Designing a Provider-facing Intervention for Patient-Reported Outcomes in Ophthalmology

Abstract

Visual impairments significantly impact individuals’ quality of life, extending beyond visual acuity loss to various daily activities. Objective measures often fail to capture the comprehensive effects of eye conditions on patients’ well-being. Patient-reported outcome (PRO) tools like the National Eye Institute’s 9-item Visual Function Questionnaire (VFQ-9) assess the broader impacts of visual impairment on daily activities, mental health, and overall functional status, providing insights beyond traditional clinical measures. Despite the recognized value of PROs, challenges persist that prevent their routine use in clinical practice. At the organizational level, workflow integration is a primary challenge, while at the provider level, key challenges for PRO adoption are efficiency in their delivery to healthcare providers who have diverse needs and priorities. However, guidance for understanding user needs and designing prototypes for efficient delivery of PRO information in routine clinical practice is lacking in ophthalmology and many other contexts. This study employs User-Centered Design (UCD) methods to address the challenges associated with PRO reporting in routine ophthalmology practice. Through iterative prototyping and evaluation, this approach ensures that the designed PRO intervention meets the specific needs of the users. Aim 1 of the study characterizes variation in vision-related quality of life and changes related to patients’ demographic factors to understand the potential impact of PRO information. Aim 2 identifies contextual factors, information needs, and preferences influencing providers' use of PROs in clinical practice. Aim 3 employs iterative prototyping and evaluation to design a PRO reporting tool for routine clinical practice and to formulate design recommendations for such tools. Through collaborative design processes and iterative refinement, this research produces guidance for designing PRO reporting interventions to enhance patient-centered care in ophthalmology. By providing insights into contextual factors and provider needs, this study lays the groundwork for future advancements in provider-facing PRO reporting tools, with the ultimate goal of improving patient care and outcomes in ophthalmology.