Home Monitoring System for Comprehensive Geriatric Assessment in Patient's Dwelling: System Design and UX Evaluation

Abstract

Population aging threatens the sustainability of welfare systems since it is not accompanied by an extended healthy and independent period in the last years of life. The Comprehensive Geriatric Assessment (CGA) has been shown to be efficient in maintaining the healthy period at the end of the life. Frailty monitoring is typically carried out for an average period of 6 months in clinical settings, while more regular monitoring could prevent the transition to disability. We present the design process of a system for frailty home monitoring based on an adapted CGA and the rationale behind its User eXperience (UX) design. The resulting home monitoring system consists of two devices based on ultrasound sensors, a weight scale, and a mobile application for managing the devices, administering CGA-related questionnaires, and providing alerts. Older users may encounter barriers in their usage of technology. For this reason, usability and acceptability are critical for health monitoring systems addressed to geriatric patients. In the design of our system, we have followed a user-centered process, involving geriatricians and older frail patients by means of co-creation methods. In the iterative process of design and usability testing, we have identified the most effective way of conducting the home-based CGA, not just by replicating the dialogue between the physician and the patient, but by adapting the design to the possibilities and limitations of mobile health for this segment of users. The usability evaluation, carried out with 14 older adults, has proved the feasibility of users older than 70 effectively using our monitoring system, additionally showing an intention over 80% for using the system. It has also provided some insights and recommendations for the design of mobile health systems for older users.

Design Guidelines of Mobile Apps for Older Adults: Systematic Review and Thematic Analysis

“…The recommendation to favor video tutorials over written instructions matches our own experience in performing usability tests on eHealth apps for geriatric patients, wherein we observed users tiring easily from lengthy textual instructions [ 84 , 85 ]. Although the study by Ahmad [ 86 ] focused on younger tech-proficient adults (aged >50 years), it showed the user preference for video tutorials.…”

The role of digital mobile technology in elderly health management among health care workers in Indonesia: Analysis of knowledge, attitudes, and practice

“…15,16 mHealth interventions also produced some evidence of behavior change and improvements in clinical outcomes. 17 In our study, 43.3% of health care workers used mHealth applications for general practice at least once per week. for many important tasks, such as information and time management, health record maintenance and access, communications and consulting, reference and information gathering, patient management and monitoring, clinical decision-making, and medical education and training that can be used for general practice.…”

“…15 , 16 mHealth interventions also produced some evidence of behavior change and improvements in clinical outcomes. 17 …”

Usability, User Experience, and Acceptance Evaluation of CAPACITY: A Technological Ecosystem for Remote Follow-Up of Frailty

“…Figure 4 shows how the interaction system evolved during the process. An in-depth description of this iterative process and the resulting interaction system can be found in [51]. This interaction system was iteratively designed under a user-centered approach.…”

“…Figure 4 shows how the interaction system evolved during the process. An in-depth description of this iterative process and the resulting interaction system can be found in [51]. Figure 5 shows the workflow that needs to be followed to interact with any of the components of the monitoring kit.…”