Design Requirements for Patient-Centered Digital Health Applications: Supporting Patients' Values in Postoperative Delirium Prevention

Abstract: Postoperative delirium (POD) is among the most common complications after surgeries for older adults and can entail long-term adverse health consequences. Active patient participation in POD prevention presents a central factor in reducing these risks. To support patient engagement through a digital health application, we use value sensitive design approaches to identify the requirements for a patient-centered digital health application supporting patient engagement in POD prevention. Through interviews with medical professionals and patient representatives, we construct a patient journey, which serves as the basis for twelve patient value journey interviews. In these interviews, patients from the high-risk group for POD revisit their recent experience of undergoing surgery to elicit barriers, needs, and values concerning POD prevention from a patient perspective. An analysis of the patient interviews derives four design requirements for a digital health application supporting patients regarding POD prevention: the adaptation of patient-centered communication, the provision of procedural transparency, fostering patient empowerment through consistent guidance, and explicitly addressing relatives as mediators and supporters for a patient after a POD occurrence.