A Patient-Facing Diabetes Dashboard Embedded in a Patient Web Portal: Design Sprint and Usability Testing

Abstract

BackgroundHealth apps and Web-based interventions designed for patients with diabetes offer novel and scalable approaches to engage patients and improve outcomes. However, careful attention to the design and usability of these apps and Web-based interventions is essential to reduce the barriers to engagement and maximize use.ObjectiveThe aim of this study was to apply design sprint methodology paired with mixed-methods, task-based usability testing to design and evaluate an innovative, patient-facing diabetes dashboard embedded in an existing patient portal and integrated into an electronic health record.MethodsWe applied a 5-day design sprint methodology developed by Google Ventures (Alphabet Inc, Mountain View, CA) to create our initial dashboard prototype. We identified recommended strategies from the literature for using patient-facing technologies to enhance patient activation and designed a dashboard functionality to match each strategy. We then conducted a mixed-methods, task-based usability assessment of dashboard prototypes with individual patients. Measures included validated metrics of task performance on 5 common and standardized tasks, semistructured interviews, and a validated usability satisfaction questionnaire. After each round of usability testing, we revised the dashboard prototype in response to usability findings before the next round of testing until the majority of participants successfully completed tasks, expressed high satisfaction, and identified no new usability concerns (ie, stop criterion was met).ResultsThe sample (N=14) comprised 5 patients in round 1, 3 patients in round 2, and 6 patients in round 3, at which point we reached our stop criterion. The participants’ mean age was 63 years (range 45-78 years), 57% (8/14) were female, and 50% (7/14) were white. Our design sprint yielded an initial patient-facing diabetes dashboard prototype that displayed and summarized 5 measures of patients’ diabetes health status (eg, hemoglobin A1c). The dashboard used graphics to visualize and summarize health data and reinforce understanding, incorporated motivational strategies (eg, social comparisons and gamification), and provided educational resources and secure-messaging capability. More than 80% of participants were able to successfully complete all 5 tasks using the final prototype. Interviews revealed usability concerns with design, the efficiency of use, and content and terminology, which led to improvements. Overall satisfaction (0=worst and 7=best) improved from the initial to the final prototype (mean 5.8, SD 0.4 vs mean 6.7, SD 0.5).ConclusionsOur results demonstrate the utility of the design sprint methodology paired with mixed-methods, task-based usability testing to efficiently and effectively design a patient-facing, Web-based diabetes dashboard that is satisfying for patients to use.

Patient Portal Barriers and Group Differences: Cross-Sectional National Survey Study

“…A prior study recommended using real-life patient stories that demonstrate how a patient portal can be used to make the case for why a patient portal might be valuable [ 54 ]. There also remains a need to do more usability testing with patient portals and apply user-centered design approaches to better understand what features within the patient portal would be valuable to patients [ 55 - 57 ]. Studies have identified a number of usability issues, including not having information presented in multiple languages, lack of educational resources, poor data visualization and lack of contextualization for laboratory values, and lack of personalization [ 58 - 60 ].…”

“…Studies have identified a number of usability issues, including not having information presented in multiple languages, lack of educational resources, poor data visualization and lack of contextualization for laboratory values, and lack of personalization [ 58 - 60 ]. In response, some systems have tested creative strategies, such as offering tailored patient education, and have used motivational strategies (eg, social comparisons and gamification) to enhance the relevance of the patient portal and ensure that the portal is meeting user needs [ 55 , 61 ]. Future studies are needed to test strategies that align the patient portal with patients’ information needs.…”

Patient Challenges and Needs in Comprehending Laboratory Test Results: Mixed Methods Study

“…In brief, when communicating test results via portals, it is necessary to include information about the test itself (eg, test capability, the purpose of test), easy-to-understand explanations of medical jargon, the results in the context of the patient’s health, directions for next steps, and specific educational resources [ 35 , 50 , 51 ]. Furthermore, designers and developers of patient portals should embody user-centered approaches to significantly improve the design of patient portals to present information in a more meaningful way [ 29 , 52 ]. Finally, national test result notification and interface design standards for patient portals should be developed to ensure interoperability and consistency in features across portal vendors.…”

Human Factors and Usability for Health Information Technology: Old and New Challenges

“…Studies are also published on the role of human factors engineering in designing usable health IT for patients, such as a diabetes dashboard embedded in a patient portal 37 , an app for geriatric heart failure self-care 38 , and an app for medication management 39 . The domain of consumer health IT has embraced human factors and usability methods 40 .…”