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Design Requirements for Patient-Centered Digital Health Applications: Supporting Patients' Values in Postoperative Delirium Prevention

David Leimstädtner, Fatima Halzl-Yürek, Claudia Spies, Claudia Müller-Birn

TL;DR

The paper addresses how to design patient-centered digital health applications to support POD prevention by centering patient values. It combines Value Sensitive Design with Patient Value Journey mapping, validated through stakeholder and patient interviews, to produce design requirements expressed as strong concepts. Four interlinked requirements emerge: patient-centered communication, phase-specific procedural transparency, continuous guidance empowering patient autonomy, and social embedding that explicitly includes relatives. The work provides a practical blueprint for translating patient barriers and values into actionable digital health design, with implications for CSCW and health informatics to improve engagement and outcomes in POD prevention. By articulating phase-aware information, relational roles, and sustained support, the approach aims to reduce POD incidence and enhance patient agency across the perioperative journey.

Abstract

Postoperative delirium (POD) is among the most common complications after surgeries for older adults and can entail long-term adverse health consequences. Active patient participation in POD prevention presents a central factor in reducing these risks. To support patient engagement through a digital health application, we use value sensitive design approaches to identify the requirements for a patient-centered digital health application supporting patient engagement in POD prevention. Through interviews with medical professionals and patient representatives, we construct a patient journey, which serves as the basis for twelve patient value journey interviews. In these interviews, patients from the high-risk group for POD revisit their recent experience of undergoing surgery to elicit barriers, needs, and values concerning POD prevention from a patient perspective. An analysis of the patient interviews derives four design requirements for a digital health application supporting patients regarding POD prevention: the adaptation of patient-centered communication, the provision of procedural transparency, fostering patient empowerment through consistent guidance, and explicitly addressing relatives as mediators and supporters for a patient after a POD occurrence.

Design Requirements for Patient-Centered Digital Health Applications: Supporting Patients' Values in Postoperative Delirium Prevention

TL;DR

The paper addresses how to design patient-centered digital health applications to support POD prevention by centering patient values. It combines Value Sensitive Design with Patient Value Journey mapping, validated through stakeholder and patient interviews, to produce design requirements expressed as strong concepts. Four interlinked requirements emerge: patient-centered communication, phase-specific procedural transparency, continuous guidance empowering patient autonomy, and social embedding that explicitly includes relatives. The work provides a practical blueprint for translating patient barriers and values into actionable digital health design, with implications for CSCW and health informatics to improve engagement and outcomes in POD prevention. By articulating phase-aware information, relational roles, and sustained support, the approach aims to reduce POD incidence and enhance patient agency across the perioperative journey.

Abstract

Postoperative delirium (POD) is among the most common complications after surgeries for older adults and can entail long-term adverse health consequences. Active patient participation in POD prevention presents a central factor in reducing these risks. To support patient engagement through a digital health application, we use value sensitive design approaches to identify the requirements for a patient-centered digital health application supporting patient engagement in POD prevention. Through interviews with medical professionals and patient representatives, we construct a patient journey, which serves as the basis for twelve patient value journey interviews. In these interviews, patients from the high-risk group for POD revisit their recent experience of undergoing surgery to elicit barriers, needs, and values concerning POD prevention from a patient perspective. An analysis of the patient interviews derives four design requirements for a digital health application supporting patients regarding POD prevention: the adaptation of patient-centered communication, the provision of procedural transparency, fostering patient empowerment through consistent guidance, and explicitly addressing relatives as mediators and supporters for a patient after a POD occurrence.
Paper Structure (45 sections, 3 figures, 2 tables)

This paper contains 45 sections, 3 figures, 2 tables.

Table of Contents

  1. Introduction
  2. Related Work
  3. Designing Patient-Centered Digital Health
  4. Value Sensitive Design and Patient Values
  5. Supporting Patient Engagement for POD
  6. Research Context
  7. Positionality Statement
  8. Method
  9. Participants and Recruitment Process
  10. Clinical Staff and Patient Representatives
  11. Patients
  12. Interviews
  13. Semi-Structured Background Interviews
  14. Patient Value Journey Interviews
  15. Thematic Analysis
  16. ...and 30 more sections

Figures (3)

  • Figure 1: Overview of the identified barriers patients from the high-risk group for POD experience when undergoing surgery, including selected codes pertaining to these barriers.
  • Figure 2: Overview of the identified patient values across the patient value journey.
  • Figure 3: Overview of the operationalization of design requirements from patient values and barriers across the patient value journey.