Comparative Usage of a Web-based Personally Controlled Health Management System and Normal Support: a Case Study in IVF

Background: Research into the impact of personal health record-enabled consumer systems is still in its infancy.  Little is known about effective designs of web-based personally controlled health management system (PCHMS), how people use these systems in their real-life settings, nor how usage relates to concurrent support from other sources. Objective: To inform PCHMS design and feature development by assessing how patients undergoing in-vitro fertilization (IVF) use a web-based PCHMS in their real-life setting, and how their usage compares to concurrent support from other sources. Methods: An in-depth formative evaluation study was conducted with 17 women undergoing IVF, who were invited to use a web-based PCHMS called Healthy.me , providing targeted IVF program information over an eight-week treatment. Online interactions were recorded on computer logs. Participants were interviewed weekly by telephone throughout their cycle, and were specifically questioned about their feedback of PCHMS and concurrent sources of support beyond that provided by the system. Interview data was coded and analysed using two-way repeated ANOVA. Results : 62 interviews were collected from 14 participants who completed the study.  Twelve of 14 participants accessed all features in Healthy.me, which included i) accessing information about the next steps of their treatment (i.e. journey), and ii) viewing or updating details in their pillbox, schedule, test results and team members during their IVF treatment. Healthy.me alerted 21% (3/14) participants to seek advice from clinic staff on issues that could affect treatment outcome of which they were previously unaware (e.g. sexual practices, frequency and order of ultrasound screenings after a sequence of blood tests).  Patients additionally sought support from people, information and organisational tools outside Healthy.me to help decide IVF and manage different stages of their treatment. There was a significant interaction between IVF stage and sources of support (F(10,50)=2.54, p=.015, η p 2 =.34).  Suggestions are presented on ways to tailor support at different stages of the IVF cycle using a PCHMS. Conclusions: IVF patients seek support from the web-based PCHMS, and concurrently do so with other sources of support.  More research is needed to inform PCHMS design that effectively tailors support for patients at different stages of their health journey.