Dashboards for supporting cancer care in value-based healthcare context – Information needs, design principles and acceptance

Improving the value of care is central to the value-based healthcare model. This model emphasises the active role of patients in decision making and providing them with the information they require during the different stages of care to make value-based decisions. Thus, effective decision aid tools should help patients to actively participate in making informed, deliberate and well-considered choices among different healthcare options. However, designing such decision aid tools such as dashboards for patients as intelligent non-expert users is challenging given the variety of information required for making informed decisions and for monitoring and tracking health outcomes. To our knowledge, there is a paucity of research to guide the design and development of dashboards to support patients’ decision making in their care journey in a value-based healthcare context. We address this gap in the context of prostate cancer care in the following three steps. First, the thesis explores the information needs of patients with prostate cancer using a survey approach. This step enabled the determination of the information that patients consider essential to address their information and decision needs in a value-based healthcare context. Secondly, it generates design specifications and synthesises considerations for developing value-based decision aid dashboards for prostate cancer patients by employing a design science research approach. Specifically, the design specifications of three dashboards prototypes were developed by 1) considering both cognitive and socio-technical perspectives of design artefact, 2) the identified information needs, and 3) feedback obtained through interviews with healthcare specialists, managers, design experts, patients, and the public. These dashboards include treatment, hospital, and health data tracker dashboards. The evaluation of dashboard designs enabled us to identify salient design considerations that must underpin the design of dashboards in value-based healthcare contexts. Thirdly, focusing on the characteristics of dashboard interfaces and in particular, the socio-technical fit, users’ emotional reaction while using dashboards and healthcare managers support, we proposed a theoretical model for dashboards acceptance in the value-based healthcare context. The proposed theoretical model was validated using partial least structural equation modelling. The results helped to further validate the design features or considerations (in step 2) in creating acceptable and effective dashboards design specifications. Furthermore, the inclusion of constructs on socio-technical fit and dashboard interface components in the theoretical model contributed to the body of knowledge in design evaluation studies. Overall, results from the thesis provide valuable insights on the information needs of patients and principles that must guide how such information should be presented in dashboards to support patient decision needs. From a theoretical perspective, the dashboard acceptance model provides novel design-related constructs that could be used in future studies. Finally, we believe that the thesis provides the know-what and -how in developing dashboards to effectively support prostate cancer care and significantly contributes to the transition to value-based healthcare systems.