In order to develop and test a patient-centered mHealth tool, researchers should employ an iterative design process to allow stakeholders to assess usability, according to a study published in JMIR mHealth and uHealth.
The study, led by Courtney R. Lyles, PhD, looked at the development of a patient-facing tablet application geared toward improving patient-provider communication. Patients would use the tablet in the waiting room to report the health issues they wanted to discuss during their primary care appointments.
To make the app most effective, the researchers conducted one-on-one interviews with 40 users and their providers, completed three rounds of design consultations with stakeholders, and held meetings with fifteen health communication, education, and technology experts.
The iterative design process helped providers better assess the application’s usefulness, as well as ensure that it was fully patient-centered. According to the researchers, all mHealth technology projects could potentially benefit from this development process.
This design process could likewise help determine the application’s overall effectiveness. In the case of Lyles’ research, iterative approaches helped create a tool that was overall more patient-centric.
“Through the use of user-centered design methods, we substantially modified our initial design concept based on robust input from patients, physicians, and key informant leaders within a large integrated delivery system,” the research team reported.
“The final tool was simpler to use while also providing richer choices and more engaging layouts and was better suited for widespread implementation within the healthcare system.”
Additionally, the researchers emphasized the importance of consulting with multiple different stakeholders – including patients, providers, and technology developers – in order to gain a better understanding of how the application may improve. Hearing from providers, for example, informed Lyles and colleagues of the benefits their application could have for multiple patient demographics.
The provider consultations likewise indicated additional content categories for the application, as well as potential areas where the application could improve patient education.
Providers also Additionally, providers said that the application should be revised to serve patients who are new to the practice or provider to facilitate conversations that allow providers to understand the concerns of new patients. By considering new users, providers could better understand their new patients’ needs.
The iterative design process also informed revisions that made the tool easier for patients to navigate.
After the user consultations, for example, the researchers revised the tablet application to be usable for patients across all levels of technology proficiency. They also added to the list of potential discussion topics from which users could choose for their appointments, including individual symptom concerns.
During the design consultations, stakeholders recommended that the tablet feature text alongside educational videos to better reinforce educational messages. They also suggested creating different videos depending upon a patient’s sociodemographic.
The final development consultation resulted in design and usability changes. The researchers eliminated scrolling from the app, increased font and button sizes, and kept text at a seventh grade reading level.
They also reduced the amount of text presented on each screen. Rather than inundating patients with information, the researchers determined that it was more helpful to simply provide straightforward directions.
Multiple design consultations also allowed the researchers to gain feedback from more stakeholders. In this instance, it led them to make the application useful for different healthcare conditions. On a broader scale, this approach may result in an application useable for various patient populations.
According to the researchers, their results also demonstrate the importance of iterative design processes and create a model for future health IT developers.
“Future mHealth research should combine several design and usability testing methods in health technology development, as well as document this design process,” Lyles and colleagues concluded. “This can not only improve the technology and its ultimate impact but also disseminate key lessons learned that other developers and investigators can build on.”