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With smartphone use among older populations on the rise, older adults have increased access to health-focused mobile apps. Despite their potential benefits for managing health, currently no guidelines exist for designing these apps specifically for older adult users. We evaluated the usability of one medication management app and two congestive heart failure management apps using cognitive walkthroughs, heuristic analysis, and user testing. We identified design issues that may affect usability for older users, including poor navigation, small button sizes, and inadequate data visualizations. We provide guidelines for developers of health apps to facilitate use by older adults.

experts and the patients' role does not extend much beyond reporting on their symptoms and following the "orders" set by health professionals. However, this relationship is moving toward a patient-professional partnership, in which patients play a more significant role in their care. A patient-professional partnership involves collaborative care, in which the physician and patient make decisions together. A patient-professional partnership is also characterized by more education about self-management. Whereas traditionally the physician educates patients by offering information and technical skills, health professionals are now providing self-management education, which includes teaching problem-solving skills (Bodenheimer, Lorig, Holman, & Grumbach, 2002). Other commonly used terms for these two medical models include paternalistic and shared decision making (Elwyn, Edwards, Gwyn, & Grol, 1999). Evidence from clinical trials suggests that interventions teaching such selfmanagement skills are more effective than information-only patient education in improving clinical outcomes, even for patients with multiple chronic conditions (Bodenheimer et al., 2002). An increase in involvement from the patient as compared to the traditional physician-centered medical model has many additional benefits, including reduced costs (

Introductions should be designed according to desired outcomes for expectations, perceptions, and use of the automation. Low expectations have long-lasting effects.

Purpose-Maintaining physical activity is a key component of successful aging and has benefits for both physical and cognitive functioning in the older adult population. One promising method for engaging in physical activity is through exergames, which are video games designed to promote exercise. Exergames have the potential to be used by a wide range of people, including older adults, in a variety of settings, such as at home, in community living environments, or senior centers. However, exergames have not been designed for older adults (e.g., with respect to their attitudes, needs). Thus, older adults may not adopt these systems if they perceive them as not useful or relevant to them. Method-Twenty older adults (aged 60-79) interacted with two exergames, and were then interviewed about their perceptions of the system's ease of use and usefulness, as well as their general attitudes towards the system. Results-Participants identified the potential for exergames' usefulness for various goals, such as to increase their physical activity. However, they also reported negative attitudes concerning the system, including perceiving barriers to system use. Overall, participants said they would use the system in the future and recommend it to other people at their age for improving health, despite these use challenges. Conclusion-The older adults were open to adopting exergames, which could provide opportunities to increase physical activity. Given the participants' overall positive perceptions of the usefulness of exergames, designers must address the perceived challenges of using these systems. Understanding barriers and facilitators for older adults' use of exergames can guide design, training, and adoption of these systems.

In 2017, Academic Emergency Medicine convened a consensus conference entitled, "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes." This article, a product of the breakout session on "understanding complex interactions through systems modeling," explores the role that computer simulation modeling can and should play in research and development of emergency care delivery systems. This article discusses areas central to the use of computer simulation modeling in emergency care research. The four central approaches to computer simulation modeling are described (Monte Carlo simulation, system dynamics modeling, discrete-event simulation, and agent-based simulation), along with problems amenable to their use and relevant examples to emergency care. Also discussed is an introduction to available software modeling platforms and how to explore their use for research, along with a research agenda for computer simulation modeling. Through this article, our goal is to enhance adoption of computer simulation, a set of methods that hold great promise in addressing emergency care organization and design challenges. W ith over 130 million annual ED visits,1 a declining number of EDs to provide emergency care, 2 and lengthening wait times to see providers, 3 EDs are operating under increasingly arduous conditions. One underutilized approach to addressing problems in health care quality and value, particularly in emergency care, is through the use of computer simulation modeling. Computer simulation is a method to build dynamic models that quantitatively abstract a system, such as a facility (e.g., ED) or a process (e.g., physician-in-triage). Not unlike "highfidelity patient simulation" for training clinicians in clinical care through the use of mannequins, computer simulation provides a platform to inform decision making prior to implementation in the real world.

Mobile apps for self-managing chronic health conditions are widely available for download from online app stores. Mobile health (mHealth) apps provide a convenient way of managing health conditions (e.g., congestive heart failure); however, little is known about their design specifications with respect to older adult users. We conducted a 3-phase assessment of human factors issues for common mHealth apps designed for managing congestive heart failure. In Phase 1, we identified two apps often used by older adults. In Phase 2, we evaluated these apps according to standard human factors principles. In Phase 3, we conducted usability testing of the apps with six older adults. We report design issues identified in the apps that limit usability by older adults. We encourage mHealth app designers to improve usability by: 1) providing easier navigation, 2) streamlining data entry processes, 3) providing clear recovery from errors, and 4) simplifying visualizations of data patterns.

Multiple task coordination involves scheduling tasks, completing tasks, and integrating tasks into a workflow. Task scheduling can influence outcomes of safety, satisfaction, and efficiency when completing tasks. This is especially important in complex life-critical environments such as healthcare, which incurs many situations where there are multiple tasks and limited resources for addressing all tasks. One approach for understanding tasks coordination is the Strategic Task Overload Management (STOM) model, which is a model for task scheduling behavior. In this theoretical paper, we discuss how this model can be extended to a complex healthcare environment. There are additional considerations (e.g., time) which must be considered when applying this model to healthcare. Ultimately, understanding how emergency physicians make multiple task scheduling decisions will advance theories and models, such as STOM, which can then in turn be implemented to improve scheduling behaviors in complex healthcare environments.