COMputerized PAtient-centered Collaborative Technology (COMPACT) to Support Personalized Decision Making in Breast Cancer

Delivering patient-centered, high-quality cancer care is a challenge exacerbated by the ‘preference-sensitive’ nature of several cancer decisions. For instance, treatment decisions for breast cancer, the most common cancer in women, are complex as there are usually several appropriate treatment options with differing risks, benefits, and implications for the patient’s life. Patients need to be involved in these preference-sensitive decisions, but patients report knowing only 50 percent of the information needed to make a decision, and less than half of patients make high-quality decisions about their care. Patients who are less involved in their breast cancer decision making have lower satisfaction and higher regret with chosen treatments. Numerous decision aids have been developed to support patient-centered decision making in breast cancer. However, sustained implementation and use of these tools has been limited.

This research will design and evaluate a COMputerized PAtient-centered Collaborative Technology (COMPACT) to support personalized breast cancer decision making, with the goals of improving outcomes, increasing patient satisfaction, and reducing healthcare costs. COMPACT will be designed using human factors engineering principles and a human-centered design (HCD) approach, and will include clinician- and patient-facing dashboards in the electronic health record and patient portal.

The specific aims of the research are as follows:

• Elucidate design requirements for a system to support personalized decision making in breast cancer.
• Apply an HCD process to develop and evaluate COMPACT.
• Evaluate the COMPACT prototypes in a high-fidelity, scenario-based simulation.

A human factors engineering work system analysis will be done to understand the sociotechnical work system around breast cancer care. A combination of interviews and observations of patients and clinicians will inform detailed care process and patient journey maps that will support COMPACT’s design. Collaborative design sessions will be held with patients, their caregivers, and clinicians to inform the development of the user interface. Formative usability testing and a heuristic evaluation will be done leading to design improvements to prototypes. Scenario-based simulations with patients and clinicians will be used in the evaluation phase of the research, analyzing usefulness, usability, and acceptance of COMPACT. The results of this research will be used to inform a future randomized controlled trial of COMPACT to study its impact on patient care.