Development of App Aimed at Improving Patient Navigation Services in Underserved Populations

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Researchers collaborated to develop a tablet app prototype to replace an existing online patient navigation evaluation tool with an easy-to-use, portable app.
Researchers collaborated to develop a tablet app prototype to replace an existing online patient navigation evaluation tool with an easy-to-use, portable app.
The following article features coverage from the 2018 Oncology Nurse Advisor Navigation Summit. Click here to read more news highlights and expert perspective from the Summit on Oncology Nurse Advisor. 

“A Tool to Improve Evaluation of Patient Navigation Services in Underserved Populations” (1R43 MD011350-01)is a Small Business Innovative Research grant under the direction of Linda Burhansstipanov, PhD, and is being used to develop a patient navigation evaluation tablet app to facilitate data entry for patient navigation activities, evaluation of one or more patient navigators (PNs), and report generation on individual patients, navigator(s), and the overall navigation program. Additional research team members include Linda Krebs, PhD, RN, AOCN®, FAAN,Sheik Iqbal Ahamed, PhD, Mark Dignan, PhD, MPH, Corrie Santos, PhD, and Lisa Harjo, BS, MA. The grant is funded by the National Institutes of Health (NIH) as a project through Native American Cancer Initiatives, with an app development subcontract to Ubitrix. The team collaborated to develop a tablet app prototype to replace an existing online patient navigation evaluation tool with an easy-to-use, comprehensive and portable tool that the PN can use for data entry within a hospital/clinic/office and in the field in urban and rural settings and that programs can use for report generation.

During phase 1, the project focused on three components: (1) PN activities with patients; (2) PN(s) evaluation(s) by supervisors; and (3) overall assessment of the navigation program.  App content was directed towards PN actions and activities during the survivorship phase of the cancer continuum. Content included standard demographic and cancer-related data, survivorship care planning, barriers and facilitators to treatment and follow-up, quality of life concerns, symptoms and symptom management, access to resources and education, and patient satisfaction. All data could be used to generate PN and program reports tailored to the needs of an individual navigation program and to meet organization and other accreditation requirements. Advisory to the project were an expert advisory committee comprised of navigation program administrators and researchers and a patient navigation advisory committee comprised of experienced patient navigators. Along with the research team, these groups oversaw app content development. Dr Ahamed's Ubitrix, a global mobile and web application development company, served as the app developers.

Prior to content development, informant interviews, conducted with patient navigators, navigator supervisors/administrators, navigation researchers, and a PN focus group, were held to identify both required and desired app content. Simultaneously, Ubitrix began app development using an iterative process. Once developed, three usability tests were held to assess the content, layout, usefulness, ease of use, and overall value of the phase 1 app by (1) navigators, (2) supervisors/administrators, and (3) app development experts. Additionally, evaluation for readiness for full development through a phase 2 Small Business Innovation Research was assessed.

During phase 2, the components will be expanded/new aspects developed to include documenting PN actions across the cancer care continuum (outreach through end-of-life) and creating reports that meet program needs and facilitate PN and navigation program compliance with standardized metrics and requirements for patient navigation. The app will communicate with the Ubitrix HIPAA compliant cloud server to store, retrieve, and update data and generate multiple tailored reports from all relevant data. The product will be supported by user guides, tutorials, a website, and a helpline and will integrated with multiple EHR systems such as EPIC, Cerner, and RPMD.
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