MyPath to Home Web-Based Application for the Geriatric Rehabilitation Program at Bruyère Continuing Care: User-Centered Design and Feasibility Testing Study

Abstract

Background When older adults return home from geriatric rehabilitation in a hospital, remembering the plethora of medical advice and medical instructions provided can be overwhelming for them and for their caregivers. Objective The overall objective was to develop and test the feasibility of a novel web-based application called MyPath to Home that can be used to manage the personalized needs of geriatric rehabilitation patients during their transition from the hospital to home. Methods This study involved (1) co-designing a patient- and clinician-tailored web-based application and (2) testing the feasibility of the application to manage the needs of geriatric rehabilitation patients when leaving the hospital. In phase 1, we followed a user-centered design process integrated with the modern agile software development methodology to iteratively co-design the application. The approach consisted of three cycles in which we engaged patients, caregivers, and clinicians to design a series of prototypes (cycles 1-3). In phase 2, we conducted a single-arm feasibility pilot test of MyPath to Home. Baseline and follow-up surveys, as well as select semistructured interviews were conducted. Results In phase 1, semistructured interviews and talk-aloud sessions were conducted with patients/caregivers (n=5) and clinicians (n=17) to design the application. In phase 2, patients (n=30), caregivers (n=18), and clinicians (n=20) received access to use the application. Patients and their caregivers were asked to complete baseline and follow-up surveys. A total of 91% (21/23) of patients would recommend this application to other patients. In addition, clinicians (n=6) and patients/caregivers (n=6) were interviewed to obtain further details on the value of the web-based application with respect to engaging patients and facilitating communication and sharing of information with the health care team. Conclusions We were successful at designing the MyPath to Home prototype for patients and their caregivers to engage with their clinicians during the transition from geriatric rehabilitation to home. Further work is needed to increase the uptake and usage by clinicians, and determine if this translates to meaningful changes in clinical and functional outcomes. International Registered Report Identifier (IRRID) RR2-10.2196/11031

Inclusion of Older Adults in Digital Health Technologies to Support Hospital-to-Home Transitions: Secondary Analysis of a Rapid Review and Equity-Informed Recommendations

“…In addition, of 34 studies, 1 (n=1, 3%) study used qualitative methodology [ 111 ], 1 (n=1, 3%) study was a report [ 98 ], and another used a case study design (n=1, 3%) [ 81 ]. A total of 9% (n=3) of studies used a mixed methods methodology [ 3 , 87 , 96 ], whereas the remaining studies (28/34, 82%) used a quantitative methodological approach. Of the 28 quantitative studies, 8 (n=8, 28%) used a randomized controlled trial design [ 89 , 90 , 97 , 101 , 106 , 107 , 109 , 110 ].…”

“…The focus of digital health interventions varied. For example, some were related to medication reconciliation [ 79 , 81 , 97 , 104 ], whereas others aimed at providing education (eg, about rehabilitative exercises), internet-based care, and resources [ 83 , 86 , 89 , 92 , 94 , 96 , 100 , 104 - 106 , 111 ] and improved communication and care coordination with older adults’ care providers [ 3 , 82 , 91 , 104 , 108 ]. A total of 2 interventions aimed to improve communication processes among health care providers regarding discharge processes and care plans [ 93 , 109 ].…”

“…There was heterogeneity in the mean age of the participants included in the studies. The mean of age included older adult participants ranged from 65 to 69 years [ 83 , 99 , 105 , 111 ], 70 to 74 years [ 3 , 80 , 84 , 85 , 89 , 94 , 101 , 106 , 108 ], and 75 to 79 years [ 82 , 87 , 92 , 97 , 101 ] to 80 to 84 [ 86 , 88 , 90 - 93 , 96 , 104 , 107 , 109 , 110 ]. Only 2 studies had a mean age of ≥85 years [ 79 , 109 ].…”

“…One study included patients hospitalized for any nonelective reason [ 104 ]. A total of 14 studies included patients who underwent or had been scheduled for a surgical procedure [ 102 ], such as elective surgery [ 80 ], hip surgeries [ 82 , 86 , 92 , 96 , 108 , 111 ], total knee arthroplasty [ 106 ], oncological surgeries [ 84 , 85 , 100 ] (eg, lung or gastrointestinal cancers) [ 91 ], or cardiac or major vascular surgery [ 112 ]. The family caregivers of patients participated in 5 studies [ 96 , 100 , 102 , 107 , 110 ].…”

“…A total of 23% (8/34) of studies described their actual sample’s ethnicity, race, and culture [ 85 , 96 , 100 , 101 , 104 , 105 , 111 , 112 ]. The samples within all these studies were primarily White, except one, which included participants who were primarily Black (75% of the sample) [ 105 ].…”