Evaluation of a Patient-Facing Digital Prototype for Perioperative Risk Assessment

Preparations for anesthesiological management of patients build on preoperative patient self-reports concerning risk factors and comorbidities. In this setting, electronic documentation could facilitate innovative computerized functions, although patient-facing digital questionnaires require appropriate tools that patients can access effectively. To explore the feasibility of an electronic application for preoperative data acquisition directly from patients, a digital, tablet-based prototypical application has been developed within a user-centered design process in order to replace a previously used paper-based anamnesis sheet for perioperative risk evaluation. The implemented prototype has been extensively tested and iteratively improved to progressively provide an easy-to-use data entry function. To assess the suitability of this tool for everyday data acquisition by patients and physicians and to identify usability problems, the stepwise development process was accompanied by a heuristic evaluation as well as a think-aloud evaluation, while another 56 participating patients completed a feedback sheet according to ISO 9241/10. The latter method detected additional usability problems that occurred during the use of the application, which contributed to iterative improvements of the prototype. Throughout the development process, 81 issues were identified and largely resolved. After these revisions of the prototype, the number of problems found per tester decreased from 4.75 to 0.96, while the overall rating increased to 6.14 out of 7 points (SD = 1.2). These improvements demonstrate the value and efficiency of such a user-centered design process and illustrate that a user-friendly patient-facing digital data entry can replace preoperative paper questionnaires for anesthesiological management.