Berlin design 2012

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  • 1. IVF patients preferences in service design Jan Kremer & Wouter Tuil Radboud University Nijmegen MC
  • 2. INTRODUCTION 2001Saturday, April 21, 2012 2
  • 3. INTRODUCTION• Preliminary research (Haagen et al. 2003) – Patients are online (81%) – Patients are on the internet for medical purposes (54%) – Patients want online interaction with their physician (69%) – Patients want online access to their medical records (82%)• Based on these findings the virtual IVF clinic was created Human Reproduction Vol.18, 2073, 2003Saturday, April 21, 2012 3
  • 4. VIRTUAL IVF CLINIC 2003Saturday, April 21, 2012 4
  • 5. VIRTUAL IVF CLINIC• Interactive website – General information – Personal information – Communication• Promote patient empowerment• Safe, secure and efficientSaturday, April 21, 2012 5
  • 6. VIRTUAL IVF CLINIC Generic Personal Communication Information information • IVF treatment • Medical record • Chat • Clinic • Dayplanner • Discussion forum • FAQ • Embryo-pictures • E-mail • Stories • Prognosis • Links • Correspondence • Literature • VideosSaturday, April 21, 2012 6
  • 7. RESEARCH QUESTIONS 1. Use and usefulness of the website 1. What are the time-dynamics of the website? • Weeks, Treatment phase 2. Types of online behavioral styles?Saturday, April 21, 2012 13
  • 8. METHODS• Questionnaire (n=54) – Demographics – Usefulness of the website• Automated logging of viewed pages (n=1050) – User – Requested functionality – Date & timeSaturday, April 21, 2012 14
  • 9. 1. USE AND USEFULNESSSaturday, April 21, 2012 15
  • 10. USE and USEFULNESS UsefulGeneral information (top 3)1. Frequently Asked Questions 88 %2. Information about the clinic 67 %3. Information about the treatment 63 %Personal information (top 3)1. Medical Record 96 %2. Day planner 92 %3. Embryo photos 79 %Communication1. E-mail 77 %2. Discussion forum 73 %3. Chat 58 %Saturday, April 21, 2012 Tuil et al. Hum Reprod. 2006: 2955-9. 16
  • 11. USE and USEFULNESS Useful PageviewsGeneral information (top 3)1. Frequently Asked Questions 88 % 7,92. Information about the clinic 67 % 8.83. Information about the treatment 63 % 62,2Personal information (top 3)1. Medical Record 96 % 36,02. Day planner 92 % 30,43. Embryo photos 79 % 50,1Communication1. E-mail 77 % 2,42. Discussion forum 73 % 139,53. Chat 58 % 45,3Saturday, April 21, 2012 Tuil et al. Hum Reprod. 2006: 2955-9. 17
  • 12. TIME DYNAMICSSaturday, April 21, 2012 18
  • 13. PAGEVIEWS OVER TIME Communication (34.2%) General information (25.4%) Personal Information (17.9%) Navigation (22.4%) 6000 5000 pageviews 4000 3000 2000 1000 0 1 2 3 4 5 6 7 8 9 10 weeks after first visitSaturday, April 21, 2012 Tuil et al. Fertil Steril. 2009; 953-6 19
  • 14. PAGEVIEWS PER TREATMENT PHASE Generic Information Patient specific Communication Pageviews per visitor per day (CI) Information 12 10 8 6 4 2 0 T1 T2 T3 T4 T5 T1 T2 T3 T4 T5 T1 T2 T3 T4 T5 T1: pretreatment T2: stimulation T3 opu&et T4: luteal phase T5: posttreatmentSaturday, April 21, 2012 Tuil et al. Fertil Steril. 2009; 953-6 20
  • 15. 3. BEHAVIORAL STYLESSaturday, April 21, 2012 21
  • 16. BEHAVIORAL STYLES (factor analysis) Individual Generic information CommunicationContent Type information style style styleMedical records 0.89 0.23 0.30Treatment information 0.89 0.30 0.30Personalised prognosis 0.80 0.31 0.22FAQ 0.67 0.40 0.12Downloadable documents 0.67 0.39 0.29Day planner 0.46 0.41 0.23Literature 0.20 0.71 0.17General information 0.45 0.62 0.23External links 0.25 0.62 0.17Website help 0.20 0.61 0.13Hospital information 0.48 0.60 0.23Bulletin board (viewing) 0.38 0.24 0.86Bulletin board (posting) 0.14 0.14 0.83Chatroom 0.24 0.25 0.62Saturday, April 21, 2012 Tuil et al. Hum Reprod. 2008:2501-5 22
  • 17. BEHAVIORAL STYLES (prevalence) Individual Generic Communication n (%) information style information style styleNone of the ○ ○ ○ 411 (35.7%)stylesOne of the styles ● ○ ○ 195 (17.0%) ○ ● ○ 156 (13.6%) ○ ○ ● 52 (4.5%)Two of the styles ● ● ○ 138 (12.0%) ● ○ ● 66 (5.7%) ○ ● ● 60 (5.2%)All three styles ● ● ● 72 (6.3%)Saturday, April 21, 2012 Tuil et al. Hum Reprod. 2008:2501-5 23
  • 18. BEHAVIORAL STYLES (dominance) 40% 38% 35% 33% 30% 29% 25% 20% 15% 10% 5% 0% Generic information Personal Information Communication12 november 2008 Tuil et al. Hum Reprod. 2008:2501-5 24
  • 19. DETERMINANTS OF BEHAVIORAL STYLES Personal information style:  Sharing emotions (p=0.028)  Paid employment (p=0.007) Generic information style:  Depression (p=0.028) Communication style:  Anxiety (p=0.005)  Paid employment (p=0.021)Saturday, April 21, 2012 Tuil et al. Hum Reprod. 2008:2501-5 25
  • 20. CONCLUSIONSSaturday, April 21, 2012 26
  • 21. CONCLUSIONS• The majority of functions are used and perceived as useful – Discussion forum is used most frequently – Personalized information is valued as most useful• Usage varies greatly over time – High number of page views during the OPU and ET – Information at the beginning and communication at the end of treatment• There are three types of online behavior styles – Personal information, generic information and communication – Anxiety, depression and employment are determinants of these stylesSaturday, April 21, 2012 27
  • 22. Patients play a crucial role in service design @JKNL and @WouterTuil