Background: Care management for patients with cancer is especially difficult. Patients and caregivers experience a plethora of unmet needs with information deficits, psychological support, and pain management being the most common. Cancer care coordination can be effective in relieving these gaps but requires successful implementation of technologies to fill these needs. The Personal Health Network (PHN) study sought to understand these gaps through the comparison of the impact of nurse-led care coordination in the presence and absence of a technology-enabled health platform and demonstrated how multiple system solutions, human and technological, can be operationalized to facilitate high-quality cancer care.
Objective: This study aimed to assess user acceptance of the PHN as measured by the Health Technology Acceptance and Use instrument and actual usage of the technology to evaluate usefulness and usability.
Method: The original PHN study was a randomized pragmatic clinical trial of a technology-enabled care coordination intervention for patients initiating chemotherapy. Participants in the intervention arm received care coordination and access to the PHN, while participants in the control group received only care coordination. The HTAU survey was administered to participants in the intervention arm at baseline and 6-months. In this thesis study, acceptance was evaluated based on correlation between the HTAU scores and usage of key PHN functions and the changes in the HTAU scores. A content analysis of secure messages between participants and care coordinators was also conducted to determine the usefulness of the technology for participants.
Results: A total of 30 participants were analyzed in this study. Findings showed no significant correlation between HTAU scores and total usage of the PHN at baseline or 6-months. There was a significant decrease of in the HTAU scores from baseline (at approximately 2-months of usage) to study end (at 6-months). The content analysis showed the most frequent topic raised in the messages was scheduling appointments (56.60%) followed by symptoms and side effects (16.98%). Utilization of the PHN occurred mostly in the first three months of adoption (87.03% of total usage) and decreased over the study period.
Conclusion: These findings imply a technology-enabled health platform can facilitate care coordination, especially at the start of treatment. Patients are also capable of capturing self-reported data and monitoring their symptoms. However, further investigation should be conducted to understand how to keep patients engaged with the technology and determine if patient needs are being met over time.
|Advisor:||Kim, Katherine K.|
|Commitee:||Anderson, Nicholas, Keegan, Theresa|
|School:||University of California, Davis|
|Department:||Health Informatics (formerly Medical Informatics)|
|School Location:||United States -- California|
|Source:||MAI 82/5(E), Masters Abstracts International|
|Subjects:||Health care management, Information Technology, Oncology, Public health|
|Keywords:||Cancer care, Care coordination, Consumer health, Health informatics, Mobile health, Personal Health Network|
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