A Human-Centered Design Methodology to Enhance the Usability, Human Factors, and User Experience of Connected Health Systems: A Three-Phase Methodology

Richard Harte, Liam Glynn, Alejandro Rodríguez-Molinero, Paul Ma Baker, Thomas Scharf, Leo R Quinlan, Gearóid ÓLaighin, Richard Harte, Liam Glynn, Alejandro Rodríguez-Molinero, Paul Ma Baker, Thomas Scharf, Leo R Quinlan, Gearóid ÓLaighin

Abstract

Background: Design processes such as human-centered design, which involve the end user throughout the product development and testing process, can be crucial in ensuring that the product meets the needs and capabilities of the user, particularly in terms of safety and user experience. The structured and iterative nature of human-centered design can often present a challenge when design teams are faced with the necessary, rapid, product development life cycles associated with the competitive connected health industry.

Objective: We wanted to derive a structured methodology that followed the principles of human-centered design that would allow designers and developers to ensure that the needs of the user are taken into account throughout the design process, while maintaining a rapid pace of development. In this paper, we present the methodology and its rationale before outlining how it was applied to assess and enhance the usability, human factors, and user experience of a connected health system known as the Wireless Insole for Independent and Safe Elderly Living (WIISEL) system, a system designed to continuously assess fall risk by measuring gait and balance parameters associated with fall risk.

Methods: We derived a three-phase methodology. In Phase 1 we emphasized the construction of a use case document. This document can be used to detail the context of use of the system by utilizing storyboarding, paper prototypes, and mock-ups in conjunction with user interviews to gather insightful user feedback on different proposed concepts. In Phase 2 we emphasized the use of expert usability inspections such as heuristic evaluations and cognitive walkthroughs with small multidisciplinary groups to review the prototypes born out of the Phase 1 feedback. Finally, in Phase 3 we emphasized classical user testing with target end users, using various metrics to measure the user experience and improve the final prototypes.

Results: We report a successful implementation of the methodology for the design and development of a system for detecting and predicting falls in older adults. We describe in detail what testing and evaluation activities we carried out to effectively test the system and overcome usability and human factors problems.

Conclusions: We feel this methodology can be applied to a wide variety of connected health devices and systems. We consider this a methodology that can be scaled to different-sized projects accordingly.

Keywords: connected health; human factors; human-centered design; mHealth; usability testing; user interface design; user-centered design.

Conflict of interest statement

Conflicts of Interest: None declared.

©Richard Harte, Liam Glynn, Alejandro Rodríguez-Molinero, Paul MA Baker, Thomas Scharf, Leo R Quinlan, Gearóid ÓLaighin. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 16.03.2017.

Figures

Figure 1
Figure 1
Human-centered design has four main activity phases: (1) Specify the user and the context of use; (2) Specify the user requirements; (3) Produce design solutions; and (4) Evaluate designs against requirements.
Figure 2
Figure 2
Our human-centered design approach to a connected health app.
Figure 3
Figure 3
The Wireless Insole for Independent and Safe Elderly Living (WIISEL) system.
Figure 4
Figure 4
Phase 1 activity flow.
Figure 5
Figure 5
Examples of the information included in the WIISEL use case. (A) A scenario presented in the use case where the user, John, must carry out a troubleshooting sequence with the app; a life-size color screenshot of the mobile phone interface is shown. (B) A section of the use case that profiles typical physical capabilities of the target user and how this might affect their interaction with the mobile phone. (C) A storyboard at the beginning of the document summarizing the whole process, from when the user is prescribed the system to when they return to the clinic having worn it for a period of time. (D) A scenario in the use case where it describes what might happen to the phone while the user is doing daily home chores. WIISEL: Wireless Insole for Independent and Safe Elderly Living; GP: general practitioner.
Figure 6
Figure 6
Older adult participants analyzing and providing feedback on the use cases.
Figure 7
Figure 7
Structured process for prioritizing usability problems.
Figure 8
Figure 8
Phase 2 activity flow. ASQ: After-Scenario Questionnaire; SUS: System Usability Scale.
Figure 9
Figure 9
Phone screen interface. (A) The experts walk through each scenario in the user manuals with the phone; the cradle camera captures all of their interactions with the mobile phone. (B) An expert attempts to log in to the mobile phone app. (C) An expert follows the connection sequence from the user manual. (D) An expert carries out the data upload sequence.
Figure 10
Figure 10
An example of Phase 3 activities. ASQ: After-Scenario Questionnaire; SUS: System Usability Scale.
Figure 11
Figure 11
Older adult users carrying out tasks using the user manual as a guide during the user testing phase.
Figure 12
Figure 12
An overview of the complete methodology and all the suggested activities in each phase as applied to the Wireless Insole for Independent and Safe Elderly Living (WIISEL) system. ASQ: After-Scenario Questionnaire; TLX: Task Load Index.

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