Access and Authentication
Drupal’s innate authentication system relying on a username and password
is used keeping in mind concerns regarding data safety and patient
privacy. We plan to have an internal database of patient usernames
against patient hospital unique IDs which will be maintained separately
from the system. Administrators will be responsible for creating
users and assigning them roles and privileges. No personal identifying
information will be collected and retained in the system including
patient name, age, gender etc.
Preliminary User Experience Testing
We determined that the key user of the system was the patient and we could expect that
they would have a diverse range of literacy and proficiency with
electronic devices. It was unlikely that a system could be designed such
that users who had never used computers and smartphones could use the
system without some help. However, from the patient's perspective, it was important to reduce and eliminate roadblocks on the system so that they
required minimum assistance. While dedicated testing of the system would need real patients, we proceeded with an initial round of user experience testing such that some data is available as a benchmark for the planned validation studies in future. Physicians and other health care workers would usually be more proficient with the use of electronic devices but would need
specific training in the site so that they can use it to maximum
benefit.
To get a preliminary idea of the user experience of the website in the patient role, we invited laypersons to do a series of tasks on the website pretending to be a patient and then provide us with feedback on the tasks performed. Social media contacts of authors were invited to participate in this testing. These were a mix of laypersons as well as physicians. We requested all participants to ask their parents and other senior family members to do the tasks if possible. The key tasks to be performed included:
- Navigation to the website
- Logging in to the website
- Checking if changing the language was easy and working.
- Find the available questionnaire
- Fill the questionnaire
- Fill a user experience questionnaire.
Three dummy patient accounts were created (one for each language -
English, Hindi and Bengali) and assigned to the cervical cancer disease
group. A document with instructions for the user experience testing was prepared in all three languages.
A dummy questionnaire was made available (a small subset of the
European Organization for Research and Treatment in Cancer - EORTC
quality of life (QLQ C30) questionnaire) and translated into the two Indian languages. Each question was presented in a single page and each
question was accompanied with an audio prompt that allowed users to
listen to the question in the language of choice. Time taken to complete the questionnaire was recorded in the system.
After the questionnaire was completed patients were automatically redirected to a user
experience evaluation questionnaire. The questionnaire asked questions
on whether there was any difficulty in performing the above tasks and
gave the option to the user to give a free text opinion. Additionally, a
few demographic questions were asked on patient age, gender, the device used
for the task as well as the degree of proficiency with the use of
computer or mobile.
Statistical Analysis
Descriptive analysis of the results of the user experience testing is
presented. Summaries of continuous variables like time are presented
using the median and interquartile range. For categorical variables
frequencies are reported. Formal sample size calculations were not done
and no group-wise comparisons have been performed.