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

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.

Effects of User Characteristics on the Usability of a Home-Connected Medical Device (Smart Angel) for Ambulatory Monitoring: Usability Study

“…Health literacy is a user characteristic that can be expected to influence medical device usability [ 18 , 20 , 28 , 30 ]. Due to its multidimensionality, however, this characteristic is complex to define and difficult to assess.…”

“…This latter finding is consistent with those of Kaufman et al [ 24 ], who also concluded that low numeracy could be a barrier to using a telemedicine system. Chaniaud et al [ 30 ] showed that it is necessary to obtain a minimum level of prior health knowledge to use home medical devices. Finally, to our knowledge, no experimental studies have empirically characterized links between health literacy and usability in terms of efficiency, effectiveness, and satisfaction.…”

Patient and clinician use characteristics and perceptions of pulse oximeter use: A scoping review

“…Four more were development studies that described the design and development of a new phone-oximeter and evaluated its usability [17] , [18] , [19] , [20] . Three more were qualitative studies evaluating: 1) the wearability of multiple monitoring devices; 2) the effect of prior health knowledge on the usability of a pulse oximeter; and 3) clinicians’ perceptions, beliefs, and motivations to use pulse oximeters [4] , [21] , [22] .…”

“L’évaluation ergonomique de dispositifs connectés en santé pour le domicile patient dans le cadre de la chirurgie ambulatoire : Vers un modèle de l’utilisabilité adapté à la e‑santé” [Résumé]

“…En effet, dans l'ensemble des études menées, nos résultats quantitatifs ont pu mettre en exergue l'impact des connaissances en santé (étude 1a), de la littératie en santé (étude 2 et 3) et de l'âge (étude 2 et 3) sur l'utilisabilité et cela dans des conditions différentes (Chaniaud, Megalakaki, Capo, & Loup-Escande, 2021a). Plus exactement, les résultats de l'étude 1a ont révélé la présence d'un effet de seuil (Chaniaud, Métayer, Megalakaki, & Loup-Escande, 2020) suggérant qu'il existerait un niveau minimal de connaissances en santé requis permettant d'utiliser le dispositif correctement. Les résultats de l'étude 1b montrent que certains formats de présentation pouvaient compenser une mauvaise lecture des instructions (Chaniaud, Métayer, Loup-Escande, & Megalakaki, 2021b).…”