E-HEALTH // COMMISSIONED BY PHILIPS RESEARCH
E-Health for chronic disease management
For my master thesis I worked on a study which was commissioned by Philips Research. The study aimed to come up with findings of design guidelines for an e-health system for stable, low acute heart failure patients. These insights were, in combination with design guidelines from literature, used for designing a new prototype of a user interface of such an e-health system. A qualitative exploratory study has been used of which several insights resulted in quantitative data.
Research question
What are the needs and expectations of stable heart failure patients (65+) for an e-health system for chronic disease management and which design guidelines are relevant for designing and prototyping the user interface of such a system for this target patient group?
Research methods
Desk research, interviews, heuristic evaluation, prototypes, usability tests.
Design tools
Paper prototypes with pencil, proto.io.
Interviews
Method
Semi-structured interviews were used to empathize with and understand the user. The user’s needs, expectations and attitude towards an e-health system were measured with this method, which was necessary to design a prototype that satisfies their needs and expectations. Furthermore, these interviews yielded first insights into the user’s motivations for initial and ongoing use of an application like Philips’ digital solution idea for chronic disease management. Two mood boards have been used as part of this interview in order to investigate the preferences of the interviewees with regard to the design of the application.
Results
All interviewees think that an e-health system would be helpful to get more insights in their health status and that the system can help them to adapt their lifestyle. This is also why they have a positive attitude towards an e-health system; they would like to use it to manage their disease more by themselves. They also expect to have more control over their disease with an e-health system; they are convinced that it gives them more insights in their disease over longer periods than a specialist because a specialist is taking a snapshot. Although two of the interviewees mentioned that a specialist has additional tools, such as an ECG scan, all interviewees are willing to use an e-health system, especially when it would reduce the number of their medical appointments in hospital.
All interviewees had opinions about how they think that their needs for having more control over their disease and adjusting their lifestyle can be fulfilled.
Heuristic evaluation
Method
A heuristic evaluation was used to measure potential usability issues of the prototype. A set of eight heuristics was used to detect design problems in technologies that are specially developed for changes in health behavior: 1) Usability, Ease of use, Functionality, 2) Aesthetics, 3) Safety, 4) Content, 5) Engagement, 6) Persuasive design, 7) Research evidence, and 8) Owners’ credibility. The experts were asked to complete two tasks that were chosen to cover the most essential elements of the app. These tasks were: 1) Fill in the vital signs, symptoms, and fluid intake, and 2) Search for the information about nutrition, activities, and tips.
Results
Both experts performed two tasks and navigated freely through the prototype. During these interactions with the interface, both experts encountered usability issues, which were collected in a list. Both experts rated the severity of each problem based on Nielsen’s scale for severity ratings, and there was an agreement of 70 percent in these ratings. The researcher has taken the average of the given severities that differed. In total, 13 usability issues were encountered by the experts of which nine were related to the broad ‘usability, ease of use, functionality’ heuristic. One usability issue was related to the heuristic about ‘content’ and two issues were related to the heuristic called ‘engagement’. The encountered issues were translated into expectations of the application that are useful for improving the design of the prototype.
Usability tests & interviews based on task
Method
The methods task-based scenarios, thinking aloud, and sentence completion were used to measure the usability and user experience of the designed user interface and to check whether and where task completion and usability issues occurred.
Task-based scenarios have been used to measure whether users were able to complete the most essential tasks of this e-health system, which were defined based on the signals and symptoms which the intended end-users should log to gain clear insights into the effects of their lifestyle on their disease. The thinking aloud method has been used to measure whether the system corresponded with the user’s expectations and to obtain insights into the user’s thoughts while using the system . The tasks for all users were: 1) Logging data in ‘logboek’, 2) Entering fluid intake, 3) Gaining insights in the data that was logged, and 4) Finding more information about activities, nutrition, and tips.
Interviews were conducted with heart failure patients after the task-based scenario and thinking aloud methods. These interviews were based on the tasks, with the aim to evaluate the episodic user experience, in which users had to reflect on their experience, and the user’s attitude towards the e-health prototype.
Results
All users for the prospective target patient group were able to complete the assigned user tasks to them used to assess the usability of the e-health system, which is a positive effect of the applied guidelines for this specific target group. However, several recommendations have been done based on the needs and expectations that were obtained with several methods. The users’ expectations have been translated into broader design guidelines which are relevant for designers to apply to e-health systems for chronic disease management. All guidelines have been underpinned by various methods, which shows the importance of each guideline.
Prototype
