Researchers: Health application design must include target audience

Health website designers need to critically evaluate their assumptions about usability, especially for older populations, according to research published at eGEMS (Generating Evidence and Methods to improve patient outcomes).

The study involves a project by Healthcentric Advisors, a Rhode Island Department of Health's contractor, and Brown University to create a Web application allowing consumers to compare home health agencies.

Though the application was specifically designed for older consumers with low literacy and low health literacy, the researchers found that some general Web design principles didn't work for these people. They created a prototype, then tested it with consumers and hospital case managers, both of whom recommended changes. The case managers, for instance, wanted a mobile version and the ability to email search results.

The researchers found, however, that they had overestimated the target audience's familiarity with computers. Some people didn't understand concepts such as scrolling down a page to see more information or that clicking on a button would submit their responses and lead to a subsequent page.

Though one of the guiding principles in writing for web audiences is to use 50 percent fewer words than in a written document, the older adult users preferred detailed instructions and prompts, and seemed reluctant to experiment with the application without written instructions.

The authors stress the importance of understanding the target audience, testing with that target audience and incorporating their input into any user interface design.

Many healthcare organizations are looking to patient portals to increase patient engagement, but for many, it's only a way to meet Meaningful Use directives. A study from the Chicago area found stark differences among those who register and use patient portals. Men, whites and those with fewer chronic conditions were more likely to register, as were those who were highly educated or health-literate.

Personal health records can be "smart tools" for patients, according to a recent report from the Robert Wood Johnson Foundation, which looked at whether they should be more than electronic copies of medical records. It found that when actively used, they can help improve outcomes.

Overall eHealth usage by U.S. adults is low, with only about 19 percent of adults engaging in activities like emailing providers; 19 percent tracking their health information online; and 17.6 percent buying medicine online, according to a June study published at the Journal of Medical Internet Research. Adults between the ages of 18 and 34 had more than twice the odds of engaging in online provider searches compared to the oldest group, ages 65 years and older, the study found

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