PROMis for quality care

Abstract

This report outlines a project that aimed to increase engagement with patient reported outcome measures (PROMs) for patients at an outpatient clinic. The target group was people living with HIV (PLHIV). This study was made possible thanks to the client, Amsterdam UMC, who are undertaking a larger research project that aims to improve the quality of life (QoL) of PLHIV.

The project included a comprehensive literature review and user research that involved shadowing of nurses in order to explore the clinic’s context. At this point PROMs started being introduced at the outpatient clinic. To identify design opportunities, attitudes towards PROMs, and initial impressions of PROMs, semi-structured interviews were done with patients and nurses. To further the discussion of PROMs three provotypes were made and presented to participants during the interviews. The main takeaways related to patients not knowing the value or purpose of PROMs or lacking the motivation to complete them. From these takeaways design criteria were identified by making the design goal and interaction vision, which led to the development of four concepts by research through design, brainstorming, and role-playing.

A Harris profile was done on the four concepts and one of them was selected to move forward to design and implementation. The concept was a card game, and it was further iterated on by using accessibility guidelines and persuasive game design. The objective was to make a game that, while being accessible, would help change patient behavior regarding PROMs. A lo-fi mock-up was created for the game to test the different game elements with people, leading to refinement of the concept and turning it into a high-fi prototype that was tested with the target group, PLHIV.

The results were positive, with patients showing enthusiasm for the game, but with some room for improvement. Patients found the game to be compassionate and useful in learning about PROMs. The game was also tested with a peer navigator who offered many insights from the perspective of patients who are not open about their diagnosis and on how the card game could be used in relation to their role at the outpatient clinic.
These findings highlight the potential of using gamification to create inclusive learning tools (i.e. the card game) in the health sector to increase engagement with other health tools (i.e. PROMs) and the importance of continued work to optimize these tools for patients with chronic illnesses such as HIV.