Enhancing access to nephrology care: telenephrology dashboard optimization via human-centered design.

Area of Science:

• Nephrology
• Health Informatics
• Human-Computer Interaction

Background:

• Chronic kidney disease (CKD) burden is increasing, necessitating improved access to specialized nephrology care, particularly for underserved populations.
• The Iowa City Veterans Affairs Health Care System (ICVAHCS) serves 150,000 Veterans, facing challenges in providing equitable access to nephrology services.
• A Telenephrology Dashboard was developed to address these access barriers and enhance CKD management within the ICVAHCS.

Purpose of the Study:

• To optimize a Telenephrology Dashboard as a practical tool for end-users.
• To facilitate remote nephrology consultations and monitor kidney health effectively.
• To improve the accessibility and quality of specialized care for Veterans with kidney disease.

Main Methods:

• The Human-Centered Design (HCD) framework guided the dashboard's optimization, involving five stages: Empathize, Define, Ideate, Prototype, and Test.
• Researchers conducted 10 hours of observation of nephrologists during remote consultations and performed semi-structured interviews with clinicians.
• A rapid ideation workshop, followed by iterative prototyping and testing, refined the dashboard based on user feedback and technical requirements.

Main Results:

• The iterative design process revealed critical needs for improved visual data representation, enhanced data accuracy, and a balance between standardization and customization.
• Five dashboard prototypes were developed, tested, and refined into a final version.
• The final Telenephrology Dashboard features graphical kidney function trend representation, summarized lab data tables, detailed event examination, customizable user views, and predictive kidney disease progression models.

Conclusions:

• The Telenephrology Dashboard was successfully developed using a Human-Centered Design approach to enhance remote nephrology consultations.
• Future research will evaluate the dashboard's impact on user and referring clinician satisfaction, access to care, and patient outcomes.
• The dashboard represents a significant step towards improving specialized care delivery for Veterans with kidney disease.