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Remote Symptom Assessment in Ambulatory Palliative Care: User-Centered Development of an mHealth App
Irina Mindlis1, Emily Bivona-Maldonado2, Zilong Yu3
1Parker Health Group Division of Geriatrics, Department of Family Medicine and Community Health, Robert Wood Johnson Medical School of Rutgers University, New Brunswick, New Jersey, USA.
Background:
Ambulatory palliative care (PC) focuses on managing complex symptoms, yet assessment relies on recall during infrequent visits to manage daily fluctuating symptoms. We aimed to design a PC-anchored remote symptom assessment (RSA) tool with patients and clinicians.
Methods:
We used user-centered, Agile design to develop and iteratively refine EMA-PAL, a web-based RSA prototype. Patients and clinicians (N = 14) from an ambulatory PC clinic participated in staged prototype development and testing through focus groups and interviews.
Results:
EMA-PAL features patient- and provider-facing interfaces that visualize daily Edmonton Symptom Assessment System (ESAS) scores, highlight severe symptoms, and support shared review during visits. Participants endorsed EMA-PAL's potential to enhance communication and workflow efficiency and identified priorities for future development (medication tracking and workflow integration).
Conclusion:
This exploratory pilot suggests that PC-anchored RSA tools such as EMA-PAL may help address gaps in symptom assessment and timelier and patient-centered symptom management in ambulatory PC.
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