An eHealth Application in Head and Neck Cancer Survivorship Care: Health Care Professionals' Perspectives.
BACKGROUND
Although many cancer survivors could benefit from supportive care, they often do not utilize such services. Previous studies have shown that patient-reported outcomes (PROs) could be a solution to meet cancer survivors' needs, for example through an eHealth application that monitors quality of life and provides personalized advice and supportive care options. In order to develop an effective application that can successfully be implemented in current health care, it is important to include health care professionals in the development process.


OBJECTIVE
The aim of this study was to investigate health care professionals' perspectives toward follow-up care and an eHealth application, OncoKompas, in follow-up cancer care that monitors quality of life via PROs, followed by automatically generated tailored feedback and personalized advice on supportive care.


METHODS
Health care professionals involved in head and neck cancer care (N=11) were interviewed on current follow-up care and the anticipated value of the proposed eHealth application (Step 1). A prototype of the eHealth application, OncoKompas, was developed (Step 2). Cognitive walkthroughs were conducted among health care professionals (N=21) to investigate perceived usability (Step 3). Interviews were recorded, transcribed verbatim, and analyzed by 2 coders.


RESULTS
Health care professionals indicated several barriers in current follow-up care including difficulties in detecting symptoms, patients' perceived need for supportive care, and a lack of time to encourage survivors to obtain supportive care. Health care professionals expected the eHealth application to be of added value. The cognitive walkthroughs demonstrated that health care professionals emphasized the importance of tailoring care. They considered the navigation structure of OncoKompas to be complex. Health care professionals differed in their opinion toward the best strategy to implement the application in clinical practice but indicated that it should be incorporated in the HNC cancer care pathway to ensure all survivors would benefit.


CONCLUSIONS
Health care professionals experienced several barriers in directing patients to supportive care. They were positive toward the development and implementation of an eHealth application and expected it could support survivors in obtaining supportive care tailored to their needs. The cognitive walkthroughs revealed several points for optimizing the application prototype and developing an efficient implementation strategy. Including health care professionals in an early phase of a participatory design approach is valuable in developing an eHealth application and an implementation strategy meeting stakeholders' needs.
Department of Otolaryngology / Head and Neck Surgery, VU University Medical Center, Amsterdam, Netherlands. s.lubberding@vumc.nl.
Sanne
http://orcid.org/0000-0003-4180-557X
S
Duman-Lubberding
Cornelia F
http://orcid.org/0000-0002-3898-416X
CF
van Uden-Kraan
Niels
http://orcid.org/0000-0002-6393-9969
N
Peek
Pim
http://orcid.org/0000-0001-5497-2743
P
Cuijpers
C René
http://orcid.org/0000-0001-7887-083X
CR
Leemans
Irma M
http://orcid.org/0000-0002-4507-4607
IM
Verdonck-de Leeuw
D000328:Adult; D000368:Aged; D001290:Attitude; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D015996:Survival Rate; D017741:Survivors / Q000523:psychology*; D017216:Telemedicine / Q000379:methods*; D055512:Tertiary Prevention
cancer; follow-up care; participatory design approach; supportive care; tertiary prevention