Barr P, Haslett W, Dannenberg M, Oh L, Elwyn G, Hassanpour S, Bonasia K, Finora J, Schoonmaker J, Onsando W, Ryan J, Bruce M, Das A, Arend R, Piper S, Ganoe C. An Audio Personal Health Library of Clinic Visit Recordings for Patients and Their Caregivers (HealthPAL): User-Centered Design Approach. J Med Internet Res 2021;23(10):e25512 DOI: 10.2196/25512

This paper describes the user-centered development of HealthPAL, an audio personal health library for patients to collect and organize clinic audio recordings. Forty participants representative of older patients and caregivers were recruited from community settings. Participants gave feedback during 5 rounds of usability sessions. In the first three sessions, researchers used paper prototypes and focused on features to refine the user interface. In rounds 4 and 5, participants moved to low-fidelity and high-fidelity software versions of HealthPAL. Participants listened to a primary care visit recording before completing a series of typical user tasks (e.g., find where the provider describes a possible surgery). In the final session, patients’ actual primary care clinic visits were recorded. Perceived usability was collected at each session with the System Usability Scale and whether tasks were completed independently, with the assistance of a facilitator, or not completed. Results found usability increased over the rounds and in the final round where participants reported a score of 78.2 on average (range 20-100). By the final round, participants were able to complete most tasks (at least 88%) without any assistance. Participants also reported very positive perceptions of having a curated audio recording of a clinic visit. Concerns reported were related to privacy and computer literacy required to access recordings. Overall, HealthPAL was rigorously co-designed with patients and their caregivers; next steps include further field testing of the first patient-centered app to access recordings of clinic visits. Sharing visit audio recordings with patients is an emerging strategy for the goal of improving transparency and communication in healthcare.