Usability Study of a Computer-Based Self-Management System for Older Adults with Chronic Diseases

BACKGROUND Usability can influence patients' acceptance and adoption of a health information technology. However, little research has been conducted to study the usability of a self-management health care system, especially one geared toward elderly patients. OBJECTIVE This usability study evaluated a new computer-based self-management system interface for older adults with chronic diseases, using a paper prototype approach. METHODS Fifty older adults with different chronic diseases participated. Two usability evaluation methods were involved: (1) a heuristics evaluation and (2) end-user testing with a think-aloud testing method, audio recording, videotaping, and interviewing. A set of usability metrics was employed to determine the overall system usability, including task incompletion rate, task completion time, frequency of error, frequency of help, satisfaction, perceived usefulness, and perceived ease of use. Interviews were used to elicit participants' comments on the system design. The quantitative data were analyzed using descriptive statistics and the qualitative data were analyzed for content. RESULTS The participants were able to perform the predesigned self-management tasks with the current system design and they expressed mostly positive responses about the perceived usability measures regarding the system interface. However, the heuristics evaluation, performance measures, and interviews revealed a number of usability problems related to system navigation, information search and interpretation, information presentation, and readability. Design recommendations for further system interface modifications were discussed. CONCLUSIONS This study verified the usability of the self-management system developed for older adults with chronic diseases. Also, we demonstrated that our usability evaluation approach could be used to quickly and effectively identify usability problems in a health care information system at an early stage of the system development process using a paper prototype. Conducting a usability evaluation is an essential step in system development to ensure that the system features match the users' true needs, expectations, and characteristics, and also to minimize the likelihood of the users committing user errors and having difficulties using the system.