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Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
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Associate Dean of ResearchUniversity of Tennessee, Knoxville
Tami H. Wyat t , PhD, RN, CNE, CHSE, ANEF, FAAN
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
Nursing Excellence Data CoordinatorNorthwest Community Healthcare,
a part of NorthShore
Melis s a Serna Breth, DNP, RN-BC, CPHIMS
Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
#HIMSS21 2
Meet Our Speakers
Tami H. Wyat t Melis s a Serna Breth
Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
#HIMSS21
Conflict of Interest
Melissa Serna Breth, DNP, RN-BC, CPHIMS
• has no real or apparent conflicts of interest to report.
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Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
#HIMSS21
Conflict of Interest
Tami H. Wyatt, PhD, RN, CNE, CHSE, ANEF, FAAN
The model used to create a pediatric asthma application will be discussed in this presentation. The mHealth application is not on the market and is in testing phase. Therefore, there is no financial conflict of interest to report.
The discussion about the product will be limited to the development process and not the mHealth application itself.
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Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
#HIMSS21
Agenda
• Introduction
• Consult Current Literature
• In the Industry…
• mHealth Development Dream Team
• Get Involved
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Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
#HIMSS21
Learning Objectives
• Discuss at least 2 examples of development approaches to mHealth applications
• Describe at least 2 benefits of integrating nurse informaticists into the product life cycle of mHealth technology
• List 3 roles that nurse informaticists can fulfill throughout the mobile health app product life cycle
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Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
#HIMSS21 7
Nursing Knowledge: Big Data Science Initiative
Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
#HIMSS21
Look back at nursing informatics history…
Introduction of the Electronic Health Record
• Focus: • Adoption, Workflow, Usability, Change Management• Verification and validation
• Continued work:• Coding terminology, standardization• Retrofitting for interoperability
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Nurses should have been at the table to contribute to the design…
Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
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Product Life Cycleof Software(mHealth)
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Consult Current Literature
THE PRESENTATION TITLE GOES HERE
Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
#HIMSS21
What does current literature show?
Scoping Review
• Since Jan 2021, a working group interested in mHealth asked, "How does the literature describe the role of the nurse in mHealth app life cycles?”
• After clarifying terms, 14 databases were searched:CINAHL, Cochrane, Compendex , Education Source, Embase, ERIC, Global Index Medicus, Google Scholar, IEEE Xplore, Medline, PsycINFO, PubMed, Scopus, and Web of Science.
• All literature was screened in stages by two independent screeners using Rayyan Intelligent Systematic Review.
• Preliminary results indicate ~189 articles describe the role of the nurse during the initial stages of the product lifecycle.
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Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
#HIMSS21
Preliminary Findings from the Literature
Themes
• Nurses are mostly involved in the deployment and testing of apps.
• Apps created for nurses or to teach healthcare professionals rely on nurses for content subject matter expertise.
• IEEE literature omits nurses or nurse informaticists in the planning, requirements, design, and development stages, especially for patients and consumers products.
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In the Industry…
THE PRESENTATION TITLE GOES HERE
Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
#HIMSS21
How are mobile apps developed today?
Mental Health and Wellness App
• Commercially available, dynamic app
• Developed with subject matter experts from the mental health industry• Psychiatrists, Psychologists, Therapists, and others
• Rooted in cognitive behavioral therapy (CBT)
• No nurses involved in the development of the app, but potential to explore
involving nurse practitioners in the future
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Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
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Pediatric Asthma Self-Management App
• Developed by an interdisciplinary team including nurse informaticists, subject matter expert, graphic & instructional designer, programmer, systems engineer.
• Used agile systems XP approach with intervention mapping protocol (Bartholomew) with a SIMILAR process
• Participatory action approach to engage end users (school nurses, families, children, providers)
How are mobile apps developed today?
https://www.researchgate.net/figure/The-Similar-Process-from-Bahill-and-Gissing-1998_fig1_229711045
Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
How are mobile apps developed today?
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• Used a scrum agile approach based on discussion
• Conducted focus groups with children and parents during the planning stage to determine functions and features needed
• Team is interdisciplinary based on authorship of article but heavily directed by physicians (nurses, physicians, media and communication)
Children with Diabetes App
Image from: https://www.tuleap.org/agile/agile-scrum-in-10-minutes/
Holtz, B.E., Murray, K.M., Hershey, D.D., Dunneback, J.K, Cotton, S.R., Holmstrom, A.J., Yyas, A. Kaiser, M.K, Wood, M. A. (2017). Developing a Patient-Centered mHealth App: A Tool for Adolescents With Type 1 Diabetes and Their Parents. Journal of Medical Informatics Research, 5(4). https://mhealth.jmir.org/2017/4/e53/
Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
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Agile Systems Approaches
U s e r - C e n t e r e d | I t e r a t i v e | I n s t r u c t i o n D e s i g n | S y s t e m s L i f e C y c l e
Scrum XP Lean
Spiral V Model RAD
Kanban FDD RUP
Waterfall Crystal ASD
References:ScienceSoft https://www.scnsoft.com/blog/software-development-modelsAshishdeep, Anitha & Bhatia, Jitendra & Varma (Thakkar), Krunal. (2016). Software process models for mobile application development: A Review. International Journal of
Computer Science & Communication (ISSN: 0973-7391).Retrieved from https://www.researchgate.net/publication/299331511_Software_Process_Models_for_Mobile_Application_Development_A_Review
Barra, D.C.C., Paim, S.M.S., Sasso, G.T.M.D., Colla, G.B. (2017). Methods for developoing mobile apps in health: An integrative review of the literature. Text and Context Nursing, 26(4). https://www.scielo.br/j/tce/a/M3ZvQ3YrvbBb4p7n749JwLv/abstract/?lang=en
Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
#HIMSS21
How are mobile apps developed today?
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Iterative & Incremental Sequential
Reflects stages of development Rapid to a prototype
Feedback from end users throughout process End users evaluate the completed prototype
Takes longer to develop May require extensive revisions
Feedback for content, functionality, usability, scalability, interoperability
Non-cooperative with customer or end-user
More time spent planning than coding & testing
Testing rushed and costly to fix
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mHealth Development Dream Team
Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
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What We Do
1Planning
3 Design and Prototyping
2 Requirements
7 Operations and Maintenance
5 Testing
6 Deployment
Roles of Nurse Informaticists
4 Software Development
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Get Involved!
THE PRESENTATION TITLE GOES HERE
Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
#HIMSS21
How to Get Involved…• Investigate Funding Agencies
• Find out who’s received mHealth awards / grants• i.e. National Institutes of Health, NSF-Smart and Connected Health, Robert Wood Johnson
Foundation
• Conduct a Literature Search• Who’s frequently publishing about mobile health app development?
• Reach out and connect with him / her
• Google it…use a web search engine like Google or Bing • Look up “mobile health developer”
• Cold call. “I’m really interested….how can I help?”
• Get involved with a group – a working group!
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Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
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How to Get Involved…Join• MHealth workgroup• Forum• Special Interest Groups
Talk It Up• Presentations, white papers, social media, publications,
press releases, software development industry
Create• Best Practices• Evidence of nurse informaticists involvement• Create groundswell, a movement
• Get involved to get selected!
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Join us! Nurses for mHealth
Nurse Informaticists: Bringing value throughout the product life cycle of mHealth apps
#HIMSS21
Questions
Thank you!
• Tami H. [email protected]
https://www.linkedin.com/in/tami-h-wyatt-phd-rn-cne-chse-anef-faan-47b62a5/
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Thank you!
• Melissa Serna [email protected]
https://www.linkedin.com/in/melissa-breth-dnp-rn-bc-cphims-5208a81
• Please complete the online session evaluation.
