Combining iGoogle and personal health records to create a prototype personal health application for diabetes self-management.
OBJECTIVE
The aim of this project is to create a prototype for a personal health application (PHA) for patients (i.e., consumers) with diabetes by employing a user-centered design process. This article describes the design process for and resulting architecture, workflow, and functionality of such a PHA.


METHODS
For the design process, we conducted focus groups with people who have diabetes (n = 21) to ascertain their needs for a PHA. We then developed a prototype in response to these needs, and through additional focus groups and step-by-step demonstrations for people with diabetes as well as healthcare providers, we obtained feedback about the prototype. The feedback led to changes in the PHA's presentation and function.


RESULTS
Focus group participants said they wanted a tool that could give them timely, readily available information on how diabetes-related domains interact, how their behaviors affect them, and what to do next. Thus, the prototype PHA is Internet-based, retrieves data for diabetes self-management from a personal health record, displays those data using gadgets in the consumer's iGoogle page, and makes the data available to a decision-support component that provides lifestyle-oriented advice. Manipulation of the data enables consumers to anticipate the results of future actions and to see interrelationships.


CONCLUSIONS
A user-centered design process resulted in a PHA that uses technology that is publicly available, employs a personal health record, and is Internet based. This PHA can provide the backbone for a decision support system that can bring together the cornerstones of diabetes self-management and integrate them into the life of the person with diabetes.
Fonda
Stephanie J
SJ
Endocrinology Service, Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307, USA. fondasj@gmail.com
Kedziora
Richard J
RJ
Vigersky
Robert A
RA
Bursell
Sven-Erik
SE
D003199:Computer Systems; D003661:Decision Support Techniques; D003922:Diabetes Mellitus, Type 1; D003924:Diabetes Mellitus, Type 2; D019468:Disease Management; D017144:Focus Groups; D006442:Glycated Hemoglobin; D055991:Health Records, Personal; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000458:organization & administration; D008875:Middle Aged; D010353:Patient Education as Topic; D036301:Qualitative Research; D057386:Search Engine; D012648:Self Care; D012985:Software Design; D017216:Telemedicine / Q000458:organization & administration*; D014481:United States; D014584:User-Computer Interface
D006442:Glycated Hemoglobin