IVF patients' preferences in service design

Jan Kremer & Wouter TuilRadboud University Nijmegen MC

2

INTRODUCTION

Saturday, April 21, 2012

2001

3

INTRODUCTION

• Preliminary research (Haagen et al. 2003)– Patients are online

(81%)– Patients are on the internet for medical purposes (54%)– Patients want online interaction with their physician (69%)– Patients want online access to their medical records (82%)

• Based on these findings the virtual IVF clinic was created

Saturday, April 21, 2012

Human Reproduction Vol.18, 2073, 2003

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VIRTUAL IVF CLINIC

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2003

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VIRTUAL IVF CLINIC

• Interactive website– General information– Personal information– Communication

• Promote patient empowerment• Safe, secure and efficient

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VIRTUAL IVF CLINIC

Generic Information

• IVF treatment• Clinic• FAQ• Stories• Links• Literature• Videos

Personal information

• Medical record• Dayplanner• Embryo-pictures• Prognosis• Correspondence

Communication

• Chat• Discussion forum• E-mail

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RESEARCH QUESTIONS

1. Use and usefulness of the website

2. What are the time-dynamics of the website?• Weeks, Treatment phase

3. Types of online behavioral styles?

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METHODS

• Questionnaire (n=54)– Demographics– Usefulness of the website

• Automated logging of viewed pages (n=1050)– User– Requested functionality– Date & time

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1. USE AND USEFULNESS

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USE and USEFULNESS

Saturday, April 21, 2012 16Tuil et al. Hum Reprod. 2006: 2955-9.

Useful

General information (top 3)

1. Frequently Asked Questions2. Information about the clinic3. Information about the treatment

88 %67 %63 %

Personal information (top 3)

1. Medical Record2. Day planner3. Embryo photos

96 %92 %79 %

Communication

1. E-mail2. Discussion forum3. Chat

77 %73 %58 %

Useful Pageviews

General information (top 3)

1. Frequently Asked Questions2. Information about the clinic3. Information about the treatment

88 %67 %63 %

7,98.8

62,2

Personal information (top 3)

1. Medical Record2. Day planner3. Embryo photos

96 %92 %79 %

36,030,450,1

Communication

1. E-mail2. Discussion forum3. Chat

77 %73 %58 %

2,4139,545,3

Saturday, April 21, 2012 17Tuil et al. Hum Reprod. 2006: 2955-9.

USE and USEFULNESS

18Saturday, April 21, 2012

TIME DYNAMICS

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PAGEVIEWS OVER TIME

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1 2 3 4 5 6 7 8 9 100

1000

2000

3000

4000

5000

6000

Communication (34.2%) General information (25.4%)Personal Information (17.9%) Navigation (22.4%)

weeks after first visit

page

view

s

Tuil et al. Fertil Steril. 2009; 953-6

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PAGEVIEWS PER TREATMENT PHASE

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T1 T2 T3 T4 T5 T1 T2 T3 T4 T5 T1 T2 T3 T4 T50

2

4

6

8

10

12

Page

view

s pe

r vis

itor p

er d

ay (C

I)

Generic Information Patient specificInformation

Communication

T1: pretreatment T2: stimulation T3 opu&et T4: luteal phase T5: posttreatment

Tuil et al. Fertil Steril. 2009; 953-6

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3. BEHAVIORAL STYLES

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BEHAVIORAL STYLES (factor analysis)

Content Type Individual information style

Generic information style

Communication style

Medical records 0.89 0.23 0.30Treatment information 0.89 0.30 0.30Personalised prognosis 0.80 0.31 0.22FAQ 0.67 0.40 0.12Downloadable documents 0.67 0.39 0.29Day planner 0.46 0.41 0.23Literature 0.20 0.71 0.17General information 0.45 0.62 0.23External links 0.25 0.62 0.17Website help 0.20 0.61 0.13Hospital information 0.48 0.60 0.23Bulletin board (viewing) 0.38 0.24 0.86Bulletin board (posting) 0.14 0.14 0.83Chatroom 0.24 0.25 0.62

Saturday, April 21, 2012 Tuil et al. Hum Reprod. 2008:2501-5

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BEHAVIORAL STYLES (prevalence)

Individual information style

Generic information style

Communication style n(%)

None of the styles ○ ○ ○ 411 (35.7%)

One of the styles ● ○ ○ 195 (17.0%) ○ ● ○ 156 (13.6%) ○ ○ ● 52 (4.5%)Two of the styles ● ● ○ 138 (12.0%) ● ○ ● 66 (5.7%) ○ ● ● 60 (5.2%)All three styles ● ● ● 72 (6.3%)

Saturday, April 21, 2012 Tuil et al. Hum Reprod. 2008:2501-5

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Generic information Personal Information Communication0%5%

10%15%20%25%30%35%40%

29%33%

38%

BEHAVIORAL STYLES (dominance)

12 november 2008 Tuil et al. Hum Reprod. 2008:2501-5

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DETERMINANTS OF BEHAVIORAL STYLES

Saturday, April 21, 2012 Tuil et al. Hum Reprod. 2008:2501-5

Personal information style: Sharing emotions (p=0.028) Paid employment (p=0.007)

Generic information style: Depression (p=0.028)

Communication style: Anxiety (p=0.005) Paid employment (p=0.021)

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CONCLUSIONS

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CONCLUSIONS

• The majority of functions are used and perceived as useful– Discussion forum is used most frequently– Personalized information is valued as most useful

• Usage varies greatly over time– High number of page views during the OPU and ET– Information at the beginning and communication at the end of treatment

• There are three types of online behavior styles– Personal information, generic information and communication– Anxiety, depression and employment are determinants of these styles

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Patients play a crucial role in service design

@JKNL and @WouterTuil