by Eirik Årsand, PhD, Research scientist at University hospital of North NorwayMobile Applications (apps) withinHealthcare...
Agenda• Who we are• Methods for user-involvement• Application examples• Challenges• Discussion
Both a hospital, and anational telemedicinecentre
Internalcompetence:Our Diabetes Research Team•Technology•Systemdevelopment•Doctors•Risk management•Nurses•Statistics•Resea...
Our focus• R&D• Diabetes, Type 1 and 2• Focus on patient-operated mobile terminals,sensors with wireless communication, an...
User-involvementin design
• Focus group (á 5-8 persons)• Paper prototyping / sketching exercise• Thinking aloud• Questionnaire• Interview• Automatic...
Focus groups• Invite groups of users (5-8)• The users feedback are the maininformation source• Semi-structured questions o...
Paper Prototyping and Sketching• also referred to as “paper-and-pencil evaluation”• a good tool for quickly and inexpensiv...
• use prototype while thinking out loud• reporting also expectations, feelings and other things• should probes the usabili...
HCI-specific Questionnaires• SUS - the 10-question software usability scale• SUMI - the 50-question Software UsabilityMeas...
Applicationexamples
Many mHealth apps
Eg. EKG
Quality varies a lotThe best-performing appaccurately identifiedcancerous moles 98.1%of the time, while theworst picked th...
Health  Welfare technologyhttp://www.medhelp.org/
Our examples, based on the aim:- Gain knowledge about how to usemobile technologies to ease theeveryday life, and improve ...
The diabetes patients’ challengeMedicationNutritionPhysical activityHealthindicators
Classical education –time consuming• Only 35% of the patients in Norway achieve theInternational Diabetes Federation’s goa...
Motivation• 366 mill. with diabetes in 2011, prognosis: 552 in 2030• Poorly regulated blood glucose increases the chancefo...
Motivation no. 2
User-involved design• In all phases– From ideas to evaluation• Evaluation / research– what is preferred,– what works, and–...
The processTechnological possibilitiesUser needsNew functionalitiesResearchNew ideasAvailable servicesNew functionalitiesR...
Blood glucose on SMS• 15 children withType 1 diabetes• 3 months test• Pre-test,questionnaires,interviews
Designing a Diabetes DiaryIn an easy way – provide the users abetter overview of disease-specificelements – in a unit that...
• Focus group (á 5-8 persons)• Paper prototyping / sketching exercise• Questionnaire• Interview• Automatic logging• “Homew...
Final version
More information: www.renewinghealth.euTested in RCTNorwegian 1 year study:• 151 T2D patients• 2/3 testing theDiabetes Dia...
Type 1 diabetes version• Providing anotherversion to T1Ds• Focus groups• Questionnaires• Super-users in early versions• St...
Research  free appwww.diabetesdagboka.noIdea: New users  new feedback
Gaming  learning• Use of healthy children• Focus group meeting• Test on children withType 1 diabetes• Interview• Question...
Interaction with health care personnelas part of the EU-project FI-STARi.e. are now involving patients AND health care per...
Challenges
From research – to service• Engaging health care personnel• Integration of patient tools into health caresystems• Updating...
Is the RCT too slow for mobile health?• (mobihealthnews.com/19378/is-the-rct-too-slow-for-mobile-health/)• From the mHealt...
Rapid design/application development• Recruit and involve users early• Listen to their needs and suggestions• Then, tell a...
Building a mHealth portfolioIntegration w/GPMotivationalgroups /Social MediaNew functionalities, e.g. gamingStatistical mo...
Eirik.Arsand@telemed.nowww.telemed.no/arsandwww.telemed.no/diabetesQuestions /comments?
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mHealth Symposium University Hospital of North Norway

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  • Experiences from designing apps for patients with diabetes over a period of more than 10 years will be used as examples. Even though the technology and infrastructure for mobile-phone-based apps now finally are in place, there are still many surrounding factors that need to be addressed in health care.
  • Experiences from designing apps for patients with diabetes over a period of more than 10 years will be used as examples. Even though the technology and infrastructure for mobile-phone-based apps now finally are in place, there are still many surrounding factors that need to be addressed in health care.
  • Kan gjerne bruke litt tid på Wellness kontra health – hva er forskjellene og hva er forskjell i krav, regler, lovverk etc.
  • Understek at gjennom denne studien får vi testet det ut på helt nye pasienter.Evt si at vi også måler effekt av helserådgivning. Dett er jo et tema som knytter oss videre inn i FI-STAR
  • Gaming – er populært og i vinden – bruk gjerne tid på det. Har vi erfaringer? Studier? Hva er problemstilling isf?
  • http://mobihealthnews.com/19378/is-the-rct-too-slow-for-mobile-health/
  • mHealth Symposium University Hospital of North Norway

    1. 1. by Eirik Årsand, PhD, Research scientist at University hospital of North NorwayMobile Applications (apps) withinHealthcare – Use of Patients in the Design
    2. 2. Agenda• Who we are• Methods for user-involvement• Application examples• Challenges• Discussion
    3. 3. Both a hospital, and anational telemedicinecentre
    4. 4. Internalcompetence:Our Diabetes Research Team•Technology•Systemdevelopment•Doctors•Risk management•Nurses•Statistics•Researchers•PhD students•Lawyer
    5. 5. Our focus• R&D• Diabetes, Type 1 and 2• Focus on patient-operated mobile terminals,sensors with wireless communication, andeasy-to-use applications for self-help• i.e. eHealth consumer focus• How to involve Health Care sector?
    6. 6. User-involvementin design
    7. 7. • Focus group (á 5-8 persons)• Paper prototyping / sketching exercise• Thinking aloud• Questionnaire• Interview• Automatic logging• “Homework” between meetings• Prototyping – (re)testingMethods
    8. 8. Focus groups• Invite groups of users (5-8)• The users feedback are the maininformation source• Semi-structured questions often act as afoundation for the meeting• The meeting is often audio recorded andtranscribed, for later usage and analysis
    9. 9. Paper Prototyping and Sketching• also referred to as “paper-and-pencil evaluation”• a good tool for quickly and inexpensively obtainingdesign feedback, at an early stage• e.g. a series of prefabricated cut-outs thatrepresented various states of a mobile phoneapplication• a variant: ”sketching exercise”, involves the user insketching the ideal system design
    10. 10. • use prototype while thinking out loud• reporting also expectations, feelings and other things• should probes the usability of the prototype, and notthe user’s skills or experience• allows to understand how the prototype is perceivedduring the “whole” period of use
    11. 11. HCI-specific Questionnaires• SUS - the 10-question software usability scale• SUMI - the 50-question Software UsabilityMeasurement Inventory evaluation questionnaire• QUIS - 27-item Questionnaire for User InteractionSatisfaction• CSUQ - 19-question Computer System UsabilityQuestionnaire
    12. 12. Applicationexamples
    13. 13. Many mHealth apps
    14. 14. Eg. EKG
    15. 15. Quality varies a lotThe best-performing appaccurately identifiedcancerous moles 98.1%of the time, while theworst picked them uponly 6.8% of the time,according to the study.(published online byJAMA Dermatology, Jan.2013)
    16. 16. Health  Welfare technologyhttp://www.medhelp.org/
    17. 17. Our examples, based on the aim:- Gain knowledge about how to usemobile technologies to ease theeveryday life, and improve the healthfor people with diabetes
    18. 18. The diabetes patients’ challengeMedicationNutritionPhysical activityHealthindicators
    19. 19. Classical education –time consuming• Only 35% of the patients in Norway achieve theInternational Diabetes Federation’s goal for bloodglucose (HbA1c)• only 6 % reach all treatment goals
    20. 20. Motivation• 366 mill. with diabetes in 2011, prognosis: 552 in 2030• Poorly regulated blood glucose increases the chancefor diabetic complications  personal sufferings• Costs: $465 billion dollars in 2011(11% of total healthcare expenditures)• The number of people with type 2 diabetes isincreasing in every country• i.e. needs for self-help tools
    21. 21. Motivation no. 2
    22. 22. User-involved design• In all phases– From ideas to evaluation• Evaluation / research– what is preferred,– what works, and– what is sustainable
    23. 23. The processTechnological possibilitiesUser needsNew functionalitiesResearchNew ideasAvailable servicesNew functionalitiesResearch
    24. 24. Blood glucose on SMS• 15 children withType 1 diabetes• 3 months test• Pre-test,questionnaires,interviews
    25. 25. Designing a Diabetes DiaryIn an easy way – provide the users abetter overview of disease-specificelements – in a unit that is «always»with them12 Type 2 diabetes persons engaged over aperiod of 3 years
    26. 26. • Focus group (á 5-8 persons)• Paper prototyping / sketching exercise• Questionnaire• Interview• Automatic logging• “Homework” between meetings• Prototyping – (re)testingMany iterations of:
    27. 27. Final version
    28. 28. More information: www.renewinghealth.euTested in RCTNorwegian 1 year study:• 151 T2D patients• 2/3 testing theDiabetes Diary• 1/3 coached• 1/3 usual care• Finishes November
    29. 29. Type 1 diabetes version• Providing anotherversion to T1Ds• Focus groups• Questionnaires• Super-users in early versions• Study on 30 T1D now
    30. 30. Research  free appwww.diabetesdagboka.noIdea: New users  new feedback
    31. 31. Gaming  learning• Use of healthy children• Focus group meeting• Test on children withType 1 diabetes• Interview• Questionnaires• Testing• Plan: integration withthe Diabetes Diary
    32. 32. Interaction with health care personnelas part of the EU-project FI-STARi.e. are now involving patients AND health care personnel
    33. 33. Challenges
    34. 34. From research – to service• Engaging health care personnel• Integration of patient tools into health caresystems• Updating systems based on rapid changingtechnologies• Make sustainable services/ businesses
    35. 35. Is the RCT too slow for mobile health?• (mobihealthnews.com/19378/is-the-rct-too-slow-for-mobile-health/)• From the mHealth Summit 2012:– they’re enormously expensive. We spend at least threetimes as much doing trials as building apps themselves.– we’re learning things through small pilots that can get appsinto the field right now.– no doctor’s going to prescribe a product if they don’tbelieve it’s an effective product that will move the needle.
    36. 36. Rapid design/application development• Recruit and involve users early• Listen to their needs and suggestions• Then, tell about the possibilities andtechniques• Quick prototyping – iterations• Test in real setting – change designdue to experiences• Build on the results in further designs• Make available if possibleTechnological possibilitiesUser needsNew functionalitiesResearchNew ideasAvailable servicesNew functionalitiesResearch
    37. 37. Building a mHealth portfolioIntegration w/GPMotivationalgroups /Social MediaNew functionalities, e.g. gamingStatistical modeling(of users’ own data)User-Involved DesignIntegration w/hospitalAvailableas app
    38. 38. Eirik.Arsand@telemed.nowww.telemed.no/arsandwww.telemed.no/diabetesQuestions /comments?

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