Table 3.

Patient Concerns and Design Responses for e-EXCELS Development

Concern	Patient Concerns	Design Response	Implementation Implication
Patient burden	– Too much information input – Information needs manual updates	– Minimal data for functionality	– Patient wanted tailorable notifications (e.g. content/mode) – Integration with health care setting so less input required
Tool Redundancy	– Too many passwords/profiles	– Single profile data entry at initial sign on	– Different portals across settings fatigue end users
Timing in survivorship trajectory	– Survivors already figured out a system that “works”	– Orientation to relevance for longer-term survivors – Information temporally tailored based on diagnosis date	– Introduce e-EXCELS earlier in survivorship
Relevance	– Survivors issues changed over time	– Tailored information by age, gender, cancer site, time since diagnosis – Learn and prepare section specific to cancer site – Custom topics can be added	– Survivors express the salience of different issues over time, topics need updating for newly identified issues
Security/Privacy	– Concerns about privacy	– Hosted in protected HIPAA compliant website	– Cross organization interoperability constrained by privacy/security