Evaluation of a collaboratively designed digital rehabilitation plan: end users’ evaluating its potential for shared decision-making

BACKGROUND: Through a partnership and collaborative design process involving technologists and healthcare professionals, a web platform featuring a digital rehabilitation plan was developed. This process tackles recognised challenges in information and communication technology for rehabilitation, such as fragmented data flows and low-quality user interfaces. The digital rehabilitation plan facilitates shared decision-making by allowing patients to customise their plan while providing healthcare professionals with the necessary access to support the patient's journey. This study assessed the experiences of end-user healthcare professionals and patients regarding the plan's usability, its potential for shared decision-making, and identified potential areas for improvement. METHODS: This qualitative exploratory study employed semi-structured focus group discussions involving three distinct participant groups: (i) patients, (ii) healthcare professionals, and (iii) a combined group of patients and healthcare professionals. The discussions focused on various stages of the rehabilitation process, including the pre-admission phase, inpatient care, rehabilitation plans, evaluations during inpatient stays, and outpatient follow-ups. The recorded discussions were transcribed and analysed using reflexive thematic analysis to uncover patterns, contradictions, and dilemmas in the participants' experiences and perspectives. RESULTS: Patients and healthcare professionals appreciated the digital rehabilitation plan and acknowledged its contribution to shared decision-making. However, patients requested a wider range of digital support and communication tools for inpatient rehabilitation and follow-up, e.g., a "my page" with access to relevant information, chat support, educational tools, and videos. Professionals were reluctant to expand the use of the web platform due to past negative experiences with information and communication technology, and had less motivation to change work processes further. When patients and professionals were brought together, the discussion led to a shift in the professionals' opinions, revealing a potential for improved collaboration, communication, and shared decision-making. CONCLUSIONS: This study underscores the necessity of involving all stakeholders in the design of a digital tool to ensure that all end-users ' needs and wants are accounted for. Involving patients in both design and implementation can uncover biases, identify barriers, and enhance usability, thereby promoting digital communication and shared decision-making in rehabilitation. Bringing stakeholders together revealed that while healthcare professionals encounter barriers due to established procedures, patients' familiarity with everyday technology and enthusiasm for digital tools shifted professionals' perspectives. Lessons learned from this research project were fed back to the developer of the web platform, and taken into account to strengthen the web platform's potential for communication and shared decision-making in rehabilitation planning. TRIAL REGISTRATION: This study was approved by the Norwegian Agency for Shared Services in Education and Research, Data Protection Services for Research, reference number 116434.