There is a need to address the urban-rural disparities in healthcare regarding equal access and quality of care. Due to higher rates of chronic disease, reduced access to providers, and a continuous decline in rural hospitals, it is imperative that Appalachian cancer patients adopt the use of health information technology (HIT). The NCCN Distress Thermometer and Problem List (DT) is under-utilized, not patient-centered, does not consider provider needs, and is outdated in the current digital landscape. Digitizing patient distress screening poses advantages, such as allowing for more frequent screenings, removing geographical barriers, and rural patient autonomy. In this paper, we discuss how knowledge gained from patient-centered design led to the underpinnings of developing a rural remote patient monitoring app that provides delightful and insightful experiences to users.