Fundamentals of UX Design for eHealth Applications

Estimated at $14 billion in 2015, the mobile health solutions market is predicted to reach $60 billion by 2020. As part of eHealth agenda, telemedicine is a rapidly expanding market, the value of which is expected to reach $27.3 billion in 2016 and $52.3 billion by 2022. Mobile healthcare apps (mHealth apps) have become widespread in various branches of healthcare, especially in the field of chronic disease management. Top factors of market growth are the increasing use of connected devices like activity trackers, scales, blood pressure monitors and blood glucose meters; growing implementation of smart gadgets; and rapid development of mHealth apps – especially apps for primary care and hospital management. Widespread adoption of mobile health is also due to demand for convenient, patient-centric care, and for affordable treatment options in response to rising healthcare costs.

As mHealth expands its reach, the competition between mobile health apps increases. It is necessary to be able to determine effective apps from ineffective apps. While User Experience (UX) is a crucial factor for all applications, it is especially so for mHealth because individual health is an incredibly personal, incredibly sensitive topic.

HealthTap, a California-based mHealth company, recently published a list naming their top 10 mHealth apps for iOS and Android. The apps are judged based on three characteristics:

• ease of use,
• effectiveness and medical accuracy, and
• validity and soundness

These characteristics are important, no doubt. However, they are not the only guidelines for determining the foundation of effective UX design for mHealth apps. Functionality, security, and input are also necessary to meet user expectations.

User Expectations

According to a report summary published by Accenture, the top three features patients want most in an mHealth app are:

• the ability to request prescription refills electronically,
• access to medical records, and
• the ability to book, change, or cancel appointments with physicians.

However, only 11% of health systems offer proprietary apps providing at least one of these top three consumer demands.

The solution to this problem is to create a system for implementing user input throughout - and beyond - the app development process:

• At the beginning of the process, clearly identify the users. Typically, users fall under one of two categories: patients and providers. It’s important to research patient and provider expectations to ensure the app meets those expectations and maximizes functionality.
• Involve clinicians and specialists practicing in relevant domains. Providers know their patients (a.k.a your users), and can help to determine key objectives and features for your app. Of course, seeking input from providers also ensures that provider expectations for app functionality and usability are met. Constructive feedback can be utilized throughout the design process to create prototypes, wireframes, and mockups.
• Once the app is live, facilitate open communication with users by implementing a comprehensive feedback system. This provides the opportunity for honest user input after the initial design stage.

Functionality and usability

Once user expectations are known, specific functionality and usability features can be determined. Like any app, mobile health apps need to stand out from other competing apps in the market and “stick” with the user. At the same time, mHealth apps need to be comprehensible because health can be an unpleasant, confusing, or scary subject for many users.

Data visualization is an effective strategy for improving usability. Health care is notoriously difficult to navigate, but mHealth can be part of the solution by implementing design features that simplify the process:

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• Declutter by eliminating extraneous text, visuals, or sound. Too much stimulation can confuse users, discouraging them from using the app. The visuals that are included should be clean, consistent, and absolutely necessary.
• Data visualization should always help fulfill the app’s overall objective, whether it’s to track activity, monitor blood pressure, or educate users about healthy eating habits. For instance, the world’s first free-market telemedicine app that Intersog has built for Video Medicine, Inc. aims to provide accessible, affordable, non-emergency medical care by connecting doctors and patients. To facilitate this goal, the app utilizes features that indicate provider’s specialty, rate, online/offline status, and in which states they’re licensed to practice.

Specific functionality features vary widely depending on an app’s specific objectives. Still, there are some core principles to keep in mind:

• mHealth apps should always provide users with clear instructions on how to manage a specific disease.
• Current and updated research or data should be shared in a comprehensible way to keep users informed and educated on their condition.
• Although a majority of mHealth apps utilize the tracking feature, it is crucial to do so in a way that is comprehensible to the user, and does not confuse or distract them from the overall goal of the app.
• Flexibility and control, meaning that users should be able to easily and efficiently control interactions and carry out tasks.
• For optimal functionality, data reliability is key. Although mHealth apps vary widely by overall function, no app can achieve optimum functionality if data is not accurate or reliable. An activity tracker app that does not accurately capture or reliably transmit data will never be able to benefit users. An effective strategy to help ensure data reliability is to test apps at every stage in the design process, including the utilization of prototypes.

Security

There is no doubt that mHealth improves workflow efficiency. For example, medical devices and wearables for diabetes (such as insulin pumps) connect to mobile apps, allowing users to keep track of their vital signs without having to visit the doctor unless there is an anomaly. However, security is an ongoing issue in and a major threat to Telemedicine. In mHealth, IoT integration adds additional risk because wearables and connected medical devices (e.g., continuous blood glucose monitors and blood pressure cuffs) are vulnerable to cyber attacks. Their vulnerability stems from the fact that data typically travels from connected devices, across unlicensed wireless links, to a monitoring hub in a user’s home, to the broadband network and finally to the cloud. During this process, a breach can occur at several points.

• The most effective approach to security is to be proactive, not reactive. Prepare for data breaches and cyber attacks before they occur by making sure the app meets HIPAA compliance standards.
• Understand that cybersecurity is not a technical problem to be sent only to the IT department. Cybersecurity requires effort at all levels in a corporation, as well as implementing a comprehensive compliance and security program.
• Have a professional on board, preferably a Certified Information Security Manager (CISM).
• To protect sensitive information, include design features allowing users to opt out of sharing any personal health information (PHI).

One example of a successful cybersecurity system is the mHealth app VideoMedicine. In addition to meeting HIPAA compliance standards, VideoMedicine owns 100% of their technology instead of leasing video software from a third party, like Skype or Facetime, which cannot guarantee secure data transmission. All data is encrypted with a double layer to protect patients’ PHI. In addition, VideoMedicine provides the option for users to remain anonymous when seeking mental health advice, protecting their name, gender, age, and identity.

Wrapping up, in order to have a proper UX design, mobile health apps should keep the balance between functionality and usability, be tested, validated and optimized in each stage of software development, use stellar data visualization and have security layers embedded in UI design from the very beginning.

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This article was originally published in Feb/Mar edition of the Journal of mHealth.