Development and Implementation of a Personal Virtual Assistant for Patient Engagement and Communication in Postsurgical Cancer Care: Feasibility Cohort Study.

Abstract

Background: Cancer-care complexity heightens communication challenges between health care providers and patients, impacting their treatment adherence. This is especially evident upon hospital discharge in patients undergoing surgical procedures. Digital health tools offer potential solutions to address communication challenges seen in current discharge protocols. We aim to explore the usability and acceptability of an interactive health platform among discharged patients who underwent oncology-related procedures.

Methods: A 4-week exploratory cohort study was conducted. Following hospital discharge, a tablet equipped with an integrated Personal Virtual Assistant (PVA) system was provided to patients who underwent oncology-related procedures. The PVA encompasses automated features that provide personalized care plans, developed through collaboration among clinicians, researchers, and engineers from various disciplines. These plans include guidance on daily specific assignments that were divided into 4 categories: medication intake, exercise, symptom surveys, and postprocedural specific tasks. The aim was to explore the acceptability of the PVA by quantification of dropout rate and assessing adherence to each care plan category throughout the study duration. The secondary aim assessed acceptability of the PVA through a technology acceptance model (TAM) questionnaire that examined ease of use, usefulness, attitude toward use, and privacy concerns.

Results: In total, 17 patients were enrolled. However, 1 (5.8%) patient dropped out from the study after 3 days due to health deterioration, leaving 16/17 (94.2%) completing the study (mean age 54.5, SD 12.7, years; n=9, 52% Caucasian; n=14, 82% with a gynecological disease; n=3, 18% with a hepatobiliary disease). At the study end point, adherence to care plan categories were 78% (SD 25%) for medications, 81% (SD 24%) for exercises, 61% (SD 30%) for surveys, and 58% (SD 44%) for specific tasks such as following step-by step wound care instructions, managing drains, administering injectable medications independently, and performing pelvic baths as instructed. There was an 80% patient endorsement (strongly agree or agree) across all TAM categories.

Conclusions: This study suggests the potential acceptability of the PVA among patients discharged after oncology-related procedures, with a dropout rate of less than 6% and fair-to-good adherence to tasks such as medication intake and exercise. However, these findings are preliminary due to the small sample size and highlight the need for further research with larger cohorts to validate and refine the system.