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Post-Test Survey, Pre-Test Instruction, Feedback Forum (Mobile Content)

Despite there being a few different diagnostic tests available, the methodology for administering each is standardized. Unfortunately, there is a relatively short time to train patients (and sometimes staff), and post-test communication regarding efficacy of the testing procedure itself is minimal. Additionally, the communities at large are susceptible to misinformation at worst, and persuasion at best.

This idea covers a mobile web-based system that could be standardized at a National level (for content), but localized as a regional level (for community participation).

1. Informative awareness/training content would be published and made easy to integrate into community web pages where diagnostic tests are located, scheduled, in-take, etc. The content would prepare patients with multimedia training material in order to better prepare them for what to expect, what to do, etc., which would hypothetically result in a boost of test efficacy (e.g. for self-administered tests) or at least save time in the overall process (where people are more aware of what to do and how to do it, if they took the time to peruse the content). Content would be test-specific with a selection between different methods as applicable. Local authorities would have the option and responsibility of integrating the content themselves, with the ability to customize certain aspects as needed. 

2. Similarly, localities would be encouraged to integrate a post-test survey (or enhance an existing survey) with a prescribed set of questions aimed to gauge the patient's subjective experience, and objectively assess validity of administration of the test, as well as identify any aspects of the protocol that could potentially be refined. The primary aim of this would be to explore ways to improve the overall testing methodology for future iterations. Survey content would be dynamic according to the demographics of the test participant.

3. Independent of the pre and post test content, the system would include a feedback forum, again, standardized at the national level, but instantiated locally. The forum would be curated with specific topical content and allow for test administrators to identify macro or societal trends or issues that could affect overall administration of the program.

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Abigail Watson Nov 17, 2020

For what it’s worth, what you’re describing is really media heavy, and would constitute an entire medical illustration studio‘s production run over 6 to 9 months. There are studios out there with the content needed, or making it right now; but it’s as big or bigger lift than the technology you’re suggesting.

Do you have thoughts about which specific questionnaires or post-test surveys you’d send out and collect responses from?

JD Moore Nov 18, 2020

Hi Abigail. The weight of the media is definitely an important factor in terms of production, as you rightly point out. That said -- there are methods to greatly speed up that process, especially if the various manufacturers/providers have pre-existing content (which is an assumption).

At the very least, there are some light weight options that could be considered if the production of the content was a gating factor:
* predominantly text with more simplistic static or animated images
* mid-quality video production

Or, a set of instructions could be developed to have municipalities 'upgrade' e.g. the textual description(s) with their own staff-produced video. (That would somewhat defeat the purpose, but again, it's an option if needed.)

As for post-test surveys, the suggestion would be to do some primary research (interviews) with a small cohort of various types of facilities (e.g. rural, urban, peri-urban ; drive-through, walk-in ; free, insured, etc.) and find out which types of societal, regional, demographic or other procedural factors tend to have an impact on potential efficacy. (For example, you might find that language, accessibility or transportation might be key issues in certain areas, so you'd have a database of questions that could be used to compile the surveys that would shed the most light for a given community.)

In addition to that, I'd think there'd be a sub-set oriented around self-reported efficacy and/or experience such as:
* Rating the overall experience across dimensions such as
- organizational efficiency (of the lab setup)
- ease of booking, follow-up activities
- privacy concerns, comfort, etc.
etc.

In other words, you'd have to do upfront research in order to determine the actual research framing. :)

Andrea Pitkus Nov 18, 2020

In #1, would your model integrate education on the Ask at Order Entry questions and responses that are part of the HHS requirements for COVID results so patients are better aware and prepared to answer them when they present for testing?

How flexible would approach be to switch with testing methods deployed, especially if the laboratory is deciding (based upon supply chain issues or disease prevalence to do pooled testing or switch IVD vendor systems) nearly on the fly?

JD Moore Nov 18, 2020

Great questions, Andrea, thank you.

Similar to the response above, the idea would be to conduct some preliminary research to define the content (based on what would be most valuable). Your suggestion sounds like it would presumably be useful...and it does get at the heart of trying to better prepare the more engaged patients with the process (upfront).

Conceptually, a key benefit of this approach would be to have that flexibility you describe--enabled by the somewhat top-down standardization that the localities can then consume at will. So, in other words, Yes, the labs would theoretically be able to either choose and switch which variants they display on-the-fly...but also allow for an interface that would guide the end-users (patients) to be able to also select from variants if variants are, in fact, available in their locality.

Andrea Pitkus Nov 18, 2020

Thanks for the prompt reply. AOE content for lab based reporting of HHS requirements is here (on homepage of this site): https://www.hhs.gov/sites/default/files/hhs-g...lementation.pdf

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