A Web Application for Improving Communication on Hemodialysis Rounds

Study Overview
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Brief Summary
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To evaluate a web application tool that hemodialysis patients can use outside of dialysis time to log and prioritize their concerns for the nephrologists. Specifically, the investigators will compare the usability of a web application tool to a structured paper form. The investigators will also use data from semi-structured interviews to better understand the experience and acceptability of the web app among patient participants randomized to the web application and among participating nephrologists. Primary outcome -Usability (effectiveness, efficiency, satisfaction) Secondary outcomes -Quality of the patient-physician interaction (Communication Assessment Tool (CAT-14))

Detailed Description
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Usability is defined as Effectiveness (>70%) Number of people submitting a concern/ number of people with opportunity to submit a concern Number of concerns entered/number of times concern was satisfactorily addressed Efficiency Proportion of non-completed tasks (<70%) The amount of time to complete one concern Satisfaction Semistructured interviews Usability survey

Official Title
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Voicing Individual Concerns for Engagement in Hemodialysis (VOICE-HD): a Web Application for Rounds

Conditions
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Hemodialysis

Intervention / Treatment
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* Behavioral: Web-App
* Behavioral: Paper


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Chronic in-center hemodialysis patients in Edmonton, Alberta and Winnipeg, Manitoba Able to provide consent, understand and read English or have a family member that can do this for them Exclusion Criteria: Planning to change modality within the next year

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: 1:1 allocation
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Web-App<br>A customized web-app tool to be used by patients to communicate concerns to their nephrologist | Behavioral: Web-App<br>* Cambian IT Health solutions from Surrey BC developed the infrastructure<br>|
| Active Comparator: Paper<br>A customized paper tool to be used by patients to communicate concerns to their nephrologist | Behavioral: Paper<br>* Contains similar questions to the Web-App tool<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effectiveness - Number of patients submitting a concern divided by the number of patients | Number of patients submitting a concern divided by the number of patients with an opportunity to submit a concern | 8 weeks | 
| Effectiveness - Number of concerns entered divided by the number of concerns that were satisfactorily addressed | Number of concerns entered divided by the number of concerns that were satisfactorily addressed | 8 weeks | 
| Efficiency - The amount of time to complete one concern | The amount of time to log a concern in the web app | 8 weeks | 
| Satisfaction - Usability survey | Usability survey Defined as greater than 70% of users who agree or strongly agree with the statement on the usability survey. Ranked on a 5 -point Likert scale | 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Communication Assessment Tool | Items rated from 1 (poor) to 5 (excellent). Published at Makoul et al. Patient Educ Couns 2007 | 8 weeks |