Design and Usability of a Heart Failure mHealth System: A Pilot Study

Abstract

BackgroundDespite the advances in mobile health (mHealth) systems, little is known about patients’ and providers’ experiences using a new mHealth system design.ObjectiveThis study aimed to understand challenges and provide design considerations for a personalized mHealth system that could effectively support heart failure (HF) patients after they transition into the home environment.MethodsFollowing exploratory interviews with nurses and preventive care physicians, an mHealth system was developed. Patients were asked to measure their weight, blood pressure, and blood glucose (if they had diabetes). They were also instructed to enter symptoms, view notifications, and read messages on a mobile app that we developed. A Bluetooth-enabled weight scale, blood pressure monitor, glucometer, and mobile phone was provided after an introductory orientation and training session. HF nurses used a dashboard to view daily measurements for each patient and received text and email alerts when risk was indicated. Observations of usage, cases of deterioration, readmissions, and metrics related to system usability and quality of life outcomes were used to determine overall effectiveness of the system, whereas focus group sessions with patients were conducted to elicit participants’ feedback on the system’s design.ResultsA total of 8 patients with HF participated over a 6-month period. Overall, the mean users’ satisfaction with the system ranked 73%, which was above average. Quality of life improvement was 3.6. Patients and nurses used the system on a regular basis and were able to successfully identify and manage 8 health deteriorations, of which 5 were completely managed remotely. Focus groups revealed that, on one hand, the system was beneficial and helped patients with: recording and tracking readings; receiving encouragement and reassurance from nurses; spotting and solving problems; learning from past experiences; and communication. On the other hand, findings also highlighted design issues and recommendations for future systems such as the need to communicate via other media, personalize symptom questions and messages, integrate other health tracking technologies, and provide additional methods to analyze and visualize their data.ConclusionsUnderstanding users’ experiences provides important design considerations that could complement existing design recommendations from the literature, and, when combined with physician and nurse requirements, have the potential to yield a feasible telehealth system that is effective in supporting HF self-care. Future studies will include these guidelines and use a larger sample size to validate the outcomes.

Automated analysis of free-text comments and dashboard representations in patient experience surveys: a multimethod co-design study

“…Users valued the ability to tailor a system to individual and organisational needs. 94,[97][98][99][100] This functionality could include personalised alerts and reminders, 77,79,93,[100][101][102] the option to set default filters 75,87 and the ability to pin particular information to the screen to appear at all times, enabling comparisons. 77 Benefits were also reported from being able to dynamically add, remove and adjust elements of the system to fit the user's focus and workflow.…”

Methodological Foundations of Mhealth Design Studies: A Content Analysis of Literature

“…Based on DSR framework's 3 cycles: they conducted focus groups with end-users in the Relevance cycle; performed a review to identify technology-based interventions for meeting the health prevention needs in the Rigor cycle and they employed usability evaluation methods to iteratively develop and refine mock-ups for a mHealth app in the Design Cycle. Alharbi et al and Alnosayan et al also align their design methodology with the DSR framework's three cycles (Alharbi et al, 2018;Alnosayan et al, 2017).…”

Deep learning for cardiac computer-aided diagnosis: benefits, issues & solutions

“…Additionally, through the use of mobile or web based applications, interaction between physician and patient can be achieved on a consistent basis regardless of distance between both parties (34,35). Studies have shown that mHealth applications can achieve similar utility in urban and rural settings (36), increase patient adherence towards therapy and rehabilitation (37,38), and successfully identify and manage health deteriorations (39). Although preliminary testing demonstrates the potential of mHealth, results are still inadequate due to the limited number of trials that have been performed (28,40).…”