An Asthma Action Plan Created by Physician, Educator and Patient Online Collaboration with Usability and Visual Design Optimization

Abstract

Background: Asthma action plans (AAPs), which decrease hospitalizations and improve symptom control, are recommended in guidelines, but are seldom delivered to patients. Existing AAPs have been developed by experts, without the inclusion of all stakeholders (such as patients with asthma) and without specifically addressing usability and visual design. Objective: Our objective was to develop a more usable AAP by involving all stakeholders and considering design preferences. Methods: We created a Wiki-based system for multiuser AAP development. Pulmonologists, primary care physicians, asthma educators and patients used the system to collaboratively compile a single AAP by making multiple online selections over 1 week. We combined common elements from 3 AAPs developed in this way into 1, optimized visual design features and tested face validity in focus groups. Results: A total of 41 participants averaged 646 selections/week over a login-time of 28.8 h/week. Of 35 participants, 28 (80%) were satisfied with the final AAP and 32 (91%) perceived that they would be able to use it. The plans created by the 3 groups were very similar, with a unanimous or majority agreement in the handling of 100/110 (91%) AAP options. Conclusions: Inclusion of multiple stakeholders and focus on design preferences predict enhanced usability and uptake of medical tools. The validity of our AAP is further supported by the similarity between the AAPs created by each group, user engagement and satisfaction with the plan and agreement with existing validity criteria proposed by experts. This AAP can be implemented in care with a concurrent measurement of uptake and health impact.

Planning for Action: The Impact of an Asthma Action Plan Decision Support Tool Integrated into an Electronic Health Record (EHR) at a Large Health Care System

“…[12][13][14][15][16][17] Barriers to provider compliance include lack of time, inexperience, and insufficient confidence in generating appropriate recommendations, as well as perceptions that patients may be nonadherent to AAPs or unable to self-manage. 18,19 Providers also underutilize other recommendations in the NHLBI's guidelines, including assessments of asthma severity and control and the stepwise approach to managing asthma when choosing medication options for their patients. 15,20 Adherence to the asthma guidelines is poor in part because of their complexity.…”

Tools for primary care management of inflammatory bowel disease: Do they exist?

“…[On general practitioners' care of patients with asthma] Von Voshaar et al [23] Germany German MMW Fortschr Med 2012 [Guidelines for "Asthma in children (ages 0-19)" for youth healthcare] Breuning-Boers et al [24] The Netherlands Dutch Ned Tijdschr Geneeskd 2012 An asthma action plan created by physician, educator and patient online collaboration with usability and visual design optimization Gupta et al [25] Canada [28] South Africa English S Afr Med J 2009…”

Social media for lifelong learning

“…These collaborative documents allow colleagues to continually update, edit, and add new information that is shared and easily accessible. An example of the potential for a wiki to improve patient care was described by Gupta et al (2012). The purpose was to create an asthma action plan.…”

“…They recruited providers from Canada, the USA and Australia to take part in working groups that would contribute to wikis. At the end of their study, nearly 75% of the participants were satisfi ed with the asthma action plan outcome (Gupta et al, 2012). A second example of lifelong learning using a CWA comes from the Medical College of Georgia ' s Physician Assistant Program (Lanning & Dadiq, 2010).…”