Tools and programs that use PGHD captured via mHealth for SSI surveillance should be designed and implemented with direct involvement of core beneficiaries and stakeholders. This includes patients, providers, and administrative staff who are the primary users of mHealth tools and programs.
Direct involvement of the key stakeholder groups impacted by using PGHD captured via mHealth for SSI surveillance has the potential to greatly increase success and sustainability.12, 13 Stakeholder groups include patients, providers, non-physician clinical staff, health system administrators, and health IT specialists.15 An engagement approach that utilizes user-centered design principles and targeted stakeholder involvement to discern the preferences, concerns, practices, and desired outcomes of stakeholders will support the creation of tools and programs that best fit the needs of these groups.12,16,13,17-20 To date, stakeholder involvement in tool and program development has largely been limited to theoretical willingness to use studies21-23 or evaluation of user experience (e.g., tool usability, user satisfaction).7,24-33 With few exceptions2-3,34 these evaluative measures are most often employed outside the design phase of tool and/or program development, and thus far have addressed only the needs of patients and providers. While these two groups are the central stakeholders involved, it is crucial to consider the needs of other stakeholder groups as well. Incorporating input from a broad range of stakeholders, and soliciting stakeholder participation in the design phase, will insure that tools and programs to use PGHD captured via mHealth for SSI surveillance are positioned to maximize the potential benefits afforded by their use.12,17
Research and development activities focused on PGHD captured via mHealth for SSI surveillance should incorporate stakeholders and address the following:
Ensure diverse stakeholder representation throughout the process. Stakeholder perspectives that should be considered include patients who have experienced post-surgical complications (including SSI) as well as those who have not, the range of physicians and nurses who currently diagnose and/or treat SSI in clinic, health systems administrative staff who look to implement use of PGHD captured via mHealth for SSI surveillance, and others who are involved in the design, implementation, or support of such tools and programs. Each stakeholder group has distinct needs and perspectives on what such tools/programs can and should do.
Identify and address outcome of importance to stakeholders to whom this technology is targeted, and who benefit from its use. Outcomes to address include: What ancillary data do providers need to diagnose SSI remotely? How can mHealth tools support data/patient triage to avoid overwhelming providers with “too much” information? Patient attitudes toward and experiences with wound healing may impact acceptance of mHealth for SSI monitoring. What are patient priorities in post-operative care? What training, support, and design features can positively impact program efficacy? What capabilities promote patient engagement and retention (e.g., educational features, general post-operative management, ability to track additional health data)?