{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:43:04Z","timestamp":1785544984324,"version":"3.56.0"},"reference-count":43,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Cancer"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Breast cancer is the most common cancer among Canadian women, bringing complex demands for timely decision-making, coordination of multidisciplinary care, and efficient communication between patients and providers. The increasing reliance on fragmented and noninteroperable health information systems exacerbates workflow and documentation burdens, leading to inefficiencies and gaps in continuity of care. While nurse navigation programs partially bridge these gaps, most digital platforms remain poorly integrated into provider workflows, requiring manual tracking, which results in duplicated effort and reduced efficiency. Our team developed \u201cMyJourney\u201d at North York General Hospital (NYGH) in Ontario. It is a digital navigation platform that supports breast cancer care throughout the entire continuum, from diagnosis to survivorship.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed (1) to map the breast cancer journey and workflow to inform the design and adaptation of MyJourney at 2 oncology settings at NYGH; (2) to identify barriers and guide local implementation; and (3) to evaluate the implementation, usability, and perceived utility of MyJourney\u2019s Clinical Navigation Tool for breast cancer care teams.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A multimethod, 3-phase study was conducted at NYGH\u2019s Breast Diagnostic Centre (BDC) and Chemotherapy Clinic (CC) in Toronto, Canada. Phase 1 involved qualitative interviews with patients with breast cancer to map their care journey and inform user-centered platform design. Phase 2 included preimplementation interviews with nurses, pharmacists, and administrative staff to map workflows and customize MyJourney for the CC. Phase 3 evaluated MyJourney\u2019s implementation and usability over 6 weeks using the System Usability Scale, technology acceptance model surveys, and follow-up interviews with platform users. Data were analyzed via interpretive description and descriptive statistics. Ethics approval was obtained.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In total, 13 patient interviews revealed distinct challenges and communication needs across prediagnosis, diagnosis, treatment, and survivorship phases, emphasizing the need for personalized, integrated resources (phase 1). A total of 8 participants (3 nurses and 5 pharmacists), providers, and clinic staff highlighted pain points in fragmented information systems, inefficient manual processes, and limited team coordination (phase 2). MyJourney\u2019s phased implementation led to high user acceptance, with mean System Usability Scale scores rated \u201cexcellent\u201d (BDC: 81.3; CC: 86.3) at the 6-week follow-up (phase 3). The 4 participants (1 charge nurse, 1 administrative staff at the BDC, and 2 charge nurses at the CC) described the platform as intuitive, efficient, and well-organized, citing consolidated patient records, streamlined appointment management, and improved workflow as major benefits. Recommendations included improved interoperability, enhanced notifications, role-specific customization, and integration with electronic medical records for broader scalability.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The iterative, interest-holder engaged design and phased implementation of MyJourney facilitated rapid uptake and high usability among breast cancer provider teams. The Clinical Navigation Tool component of the MyJourney platform reduced documentation burden, improved workflow efficiency, and facilitated care coordination across oncology settings.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/87973","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:05:07Z","timestamp":1776096307000},"page":"e87973-e87973","source":"Crossref","is-referenced-by-count":0,"title":["Supporting Patients With Breast Cancer and Providers Through Treatment and Survivorship: Multimethod Implementation Study of the MyJourney Platform"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7065-8479","authenticated-orcid":false,"given":"Isabella","family":"Herrington","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2689-4013","authenticated-orcid":false,"given":"Julie","family":"Makarski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5553-3195","authenticated-orcid":false,"given":"Krystle","family":"Amog","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3345-7686","authenticated-orcid":false,"given":"Leigh","family":"Hayden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4309-4778","authenticated-orcid":false,"given":"Kate","family":"Mossman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9739-0006","authenticated-orcid":false,"given":"Norna","family":"Abbo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7340-4186","authenticated-orcid":false,"given":"Nicole","family":"Jedrzejko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1041-7497","authenticated-orcid":false,"given":"Fahima","family":"Osman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2838-7417","authenticated-orcid":false,"given":"Monika","family":"Kastner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"R1","unstructured":"Public Health Agency of Canada (PHAC). Breast cancer. Government of Canada. 2023. URL: https:\/\/www.canada.ca\/en\/public-health\/services\/chronic-diseases\/cancer\/breast-cancer.html [Accessed 29-04-2026]"},{"key":"R2","unstructured":"Breast cancer statistics. Canadian Cancer Society. 2023. URL: https:\/\/cancer.ca\/en\/cancer-information\/cancer-types\/breast\/statistics [Accessed 15-05-2026]"},{"issue":"4","key":"R3","doi-asserted-by":"publisher","first-page":"308","DOI":"10.3322\/caac.70011","article-title":"Cancer treatment and survivorship statistics, 2025","volume":"75","author":"Wagle","journal-title":"CA Cancer J Clin"},{"issue":"3","key":"R4","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/j.pec.2021.06.017","article-title":"The lived experience during the peri-diagnostic period of breast cancer: a scoping review","volume":"105","author":"Rogers","journal-title":"Patient Educ Couns"},{"issue":"3","key":"R5","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1111\/hex.12372","article-title":"Lived experiences of breast cancer survivors after diagnosis, treatment and beyond: qualitative study","volume":"19","author":"Williams","journal-title":"Health Expect"},{"issue":"10","key":"R6","doi-asserted-by":"publisher","first-page":"3209","DOI":"10.1007\/s00520-017-3730-8","article-title":"Barriers to information provision regarding breast cancer and its treatment","volume":"25","author":"Campbell-Enns","journal-title":"Support Care Cancer"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-08090-3","article-title":"Patient navigator team perceptions on the implementation of a citywide breast cancer patient navigation protocol: a qualitative study","volume":"22","author":"Loo","journal-title":"BMC Health Serv Res"},{"key":"R8","doi-asserted-by":"crossref","unstructured":"Silva V Cardoso J Fonseca J Cruz-Correia R . Study of clinical workflow and information flow of a breast care unit. Presented at: Proceedeings of the Third International Conference on Health Informatics; Jan 20-23, 2010; Valencia, Spain. [doi: 10.5220\/0002744502940301]","DOI":"10.5220\/0002744502940301"},{"issue":"3","key":"R9","doi-asserted-by":"publisher","first-page":"234","DOI":"10.4103\/apjon.apjon_72_18","article-title":"Utilizing the advances in digital health solutions to manage care in cancer patients","volume":"6","author":"Charalambous","journal-title":"Asia Pac J Oncol Nurs"},{"issue":"11","key":"R10","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-018-1075-6","article-title":"The use of electronic health records to support population health: a systematic review of the literature","volume":"42","author":"Kruse","journal-title":"J Med Syst"},{"issue":"Suppl 13","key":"R11","doi-asserted-by":"publisher","first-page":"2649","DOI":"10.1002\/cncr.33944","article-title":"Development of a workflow process mapping protocol to inform the implementation of regional patient navigation programs in breast oncology","volume":"128","author":"Casanova","journal-title":"Cancer"},{"issue":"12","key":"R12","doi-asserted-by":"publisher","first-page":"1682","DOI":"10.1080\/0284186X.2017.1358462","article-title":"The effects of individually tailored nurse navigation for patients with newly diagnosed breast cancer: a randomized pilot study","volume":"56","author":"Mertz","journal-title":"Acta Oncol"},{"issue":"1","key":"R13","doi-asserted-by":"publisher","DOI":"10.5334\/ijic.3068","article-title":"Barriers to the integration of care in inter-organisational settings: a literature review","volume":"18","author":"Auschra","journal-title":"Int J Integr Care"},{"issue":"6","key":"R14","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1001\/jama.2021.25181","article-title":"The Quintuple Aim for health care improvement: a new imperative to advance health equity","volume":"327","author":"Nundy","journal-title":"JAMA"},{"key":"R15","doi-asserted-by":"crossref","unstructured":"Thorne S . Interpretive Description: Qualitative Research for Applied Practice. 2nd ed. Routledge; 2016. [doi: 10.4324\/9781315545196]","DOI":"10.4324\/9781315545196"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1002\/nur.20362","article-title":"What\u2019s in a name? Qualitative description revisited","volume":"33","author":"Sandelowski","journal-title":"Res Nurs Health"},{"issue":"3","key":"R17","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.outlook.2005.03.005","article-title":"Developing and refining interventions in persons with health disparities: the use of qualitative description","volume":"53","author":"Sullivan-Bolyai","journal-title":"Nurs Outlook"},{"issue":"1","key":"R18","doi-asserted-by":"publisher","DOI":"10.1017\/cts.2021.789","article-title":"Understanding and applying the RE-AIM framework: clarifications and resources","volume":"5","author":"Holtrop","journal-title":"J Clin Trans Sci"},{"issue":"9","key":"R19","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","article-title":"Standards for reporting qualitative research: a synthesis of recommendations","volume":"89","author":"O\u2019Brien","journal-title":"Acad Med"},{"key":"R20","unstructured":"Cancer care. North York General Hospital. URL: https:\/\/www.nygh.on.ca\/care-service\/cancer-care\/ [Accessed 21-09-2025]"},{"issue":"5","key":"R21","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1007\/s10488-013-0528-y","article-title":"Purposeful sampling for qualitative data collection and analysis in mixed method implementation research","volume":"42","author":"Palinkas","journal-title":"Adm Policy Ment Health"},{"issue":"4","key":"R22","doi-asserted-by":"publisher","first-page":"1893","DOI":"10.1007\/s11135-017-0574-8","article-title":"Saturation in qualitative research: exploring its conceptualization and operationalization","volume":"52","author":"Saunders","journal-title":"Qual Quant"},{"issue":"7","key":"R23","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1080\/10447318.2018.1455307","article-title":"The System Usability Scale: past, present, and future","volume":"34","author":"Lewis","journal-title":"Int J Hum-Comput Interact"},{"key":"R24","doi-asserted-by":"crossref","unstructured":"Brooke J . SUS\u2014a quick and dirty usability scale. In: Usability Evaluation in Industry. Taylor & Francis; 1996:4-7. [doi: 10.1201\/9781498710411-35]","DOI":"10.1201\/9781498710411-35"},{"issue":"1","key":"R25","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1089\/tmj.2011.0066","article-title":"Using a modified technology acceptance model to evaluate healthcare professionals\u2019 adoption of a new telemonitoring system","volume":"18","author":"Gagnon","journal-title":"Telemed J E Health"},{"issue":"3","key":"R26","doi-asserted-by":"publisher","first-page":"319","DOI":"10.2307\/249008","article-title":"Perceived usefulness, perceived ease of use, and user acceptance of information technology","volume":"13","author":"Davis","journal-title":"MIS Q"},{"issue":"4","key":"R27","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1177\/001872089203400407","article-title":"Refining the test phase of usability evaluation: how many subjects is enough?","volume":"34","author":"Virzi","journal-title":"Hum Factors"},{"issue":"9","key":"R28","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis","volume":"15","author":"Hsieh","journal-title":"Qual Health Res"},{"issue":"3","key":"R29","doi-asserted-by":"publisher","first-page":"114","DOI":"10.5555\/2835587.2835589","article-title":"Determining what individual SUS scores mean: adding an adjective rating scale","volume":"4","author":"Bangor","journal-title":"J Usability Stud"},{"issue":"7","key":"R30","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13071937","article-title":"Digital health platforms for breast cancer care: a scoping review","volume":"13","author":"Kirsch","journal-title":"J Clin Med"},{"issue":"2","key":"R31","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1007\/s00520-019-04837-7","article-title":"Perspectives from oncology patient navigation programs on information management practices and needs: a descriptive study","volume":"28","author":"Phillips","journal-title":"Support Care Cancer"},{"issue":"2","key":"R32","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.soncn.2013.02.005","article-title":"Oncology nurse navigators and the continuum of cancer care","volume":"29","author":"McMullen","journal-title":"Semin Oncol Nurs"},{"issue":"3","key":"R33","first-page":"98","volume":"10","author":"Rohan","journal-title":"J Oncol Navig Surviv"},{"issue":"5","key":"R34","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1007\/s11912-024-01514-9","article-title":"Patient navigation in cancer treatment: a systematic review","volume":"26","author":"Chen","journal-title":"Curr Oncol Rep"},{"issue":"10","key":"R35","doi-asserted-by":"publisher","first-page":"4589","DOI":"10.1007\/s00520-020-05539-1","article-title":"Digital health for optimal supportive care in oncology: benefits, limits, and future perspectives","volume":"28","author":"Aapro","journal-title":"Support Care Cancer"},{"key":"R36","doi-asserted-by":"publisher","DOI":"10.1177\/20552076241288821","article-title":"Digital innovations in breast cancer care: exploring the potential and challenges of digital therapeutics and clinical decision support systems","volume":"10","author":"Jacobs","journal-title":"Digit Health"},{"key":"R37","doi-asserted-by":"crossref","unstructured":"Institute of Medicine. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis. National Academies Press; 2013. [doi: 10.17226\/18359]","DOI":"10.17226\/18359"},{"issue":"5","key":"R38","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1093\/jamia\/ocaa301","article-title":"The burden of the digital environment: a systematic review on organization-directed workplace interventions to mitigate physician burnout","volume":"28","author":"Thomas Craig","journal-title":"J Am Med Inform Assoc"},{"issue":"2","key":"R39","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1093\/jamia\/ocae295","article-title":"Ambient artificial intelligence scribes: physician burnout and perspectives on usability and documentation burden","volume":"32","author":"Shah","journal-title":"J Am Med Inform Assoc"},{"issue":"3","key":"R40","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1200\/OP.23.00493","article-title":"Implementing a patient-reported outcome dashboard in oncology telemedicine encounters: clinician and patient adoption and acceptability","volume":"20","author":"Mohindra","journal-title":"JCO Oncol Pract"},{"key":"R41","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_350151","article-title":"Leveraging digital technology to reduce cancer care inequities","volume":"42","author":"Arora","journal-title":"Am Soc Clin Oncol Educ Book"},{"issue":"2","key":"R42","doi-asserted-by":"publisher","DOI":"10.2196\/36258","article-title":"Optimizing social support in oncology with digital platforms","volume":"8","author":"Katsaros","journal-title":"JMIR Cancer"},{"issue":"7","key":"R43","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001175.pub4","article-title":"Computer-generated reminders delivered on paper to healthcare professionals: effects on professional practice and healthcare outcomes","volume":"7","author":"Arditi","journal-title":"Cochrane Database Syst Rev"}],"container-title":["JMIR Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/cancer.jmir.org\/2026\/1\/e87973","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:25:04Z","timestamp":1785536704000},"score":1,"resource":{"primary":{"URL":"https:\/\/cancer.jmir.org\/2026\/1\/e87973"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,10]]},"references-count":43,"URL":"https:\/\/doi.org\/10.2196\/87973","relation":{},"ISSN":["2369-1999"],"issn-type":[{"value":"2369-1999","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,10]]},"article-number":"v12i4e87973"}}