Cardiac rehabilitation: patient experience design- addressing challenges, opportunities, and digital interventionsin the patient journey

Campbell, Mark
Of all human illnesses, cardiovascular disease (CVD) is the number one cause of death globally, taking an estimated 17.9 million lives each year (representing 32% of all global deaths). When the consultation is predominantly verbal, existing research in the field of clinician-patient communication indicates that many patients struggle to understand and recall medical consultations or may not understand the extent of their illness or the purpose of their treatment plan. When the discussion centres around the risk of a repeated cardiovascular disease (CVD) related event, an exclusively (brief) verbal approach may not be the optimal approach. Understanding what factors affect the communication of this risk between clinicians and their patients may guide the creation of more effective solutions. Aim The research aims of this research are fourfold: (1) to gain a clearer understanding of the cardiac rehabilitation patient journey in Ireland; (2) to understand how cardiovascular disease risk is currently communicated; (3) to discover the factors that affect communication of these risks; (3) and to create a multi-media intervention to assist in clinician-patient communication in cardiac rehabilitation. Methods A mixed-method approach was adopted by directly surveying, interviewing and observing 88 patients and clinicians at the identified stages along the cardiac rehabilitation patient journey, as well as indirectly observing over 100 patients in cardiology out-patient waiting-rooms. In analysing over 52,000 words gathered from these primary data research activities, a thematic analysis approach was used to identify the factors that prevented patients from understanding the risk they face of experiencing a repeat cardiac event, and a qualitative (think aloud) method of usability testing was employed with 10 participants when testing the usability of a mobile app design intervention – the design and development of which was guided by a design thinking approach. xix Results Findings of this study include the creation of the cardiac rehabilitation patient journey map; the identification of how risk is currently communicated to patients; the factors that inhibit this communication in the form of a taxonomy of communication challenges represented by four primary themes and associated sub-themes; a model for opportunities for where digital media can best support communication of risk along this patient journey; and the creation of a bespoke 3D cardiac rehabilitation mobile application intervention. Conclusion The more accurate reflection of the patient journey has the potential to increase basic understanding of the timelines and events facing the patient 12-months post cardiac event. The proposed evidence informed model of opportunities for enhanced digital media supported communication in cardiac rehabilitation has the potential to influence software designers and developers when considering multimedia interventions along this patient journey within cardiac rehabilitation. The usability studies of the cardiac rehabilitation mobile app show that its design, development, and content have the potential for supporting clinician-patient communication of risk and that it is a solution that warrants further exploration.
University of Galway
Publisher DOI
Attribution-NonCommercial-NoDerivatives 4.0 International