decision support could be challenging because the data needed for such decisions are held by different groups in various formats. The reviewers also recommended developing a simple visual interface and voice activation capabilities for patients with limited cognitive ability or literacy.

The Big Picture

According to health system leaders, a comprehensive digital health advisor could prove valuable to providers by reducing the amount of information they need to collect during visits. The detailed information in the tracking function also could make it easier for a patient’s care team to discuss challenging treatment decisions. Creating a digital health advisor will require extensive collaboration among health care delivery organizations, large retail companies, and consumer advocacy groups.

The Bottom Line

A digital health advisor product could help the frail elderly and individuals with multiple chronic conditions manage their health better and live fuller lives. Next steps will include developing a business model and addressing data and other challenges.

Publication Details

Publication Date: June 19, 2019
Contact: Deborah Lorber, Director, Editorial Services, The Commonwealth Fund
Summary Writer: Maggie Van Dyke
Citation:

Onil Bhattacharyya et al., “Using Human-Centered Design to Build a Digital Health Advisor for Patients with Complex Needs: Persona and Prototype Development,” Journal of Medical Internet Research 21, no. 5 (May 2019): e10318. https://doi.org/10.26099/ts0p-4415

Experts

2015-2016 Harkness Fellow in Residence, The Commonwealth Fund
Kathryn Mossman
Anthropologist and Health Systems Researcher, Institute for Health Systems Solutions and Virtual Care, Women’s College Hospital, Toronto
Lovisa Gustafsson
Assistant Vice President, The Commonwealth Fund
Eric C. Schneider, M.D.
Senior Vice President for Policy and Research, The Commonwealth Fund