Challenges of integrating patient-centered data into clinical workflow for care of high-risk infants

In this paper, we outline the challenges to integrating patient-centered data into clinical workflow that were encountered during the deployment of a research prototype mobile system, Estrellita, designed to support collection of data about preterm infants and their parents. The data sources for our analysis come from approximately 4 years of collaboration, beginning in March of 2008, between an academic research team and various clinical partners specializing in high-risk infant care. Specifically, we draw from interviews with parents, pediatric health specialists, community pediatricians, and clinicians at a high-risk infant follow-up program; our collaborative experience throughout the project; and observations of one clinician as she integrated patient-generated data into her workflow over an 8-month period. We identified three major challenges to integrating patient-generated data into the clinical workflow: (1) finding an appropriate clinical partner, (2) designing for the unique workflow of the HRIF program, and (3) designing to minimize clinician liability. We further present workflow analysis from one clinician who monitored the patient-generated data. We discuss lessons learned and opportunities for design.