Table 2 Clinicians experience using the dashboard using the Technology Acceptance Model-Interviews quotes
TAM concept | Themes | Sub-Themes | Sample Quotes |
|---|---|---|---|
Perceived Usefulness | Patient motivation (F) | - | 1. “It changes the conversation from ‘What are my labs doing?’ to ’Oh, this is my disease activity score, I see that it’s not in the green zone, and we should be aiming for that’.” (P7; FG3) |
Health information (F) | Disease trajectories (F) | 2.1. “I think the visualization makes it easier for the patients to see as opposed to just looking at numbers across a chart, I find that most of my patients really appreciate it” (P6; FG2) | |
RA symptoms (F) | 2.2. “It’s interesting to use it when patients feel like they’re doing Ok, because say they’re on prednisone and I don’t think they’re doing Ok…and when they actually see their score not being as good as it could be they actually sort of think twice.” (P3; FG2) | ||
Patient-clinician communication (F) | RA outcome measures (F) | 3.1. “[Patients] ask questions about what [PROs] mean, what the [PRO] numbers are, and they were surprised that we’ve been collecting and plotting the data for so many years.” (P2, FG2) | |
Treatment (F) | 3.2. “It gives a needed perspective if they’ve been resisting the idea of modifying their treatment…their medication” (P9; FG3) | ||
Clinical relevance to all RA patients (B) | Non-inflammatory conditions (B) | 4. “A patient who also has prominent fibromyalgia. There are challenges around that. How can I point out like discordance of patient global… I don’t know how to use it in that context” (P2, FG1) | |
Perceived Ease of Use | Updated data in real time (F) | - | 5.“I put in my score, and then either their score is already in there if they filled it out online or I put in a score if they’re doing it right in front of me then I clicked this round thing, and it updates the score automatically.” (P3, FG1) |
Design (F and B) | Green Zone (F and B) | 6.1. “I liked the visual aspect of green bar on top and the timeline of everything, it helps a lot” (P10, FG3) (F) 6.2.“The green on the top it just messes with me, every time”. (P7, FG2) (B) 6.3.“It’s nice to have that bar so that patients feel like they’re doing well, but I also don’t want it to be like ‘Hey, this is where we stop and so should there be a two-tone green.” (P6; FG2) (B) | |
Disruption of workflow (B) | - | 7. “I spend a lot of time listening to everything they recall. At the end, I have to rush, explain the medications and follow up, so I think something additional is just a too much.” (P1, FG1) | |
Technical difficulties (B) | - | 8.“The medications are not there…There are technical issues with getting the medication list right” (P2; FG2) | |
External factors | Virtual visits (B) | - | 9. “I was lacking a lot of data–It was a lot of video visits and I have not been successful with that because I haven’t figured out how to really assess the tender and swollen joint count numbers which is pretty significant for the CDAI” (P3; FG1) |
Inconsistent collection of PROs by medical staff (B) | - | 10.“We have a lot of new staff, and they’re not all up to speed with [collecting PROs] and gets dropped which I find it frustrating. But it’s just all about training” (P7, FG3) | |
Clinician knowledge about RA outcome measure scoring (B) | - | 11.“I focus on the CDAI just because that’s the easiest for me to explain. But I start to see the other ones like PROMIS. I’m not exactly sure how that’s calculated” (P12, FG3) | |
Patient limited knowledge about RA outcome measures (B) | - | 12.“Patients don’t always differentiate between the pain score and the global disease activity, some of them write different scores, [but] many of them write the same thing”. (P3, FG1) | |
Intention to Use | Integration in existing workflow (F) | Enhancing availability of data (F) | 13.“It was a learning point for me that if I click RA in the follow up, that is how the patient is triggered to be given this sort of patient global assessment questionnaire…You have to select the appropriate clinic so the patients could be pathway-ed by the team.” (P4, FG1) |
Trying different approaches (F) | 14.“It took me a little bit of time to figure out the best way to use it but I’ve been actually quite surprised that once I really started using it quite regularly that actually many of my patients really liked it” (P3, FG1) | ||
Familiarity with dashboard content | - | 15.“I don’t know how to talk about the dashboard. I just say, our goal is to get you up in the green zone, but I don’t know what else to talk about” (P10, FG3) | |
Actual Use | Time of use | End of the visit | 16.1.“I do it at the end as a way to sort of justify whether or not I’m pushing for a change in medication.” (P12, FG3) |
Early in the visit | 16.2.“I’m doing that all in real time as I’m examining the patient….one hand at a time.” (P7, FG3) | ||
Frequency of use | Type of visit | 17.1.“I use it exclusively during in person visits. I don’t think I pulled it up during telehealth visits.” (P13, FG3) 17.2.“I usually use it with people who have been stable, are not having any complaints, but still good to show. Hey, we have this. Next time you’re in we can go over it in more detail.” (P2, FG3) | |
Patient disease activity | 17.3.“If the person is doing fine I may or may not use the dashboard, but, like the last patient who is very active RA, I try to like right away, get to it to really kind of show the visualization.” (P7; FG3) | ||
Perception of patient interest in PROs | - | 18.“I’m not sure I really use the PROMIS and pain graphs. I don’t know if those are things that patients want to end up discussing.” (P13, FG3) |