  There is a need to address the urban-rural disparities in healthcare
regarding equal access and quality of care. Due to higher rates of chronic
disease, reduced access to providers, and a continuous decline in rural
hospitals, it is imperative that Appalachian cancer patients adopt the use of
health information technology (HIT). The NCCN Distress Thermometer and Problem
List (DT) is under-utilized, not patient-centered, does not consider provider
needs, and is outdated in the current digital landscape. Digitizing patient
distress screening poses advantages, such as allowing for more frequent
screenings, removing geographical barriers, and rural patient autonomy. In this
paper, we discuss how knowledge gained from patient-centered design led to the
underpinnings of developing a rural remote patient monitoring app that provides
delightful and insightful experiences to users.
