„I believe that due to complexity induced by personalization on the one hand and limited resources on the other, medicine is facing a paradigm shift that can only be mastered with the help of computers. I see it as my mission to make a contribution that supports the people involved and does not patronize them.“
Thesis: Improving adherence to treatment by closing the loop from one physician–patient consultation to the next
Prof. Dr. Gerhard Schwabe (UZH)
Prof. Dr. Andrea Luise Koppitz (ZHAW)
Keywords: Medical informatics, computer-supported cooperative work (CSCW), advisory support, mHealth, adherence to treatment
Abstract: Better health outcomes, such as survival, cure/remission, or less suffering, lead to lower healthcare costs and higher patient satisfaction. Health outcomes correlate positively with adherence to treatment. However, patients‘ adherence to treatment is still poor.
In modern medicine the treatment plan is the result of shared decision-making and an agreement between physician and patient. Therefore, in order to improve health outcomes, the question is: How can adherence to treatment be improved by supporting both, the physician and the patient?
The expected contribution of my dissertation are design artifacts from which guidelines for the design of information technology to improve adherence to treatment are derived. Methodically, my dissertation is based on Design Science Research (DSR).
The core idea is to continually improve adherence to treatment by closing the loop from one physician-patient consultation to the next with information technology. I assume that this can be done using an mHealth app that is tightly integrated into the Electronic Medical Records application. The Electronic Medical Records application and the mHealth app thus become ONE system that supports the patient and the physician throughout the entire treatment process. So the mHealth App, its integration into the Electronic Medical Records application and eventual modifications of the Electronic Medical Records application itself are the design artifacts.
Two main functionalities of the mHealth app are the “physician-patient consultation to go” and adherence measurement. The “physician-patient consultation to go” captures the main points of the physician–patient consultation, translates them into lay language, and makes them conveniently accessible to the patient at any point in time. Adherence measurement reports the patient’s behavior back to the patient and the physician. This feedback on the mHealth app helps the patient at home to adhere better to the treatment. It also helps the physician and the patient to jointly evaluate the treatment and adjust it for the next treatment cycle.
The advantages of such a mHealth app are threefold: First, it helps to prevent patients from not understanding or forgetting what was agreed in the consultation. Secondly, the patient can be supported at home in adhering to the treatment. And third, adherence to treatment can be measured, which is important to evaluate the treatment plan in terms of its impact on health outcomes.
The design artifacts are developed and evaluated in close cooperation with physicians and patients. This enables a high validity of the results.
Planned Duration: 1.9.17 – 30.1.21
Andri Färber, Nicole Zigan, Mateusz Dolata, Philipp Stalder, Andrea Koppitz and Gerhard Schwabe, 2019: The digital transformation of physician–patient consultations: Identifying problems and approaches to improve adherence , 52nd Hawaii International Conference on System Sciences (HICSS 2019), Maui Hawaii Maui