Human Factors Analysis, Design, and Evaluation of Engage, a Consumer Health IT Application for Geriatric Heart Failure Self-Care

ABSTRACT

Human factors and ergonomics (HFE) and related approaches can be used to enhance research and development of consumer-facing health information technology (IT) systems, including technologies supporting the needs of people with chronic disease. A multiphase HFE study of health IT supporting self-care of chronic heart failure by older adults is described. The study was based on HFE frameworks of “patient work” and incorporated the three broad phases of user-centered design: study or analysis, design, and evaluation. In the study phase, data from observations, interviews, surveys, and other methods were analyzed to identify gaps in and requirements for supporting heart failure self-care. The design phase applied findings from the study phase throughout an iterative process, culminating in the design of the Engage application, a product intended for continuous use over 30 days to stimulate self-care engagement, behavior, and knowledge. During the evaluation phase, a variety of usability issues through expert heuristic evaluation and laboratory-based usability testing were identified. The implications of our findings regarding heart failure self-care in older adults and the methodological challenges of rapid translational field research and development in this domain are discussed.

Acknowledgments

We would like to thank the participants of the study and the multiple clinicians who partnered with our research team. Thanks to Amanda McDougald Scott, Courtney Thomas, Nan Ye, Anand Kulanthaivel, Yamini Karanam, Luiz Cavalcanti, Dr. Christiane Schubert, Dr. Steve Voida, Dr. James Hill, Dr. April Savoy, Dr. Saptarshi Purkayastha, Dr. Irmina Gradus-Pizlo, Dr. Pantila Vanichakarn, and Dr. Sunil Kripalani for their assistance. We also thank our coauthors on the analyses performed during this investigation’s study phase, particularly Robin Mickelson. We thank the reviewers who contributed helpful comments.

Funding

This study was sponsored by grants from the National Institute on Aging (NIA) of the US National Institutes of Health (NIH): [grant number K01AG044439], and [grant numbers UL1 TR000445 and KL2 TR000446] from the National Center for Advancing Translational Sciences (NCATS/NIH) through the Vanderbilt CTSA.

Additional information

Funding

This study was sponsored by grants from the National Institute on Aging (NIA) of the US National Institutes of Health (NIH): [grant number K01AG044439], and [grant numbers UL1 TR000445 and KL2 TR000446] from the National Center for Advancing Translational Sciences (NCATS/NIH) through the Vanderbilt CTSA.

Notes on contributors

Preethi Srinivas

Preethi Srinivas is a Senior User Experience Designer at Regenstrief Institute Inc. She received a PhD in human–computer interaction from Indiana University. Her research is at the intersection of HCI, ubiquitous computing, computer supported and cooperative work, with particular interest in technology support for health care, health, and well-being.

Victor Cornet

Victor P. Cornet is a PhD candidate in human–computer interaction at the Indiana University School of Informatics and Computing. He received a Master’s degree in Computer Engineering from ESIEE Paris in 2014. His research explores the intersection of mental health and opportunities and challenges brought by new technologies.

Richard Holden

Richard J. Holden is assistant professor of BioHealth Informatics at the Indiana University School of Informatics and Computing. He received a joint PhD in industrial engineering and psychology from the University of Wisconsin-Madison in 2009. Dr. Holden’s research applies human factors engineering and psychology to study and improve the work performance of patients, informal caregivers, and clinicians.