Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep 21;8(9):e17983.
doi: 10.2196/17983.

Effect of Prior Health Knowledge on the Usability of Two Home Medical Devices: Usability Study

Noémie Chaniaud  1 , Natacha Métayer  1 , Olga Megalakaki  1 , Emilie Loup-Escande  1
Affiliations

Effect of Prior Health Knowledge on the Usability of Two Home Medical Devices: Usability Study

Noémie Chaniaud et al. JMIR Mhealth Uhealth. .

Abstract

Background: Studies 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.

Objective: Our 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.

Methods: For 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.

Results: The 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.

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.

Keywords: blood pressure monitor; home medical devices; mHealth; prior health knowledge; pulse oximeter; usability.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
The influences of the four main user characteristics filled in grey (age, experience in information technology, motivation, and health literacy) from the scientific literature on usability results (effectiveness, efficiency, and satisfaction), which have an impact on patients’ health. Solid lines are inferred from published literature, and dashed lines are hypothetical. The solid curved line is the ISO 9241-11:2018 metric.
Figure 2
Figure 2
The devices used. (A) The wireless blood pressure wrist monitor (iHealth BP7). (B) The pulse oximeter (iHealth Oximeter PO3).
Figure 3
Figure 3
Synthesis of the results of the influence of prior health knowledge on usability results (ISO 9241-11) [15]. Results shown in red correspond to the blood pressure monitor, and those in blue correspond to the pulse oximeter.
Figure 4
Figure 4
Adaptation of the Monkman and Kushniruk model [52] to the use of the blood pressure monitor and pulse oximeter.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. National Research Council . Safe, Comfortable, Attractive, and Easy to Use: Improving the Usability of Home Medical Devices. Washington, DC: National Academies Press; 1996. - PubMed
    1. Bitterman N. Design of medical devices--a home perspective. Eur J Intern Med. 2011 Feb;22(1):39–42. doi: 10.1016/j.ejim.2010.09.017. - DOI - PubMed
    1. Huvila I, Enwald H, Eriksson-Backa K, Hirvonen N, Känsäkoski H. Taking Health Information Behaviour into Account in the design of e-health services. Finnish Journal of EHealth and EWelfare. 2016;8(4):153–163. https://journal.fi/finjehew/article/view/60194
    1. Yu DX, Parmanto B, Dicianno BE, Watzlaf VJ, Seelman KD. Accessibility needs and challenges of a mHealth system for patients with dexterity impairments. Disabil Rehabil Assist Technol. 2017 Jan 7;12(1):56–64. doi: 10.3109/17483107.2015.1063171. - DOI - PubMed
    1. Mykityshyn AL, Fisk AD, Rogers WA. Learning to use a home medical device: mediating age-related differences with training. Hum Factors. 2002;44(3):354–64. doi: 10.1518/0018720024497727. - DOI - PubMed

Publication types