Developing of a web-based application to facilitate patient treatment adherence in individuals with sleep apnea treated with Continuous Positive Airway Pressure (CPAP) devices [5 Aud 1330 Dickerson]

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  • 1. Dickerson, S. et al.: Developing of a web-based application to facilitate patient treatment adherence in individuals with sleep apnea treated with Continuous Positive Airway Pressure (CPAP) devices
    • This slideshow, presented at Medicine 2.0’08 , Sept 4/5 th , 2008, in Toronto, was uploaded on behalf of the presenter by the Medicine 2.0 team
    • Do not miss the next Medicine 2.0 congress on 17/18th Sept 2009 ( )
    • Order Audio Recordings (mp3) of Medicine 2.0’08 presentations at
  • 2. Developing a web- application to facilitate patient treatment adherence . Suzanne S. Dickerson DNS RN Associate Professor Grace Dean PhD RN Assistant Professor
  • 3. Defining the Need
    • Evidence Based Literature review
    • Research to define specific needs
    • Experiential patient narratives
    • Develop problem statement
    • Determine appropriate behavioral strategies to promote adherence and timeline for effectiveness
    • Choose theory
  • 4. Gathering the team
    • Facilitate patient's adherence to CPAP treatment
    • Team members:
      • Software engineer as principle engineer
      • Clinical Sleep medicine expert
      • Psy D for cognitive behavioral intervention component
      • Software design and development
      • It support staff
  • 5. Conceptualize the problem
    • brainstorming with Software systems engineer and PIs
    • Visualize the flow of the idea
    • Understand how theory is
    • operationalized
      • I.e. Self Efficacy
        • Motivators
        • Vicarious learning
        • Support
  • 6. Visualizing the problem
  • 7. Defining expected outcomes
    • Motivational program that is web based, interactive, uses patient self management strategies.
      • Capture data by collecting self report CPAP use survey data and store on HIPPA approved server
      • Track patient progress over time for use by patient and provider
      • Provide automated motivators based on answers to questions and patient progress data
      • Use motivation enhancers
      • Provide resource library with motivational success stories for vicarious learning.
  • 8. 50,000 foot view of topics
    • User data capture
    • User progress tracking by
      • Investigators
      • Peers
      • Users themselves ( homepage)
    • Motivators
      • automated or managed by investigators
    • Resource library ( user contributions?)
    • Rolling news blog for investigators.
  • 9. The Application
    • Codify the Protocols
      • Easy capture and easy storage
      • Interactions:
        • What is displayed, when, how,
        • When are things available to use?
          • UI page designs (User Interaction)
          • UI page flows ( graphic designers or interaction designers)
  • 10. The application cont.
    • Store the data
    • Analyze data for next steps in the intervention protocol
    • Technology requirements/restrictions
      • Web application
      • Runtime/deployment environment (server)
      • Runtime framework (server software, webapp, infrastructure, libraries
    • Data storage
    • Development environment
  • 11. Software development
    • Requirements
      • Protocols
      • Tech restrictions
    • Design –user centric
    • UI interactions
      • Use case
    • Design – tech centric
      • Components , techniques
    • Build
    • Test and repair
    • Deploy and active
    • Follow up
  • 12. Timeline Initial 4 months Secure developmental server Protocols Base use cases Technology platform selection Network Admini-strator PIs Principal engineer Set up developmental Server and test security Software development: Finalized protocols Write software initial requirements Month 1–4 milestone Team member Task Timeline
  • 13. Next 2 months Prototype users scenarios (personas) Interaction task scenarios UI screen designs Data type and flow definitions PIs Principal engineer Graphic designer Interaction and interface design Data model design Month 4-6 milestone Team member Task Timeline
  • 14. Time line 6-8 months Model-View-Controller software design Implementation Plan Principal engineer Graphic designer Programmer Design tech-centric components techniques Month 6-8 milestone Team member Task Timeline
  • 15. Timeline 8-10 months Completion of initial implementation plan System test all functionality Complete fixes for high priority defects; Finalize setup of the production environment Release final deploy package PI Principal engineer Programmer Build and test Month 8-10 milestone Team member Task Timeline
  • 16. Final months Publish the application to the production environment Production test to verify installation Ready for feasibility study PIs Principal engineer Programmer Deploy and activate Months 10-12 milestone Team member Task Timeline
  • 17. Evaluation
    • Sleep quality PSQI
    • Sleepiness scale ESS
    • Quality of life CSAQLI
    • Adherence- actual use.
    • Future testing with R21 and R01 mechanisms
  • 18. Dissemination
    • Publication on development strategies
    • Feasibility study
    • Multisite study
      • local then national
    • Marketing and business plan
    • Format in multiple languages
  • 19. Obtaining funding
    • Finding grant mechanisms to support development of intervention
    • Seed monies internal research development funding
    • Corporate funding
        • Foundations or corporations that endorse idea
  • 20. Questions??
    • Thank you