Martinez William, Threatt Anthony L, Rosenbloom S Trent, Wallston Kenneth A, Hickson Gerald B, Elasy Tom A
Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, United States.
Health Information Technology, Vanderbilt University Medical Center, Nashville, TN, United States.
JMIR Hum Factors. 2018 Sep 24;5(3):e26. doi: 10.2196/humanfactors.9569.
Health apps and Web-based interventions designed for patients with diabetes offer novel and scalable approaches to engage patients and improve outcomes. However, careful attention to the design and usability of these apps and Web-based interventions is essential to reduce the barriers to engagement and maximize use.
The aim of this study was to apply design sprint methodology paired with mixed-methods, task-based usability testing to design and evaluate an innovative, patient-facing diabetes dashboard embedded in an existing patient portal and integrated into an electronic health record.
We applied a 5-day design sprint methodology developed by Google Ventures (Alphabet Inc, Mountain View, CA) to create our initial dashboard prototype. We identified recommended strategies from the literature for using patient-facing technologies to enhance patient activation and designed a dashboard functionality to match each strategy. We then conducted a mixed-methods, task-based usability assessment of dashboard prototypes with individual patients. Measures included validated metrics of task performance on 5 common and standardized tasks, semistructured interviews, and a validated usability satisfaction questionnaire. After each round of usability testing, we revised the dashboard prototype in response to usability findings before the next round of testing until the majority of participants successfully completed tasks, expressed high satisfaction, and identified no new usability concerns (ie, stop criterion was met).
The sample (N=14) comprised 5 patients in round 1, 3 patients in round 2, and 6 patients in round 3, at which point we reached our stop criterion. The participants' mean age was 63 years (range 45-78 years), 57% (8/14) were female, and 50% (7/14) were white. Our design sprint yielded an initial patient-facing diabetes dashboard prototype that displayed and summarized 5 measures of patients' diabetes health status (eg, hemoglobin A). The dashboard used graphics to visualize and summarize health data and reinforce understanding, incorporated motivational strategies (eg, social comparisons and gamification), and provided educational resources and secure-messaging capability. More than 80% of participants were able to successfully complete all 5 tasks using the final prototype. Interviews revealed usability concerns with design, the efficiency of use, and content and terminology, which led to improvements. Overall satisfaction (0=worst and 7=best) improved from the initial to the final prototype (mean 5.8, SD 0.4 vs mean 6.7, SD 0.5).
Our results demonstrate the utility of the design sprint methodology paired with mixed-methods, task-based usability testing to efficiently and effectively design a patient-facing, Web-based diabetes dashboard that is satisfying for patients to use.
为糖尿病患者设计的健康应用程序和基于网络的干预措施提供了新颖且可扩展的方法,以促使患者参与并改善治疗效果。然而,仔细关注这些应用程序和基于网络的干预措施的设计和可用性对于减少参与障碍并最大限度地提高其使用率至关重要。
本研究的目的是应用设计冲刺方法,结合混合方法、基于任务的可用性测试,来设计和评估一个创新的、面向患者的糖尿病仪表盘,该仪表盘嵌入现有的患者门户网站并集成到电子健康记录中。
我们应用了谷歌风投(Alphabet公司,加利福尼亚州山景城)开发的为期5天的设计冲刺方法来创建我们的初始仪表盘原型。我们从文献中确定了使用面向患者的技术来增强患者激活的推荐策略,并设计了与每个策略相匹配的仪表盘功能。然后,我们对个别患者进行了仪表盘原型的混合方法、基于任务的可用性评估。测量指标包括5项常见标准化任务的任务绩效验证指标、半结构化访谈以及一份经过验证的可用性满意度问卷。在每一轮可用性测试之后,我们根据可用性结果对仪表盘原型进行修改,然后再进行下一轮测试,直到大多数参与者成功完成任务、表示高度满意且未发现新的可用性问题(即达到停止标准)。
样本(N = 14)包括第1轮的5名患者、第2轮的3名患者和第3轮的6名患者,此时我们达到了停止标准。参与者的平均年龄为63岁(范围45 - 78岁),57%(8/14)为女性,50%(7/14)为白人。我们的设计冲刺产生了一个初始的面向患者的糖尿病仪表盘原型,该原型展示并汇总了5项患者糖尿病健康状况指标(如糖化血红蛋白)。该仪表盘使用图形来可视化和汇总健康数据并加强理解,纳入了激励策略(如社会比较和游戏化),并提供教育资源和安全消息功能。超过80%的参与者能够使用最终原型成功完成所有5项任务。访谈揭示了在设计、使用效率、内容和术语方面的可用性问题,这些问题促使了改进。总体满意度(0 = 最差,7 = 最佳)从初始原型到最终原型有所提高(平均5.8,标准差0.4对比平均6.7,标准差0.5)。
我们的结果证明了设计冲刺方法与混合方法、基于任务的可用性测试相结合的效用,能够高效且有效地设计出一个面向患者的、基于网络的糖尿病仪表盘,患者使用起来很满意。