Abstract
BackgroundStudies on the usability of health care devices are becoming more common, although usability standards are not necessarily specified and followed. Yet, there is little knowledge about the impact of the context of use on the usability outcome. It is specified in the usability standard (ISO 9241-11, 2018) of a device that it may be affected by its context of use and especially by the characteristics of its users. Among these, prior health knowledge (ie, knowledge about human body functioning) is crucial. However, no study has shown that prior health knowledge influences the usability of medical devices. ObjectiveOur study aimed to fill this gap by analyzing the relationship between the usability of two home medical devices (soon to be used in the context of ambulatory surgery) and prior health knowledge through an experimental approach.MethodsFor assessing the usability of two home medical devices (blood pressure monitor and pulse oximeter), user tests were conducted among 149 students. A mixed-methods approach (subjective vs objective) using a variety of standard instruments was adopted (direct observation, video analysis, and questionnaires). Participants completed a questionnaire to show the extent of their previous health knowledge and then operated both devices randomly. Efficiency (ie, handling time) and effectiveness (ie, number of handling errors) measures were collected by video analysis. Satisfaction measures were collected by a questionnaire (system usability scale [SUS]). The qualitative observational data were coded using inductive analysis by two independent researchers specialized in cognitive psychology and cognitive ergonomics. Correlational analyses and clusters were performed to test how usability relates to sociodemographic characteristics and prior health knowledge.ResultsThe results indicated a lack of usability for both devices. Regarding the blood pressure monitor (137 participants), users made approximately 0.77 errors (SD 1.49), and the mean SUS score was 72.4 (SD 21.07), which is considered “satisfactory.” The pulse oximeter (147 participants) appeared easier to use, but participants made more errors (mean 0.99, SD 0.92), and the mean SUS score was 71.52 (SD 17.29), which is considered “satisfactory.” The results showed a low negative and significant correlation only between the effectiveness of the two devices and previous knowledge (blood pressure monitor: r=−0.191, P=.03; pulse oximeter: r=−0.263, P=.001). More subtly, we experimentally identified the existence of a threshold level (χ²2,146=10.9, P=.004) for health knowledge to correctly use the pulse oximeter, but this was missing for the blood pressure monitor.ConclusionsThis study has the following two contributions: (1) a theoretical interest highlighting the importance of user characteristics including prior health knowledge on usability outcomes and (2) an applied interest to provide recommendations to designers and medical staff.
Highlights
BackgroundHome medical devices (HMDs) are increasingly being prescribed by health care professionals in order to decongest hospitals, and they are potentially cost-effective approaches of addressing the increasing health care needs [1,2]
Double coding was performed on 33% of the video data collected by two independent researchers specialized in cognitive psychology and cognitive ergonomics
The average intraclass correlation coefficient (ICC) measure for blood pressure monitor errors was 0.962
Summary
BackgroundHome medical devices (HMDs) are increasingly being prescribed by health care professionals in order to decongest hospitals, and they are potentially cost-effective approaches of addressing the increasing health care needs [1,2]. The definition of usability is still an important debate [22], the usability standard has been updated [15] to emphasize that usability is a result of interaction rather than a property of a product [23], which is defined by its context of use [15], and it includes the following four components: goals and tasks, resources, environment, and users These components influence usability results (composed by effectiveness, efficiency, and satisfaction), and it is necessary to know how these components influence usability results. Conclusions: This study has the following two contributions: (1) a theoretical interest highlighting the importance of user characteristics including prior health knowledge on usability outcomes and (2) an applied interest to provide recommendations to designers and medical staff
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