Usability Assessment of a Diabetes Hypertension Telemanagement System

Issue
Telecommunication technologies can be an effective way of enabling the management of diabetes and other chronic diseases. Issues of usability however, have hindered the widespread success of such technologies and have thus emphasized the importance of user-centric design. This project assessed the usability of a diabetes hypertension telemanagement (DHT) system being developed by the Medical Device Informatics group at the University Health Network. The objective was to make design recommendations regarding the system’s two user interfaces in order to improve its ease and adherence of use, as well as user satisfaction.

Methods
The web-based viewer and mobile phone interfaces of the DHT system were subjected to laboratory-based usability testing. Six clinicians navigated the web-based viewer and interpreted simulated patient blood pressure (BP) and blood glucose (BG) data. Four hypertensive type II diabetes patients used all the system components (BP monitor, BG monitor, and mobile phone) in a series of realistic scenarios. The Healthcare Human Factors team remained behind a one-way mirror or nearby and observed the participants’ interactions with the system. Pre- and post- study questionnaires served to further capture the participants’ impressions.

Results
High priority usability issues of both the web-based viewer and the mobile phone interface identified during testing were defined as those that could result in jeopardized patient safety. Such issues included the inability to reverse actions as well as confusion resulting from display trends that were inconsistent with user expectations. These issues could lead to the inclusion of incorrect data in the patient’s record which would negatively affect clinical decision-making. Further, these issues could also lead to incorrect interpretation of the patient’s record by both clinicians and patients which would result in inappropriate responses.

Related Publications:
Lopez R, Chagpar A, White R, McLean M, Trudel M, Cafazzo J, Logan A. Usability of a diabetes telemanagement system. 30th Annual Canadian Medical and Biological Engineering Conference Proceedings. June 2007.