Enhancing clinical information display to improve patient encounters: human-centered design and evaluation of the Parkinson’s Disease-BRIDGE platform (Preprint)

BACKGROUND People with Parkinson’s disease (PD) have a variety of complex medical problems that require detailed review at each clinical encounter for appropriate management. Digital health solutions that efficiently integrate and display this information are needed to improve the care for people with PD. OBJECTIVE To improve the efficacy and efficiency of clinical encounters with patients with PD through development of a platform (PD-BRIDGE) with personalized clinical information from both the electronic health record (EHR) and patient-reported outcome data (PROs). METHODS Using Human Centered Design (HCD) processes, we engaged clinician and patient stakeholders in developing PD-BRIDGE through three phases: an inspiration phase involving focus groups and discussions with patients with PD, an ideation phase generating preliminary mockups for feedback, and an implementation phase testing the platform. Movement disorders neurologists and patients with PD were sent surveys asking about the technical validity, usability, and clinical relevance of PD-BRIDGE after their encounter. RESULTS The HCD process led to a platform with four modules: three modules which pulled data from the EHR – (a) a longitudinal module showing motor ratings over time, (b) a display of the most recently collected clinical rating scales, and (c) a display of relevant laboratory values and diagnoses – and (d) one module displaying motor symptom fluctuation based on an at-home diary. In the implementation phase, PD-BRIDGE was used in 17 clinical encounters for patients cared for by one of 11 movement disorders neurologists. Most patients felt that PD-BRIDGE facilitated communication with their clinician (83%) and helped them understand their disease trajectory (65%) and their clinician’s recommendations (65%). Neurologists felt that PD-BRIDGE improved their ability to understand the patient’s disease course (75% of encounters), supported clinical care recommendations (87%), and helped them communicate with their patient (81%). In terms of improvements, neurologists noted that data in PD-BRIDGE were not exhaustive in 62% of encounters. CONCLUSIONS Integrating clinically relevant information from EHR and PRO data into a visually efficient platform (PD-BRIDGE) can facilitate clinical encounters with people with PD. Developing new modules with more disparate information could improve these complex encounters even further.