Development and Evaluation of a Web Application for Prenatal Care Coordinators in the United States

Abstract

Technology-based solutions have been developed to enhance competencies of maternity health workers (MHWs) in the developing countries, but there has been a limited exploration of such tools in the developed world. We developed a web-based application to support care coordination tasks of the prenatal care coordinators (PNCCs) in U.S. using a 3-phase methodology. During the first phase, following key functionalities were identified in collaboration with an expert panel: assessment, information prescription, collaborative calendar, and secure messaging. The second phase was about iterative and incremental development of the app with the expert panel using modular design and easy to use interfaces. This led to the development of a password-protected PHP web application based on a MySQL database. An outside panel consisting of sixteen PNCCs evaluated the tool and provided feedback on perceived benefits, risks and concerns. The evaluators thought that the app could be help them save resources, empower clients, identify risks, maintain continuity of care and simplify documentation. However, they expressed concerns about feasibility of the tool, implementation cost, compliance with guidelines, security issues related to storage of client data and complexity of managing a paperless system. Concerns of MHWs in the developed and developing countries have a significant overlap, hence there is an opportunity for the developed world to learn from research targeted for the developing world. To address some specific concerns of the MHWs in the developed world, we recommend further ethnographic work assuming an activity theoretic approach with the target users.