RTSL releases first-of-its-kind guide to effective, user-centered digital health tools

New playbook summarizes lessons from hundreds of health care workers and millions of patients on how to build a digital tool that saves time and lives.

 

A new playbook released by Resolve to Save Lives (RTSL) compiles lessons learned from five years of health care workers using the Simple app to improve blood pressure control in patients in low-resource settings. 

An effective digital information system can mean the difference between a long-term health program that fails and one that saves millions of lives, especially in busy primary care facilities that manage thousands of patients who need lifelong treatment for conditions like high blood pressure. “Designing an optimal digital tool for hypertension and other long-term care programs” offers step-by-step guidance for creating effective digital tools that health care workers like and use consistently, and that deliver information that can drive program improvement and scale. 

Over the past 6 years, Resolve to Save Lives and partners conducted more than 60 studies of how health care workers used the Simple app—including nearly 250 interviews with health care workers—and clear trends emerged. When digital tools are difficult to learn, cumbersome to use, or slow to function, health care workers won’t use them correctly—or at all—resulting in data that is inaccurate, incomplete, or lost. 

RTSL found a health care-worker first approach to digital tools gets results:  

It takes health care workers just 13 seconds to enter follow-up data. Reports that used to take 2-3 hours to develop now take 2-3 clicks. Health care workers save on average 24 min a day. In one facility, the number of patients treated increased 20-fold AND among those treated, blood pressure control tripled. 

“We’ve seen the difference a strong digital information system can make for hypertension control programs,” said Dr. Tom Frieden, President and CEO of Resolve to Save Lives. “Health programs that treat long-term conditions face many of the same challenges—managing large patient volumes over time, keeping patients in care, limited resources—and what we’ve learned about good digital tools can be applied to long-term treatment programs beyond hypertension. Digital tools can save lives, but they have to be done right.” 

The new digital tools playbook highlights four principles from the Simple app that can be applied to digital tools in any chronic disease program:

Minimal data entry: Effective digital tools capture only the bare minimum data needed to improve patient care. For hypertension, that means only the latest blood pressure, list of medications, and date of next follow-up visit. Fast and easy to use: Health care workers often have less than three minutes per patient. A digital system must be fast and simple enough for health care workers to enter data during the patient visit, without interrupting care. In many health care facilities, that means less than 20 seconds to schedule follow-up visits, and no more than 1 minute to enter a new patient. Patient management-focus: Making patient management easier for health care workers can result in more patients returning to care—an important challenge for programs that manage chronic conditions. Automating tasks like appointment reminders and compiling lists of patients who are overdue for a visit supports consistent follow-up with patients. Simple data visualizations: A digital tool should transform data collected by health care workers into simple visuals that provide a snapshot of program status and capture trends over time. When updated frequently, these visualizations quickly surface problems with the program, facilitate improved care, and indicate when solutions are working. 

Although many health programs for chronic conditions around the world have adopted digital tools for patient care and management, these systems are often ineffective or go unused by health workers. 

"It is only possible to make software that clinicians love by frequently testing software in the field with real users and by respecting their time,” said Daniel Burka, Director of Design for Resolve to Save Lives. “Otherwise, they risk being disruptive, making the jobs of health care workers harder and the data collected useless for monitoring health programs and driving improvements.” 

“Putting health care workers at the center of the design process creates a tool that accommodates real-life environments and time constraints—and is actually used,” said Rahul Mullick, Senior Vice President of Digital for Resolve to Save Lives. “Our new playbook takes what we learned with our partners from extensive user testing with health care workers on the Simple app and makes it available for all chronic disease program managers.” 

By learning from health care workers and incorporating these four key principles, the Simple app is now actively used in more than 5,000 public health facilities in India, Bangladesh, Ethiopia, and Sri Lanka to manage more than 4 million patients with hypertension and diabetes. The key principles outlined in the playbook can be integrated into existing digital health information systems and used as the basis for developing new systems that will improve program monitoring, management and outcomes for chronic conditions.  

Learn more about effective digital tools for chronic disease health programs here and watch our summary video: “Digital tools for long-term treatment programs — done right." 

About Resolve to Save Lives 

Resolve to Save Lives is a not-for-profit organization partnering with countries, communities and organizations to prevent 100 million deaths from cardiovascular disease and make the world safer from epidemics. To find out more, visit: resolvetosavelives.org or Twitter@ResolveTSL. 

 Cassien Tribunal Aungane, Editor