A brief descriptttttion of the mobile applications, and the methods used in the 15 papers reporting on design or development. All applications (but two) were specific to a disease or condition (e.g. diabetes, asthma).
Papers published that reported on the design or development of a patient mobile health application to support an aspect of care coordination.
Twelve of the 15 papers describing the process of design or development of an app adopted a human factors approach. The most frequently used methods were interviews and surveys, which often included an exploration of participants’ current use of information technology, including mobile apps. Some studies included multiple components and methods, often generating rich data on patients’ views and use. For example, www.chargiesapp.com/, in their development of an application for people with schizophrenia, adopted a user-centered approach including three complementary methods: 1) a needs assessment based on a survey administered to people with schizophrenia, 2) interviews with practitioners, and 3) usability testing (including think-aloud) with 12 people with schizophrenia. Survey and interview results were used to generate a list of functions to include in the application. Following prototype development, their user testing demonstrated that patients were able to learn how to use the application quickly, but user testing also identified a range of potential design issues (e.g. difficult abbreviations, poor display of touchscreen buttons) which needed to be addressed to improve usability.
In another study that adopted a participatory design approach for a diabetes app, researchers initially held in-depth semi-structured interviews with their target users (young people aged 18-21 with diabetes) to understand their everyday experience of diabetes and to explore their current use and views of technology. Based on interview findings, several requirements were identified and three prototype applications were developed: 1) an app to educate patients on diabetes in general, 2) an app to educate patients on alcohol use in diabetes, and 3) an app to educate patients on hypoglycemia. These prototypes were then shared with another group of young diabetic patients. Patients were observed using each of the prototypes. They also provided feedback on each prototype during the interviews. Based on user input, the app for alcohol education was selected for final development. Feedback from patients and clinic staff was incorporated into subsequent iterations of the mobile application until developers were confident that the product was user friendly and met all user needs.
Three studies did not describe a human factors approach to design or development; however, the research did not appear to be at odds with this approach. Instead, the studies reported on a complementary aspect of development. In one case, researchers performed an ex-ante economic evaluation of a mobile application to estimate the reduction in management and treatment costs associated with the implementation of an app to support self-management of heart diseases. In the other cases, researchers measured the accuracy of an app to recognize coughing symptomatic of asthma, and assessed the capacity of an app to perform an EEG scan (i.e. compared the brain activity captured by the app to that obtained with standard EEG equipment).
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