Mobile tele-monitoring system for chronic disease management

Team
Healthcare Human Factors

Summary

Healthcare Human Factors performed a comparative usability evaluation on two tablet devices, the iPad and Motion C5, to understand their suitability and potential uses for the healthcare environment.

Seven Registered Nurses from two different units at the Toronto General Hospital were recruited to perform a set of representative tasks using the C5 and the iPad, typical of those that might be carried out at a patient’s bed side. Tasks included browsing the web for clinical information and administering drugs using the Electronic Patient Record (EPR) application.

Both tablets used Citrix to access the Windows-base EPR, since it allowed for applications to be centralized and broadcast on demand. The iPad required the user to manually launch and log into Citrix to load EPR, while Citrix ran in the background within the Motion C5. The virtual environment limited the functionality of the tablets since neither device was able to display the keyboard automatically. Once the participants were able to successfully display the on-screen keyboard, they struggled to carry out the next task, because the keyboard obstructed the EPR’s main navigation. In addition, because EPR was designed with small targets for mouse and keyboard interaction, nurses found it difficult to use with the iPad’s touchscreen interface compared to the Motion C5’s stylus.

Five out of seven nurse participants commented that the size of the Motion C5’s keyboard was too small and slowed typing speeds. Nurses liked the size of the iPad’s keyboard, but had difficulties finding some symbols for the first time.

All nurses complained about the weight of the C5 and the awkwardness of holding it at the bedside. At almost two pounds lighter, the iPad was a huge improvement, but since most nursing tasks are hands-on, they felt that a cart would be still be required for tasks such as drug administration rounds or dressing changes.

The findings of Healthcare Human Factors indicated that neither device is completely ready to be used at the patient’s bed side. While five out of the seven participants agreed that the iPad would be more suitable for applications in healthcare, the interaction issues with the EPR application need to be resolved for effective use. Participants also expressed that the C5’s Windows-based interface was more familiar, but overall, they preferred the iPad because it was lighter and faster.

Impact

The pilot study of the tele-monitoring technology showed a high acceptance rate of the system by users. A website interface was also developed to help manage diabetes and other chronic diseases and received positive feedback from stakeholders. The website will undergo further testing with representative users to inform future design prototypes. Results from the first round of randomized clinical trials are being analyzed for publication.