Design, Development, and Evaluation of a Patient-Centered Health Dialog System to Support Inguinal Hernia Surgery Patient Information-Seeking
Lordon, Ross James
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Surgery patients engage in health information-seeking activities to better understand their health conditions. An example of this activity is patients collecting data outside of the hospital to track their surgery recovery. Patients can also seek health information from resources such as clinicians, patient education materials, multimedia, friends or family members, and websites to answer their questions. However, surgery patients could encounter barriers when trying to make sense of their collected data or engaging in health information-seeking. For example, clinicians have limited availability to help make sense of the collected data or answer patient questions. Additionally, surgery patients may have low health literacy levels or have difficulties recalling their discharge teaching. In this dissertation, I will first describe how patients collecting data outside of the hospital has an impact on patient-clinician relationships and patient efforts to make sense of the data through information-seeking. Second, I will detail an innovative approach to aid inguinal hernia surgery patient information-seeking activities - a prototype health dialog system, called “Hernia Coach,” built as a Google Assistant “Action.” To develop Hernia Coach, I investigated the information needs of inguinal hernia surgery patients by engaging patients and clinicians in participatory design sessions. Then I designed and developed Hernia Coach. Finally, I evaluated Hernia Coach to identify the system's ability to aid patient health information-seeking by recruiting design experts to perform a heuristic evaluation, engaging patients in user testing sessions, and evaluating the Hernia Coach’s ability to provide relevant health information to participant queries. This research contributes to an improved understanding of how patients collecting data to address health concerns affect patient-clinician relationships, expands on inguinal hernia surgery patient informational needs research, and demonstrates how health dialog systems can act as a tool to aid patients with their health information-seeking activities. My work also has implications beyond inguinal hernia surgery. When patients engage in health information-seeking online, the onus is on them to identify material relevant to their health condition that also contains accurate information. Health dialog systems have the potential to act as patient-centered health information repositories and allow patients to easily ask questions and quickly receive reliable answers from a reputable resource. Additionally, my work provides design recommendations for researchers creating these systems and identifies opportunities to improve the evaluation of patient-centered health dialog systems.