Patient-Derived Design Principles for Technology-Enabled Healing at Home Following Hospital Discharge: Mixed Methods...

As more patients transition from hospital to home for postacute care, a growing interest exists in leveraging technology to support recovery, yet a limited understanding exists on how to design these tools to align with patient and caregiver needs and preferences.

This study aimed to explore the perceptions, attitudes, and beliefs of recently discharged patients to develop user-centered design principles for digital tools that support safe and effective transitions from hospital to home.

A vignette-based, mixed methods survey was conducted, grounded in the technology acceptance model, to explore patient perceptions of digital tools supporting postdischarge care. A random sample of 1000 recently discharged adult patients received a survey featuring validated vignettes and technology acceptance model-informed questions, with both quantitative and qualitative items. Open-ended responses were analyzed using grounded theory to derive design principles that inform the development and implementation of patient-centered digital health tools. Quantitative items were descriptive and are summarized as counts (n) and frequencies (%).

Of the 967 eligible patients contacted, 116 completed the survey (response rate of 2%), with respondents having a median age of 71 (IQR 61-78) years, high rates of chronic illness, and access to smartphones (98/116, 84.5%) and in-home internet (111/116, 95.7%). Qualitative analysis revealed 6 key themes-connection to care, technical ease of use, solution usability, human connection, cost, and privacy-informing 3 patient-centered design principles focused on user experience, affordability, and transparent communication to guide future technology-supported hospital discharge interventions. Respondents reported the following factors as highly important: reassurance that a care team member would reach out if something seemed wrong (107/116, 92.2%), responsiveness to patient needs (95/116, 81.9%), ability to see their data (95/116, 81.9%), and out-of-pocket cost (94/116, 81.0%). Less important factors included duration of device use (22/116, 19.0%) and battery life (21/116, 18.0%).

Grounded in patient perspectives, this study identified the 3 core design principles of user experience and accessibility, cost and privacy, and communication and transparency that should guide the development and implementation of digital tools to support safe, effective, and human-centered transitions from hospital to home.