Evaluating Patient Usability of an Image-Based Mobile Health Platform for Postoperative Wound Monitoring

• Published in: JMIR mHealth and uHealth Vol. 4; no. 3; p. e113
• Main Authors: Gunter, Rebecca, Fernandes-Taylor, Sara, Mahnke, Andrea, Awoyinka, Lola, Schroeder, Chad, Wiseman, Jason, Sullivan, Sarah, Bennett, Kyla, Greenberg, Caprice, Kent, K Craig
• Format: Journal Article
• Language: English
• Published: Canada JMIR Publications 28-09-2016
• Subjects: Original Paper; telemedicine; smartphone; postoperative wound infection; surgical site infection
• ISSN: 2291-5222; 2291-5222
• DOI: 10.2196/mhealth.6023

Surgical patients are increasingly using mobile health (mHealth) platforms to monitor recovery and communicate with their providers in the postdischarge period. Despite widespread enthusiasm for mHealth, few studies evaluate the usability or user experience of these platforms.
Our objectives were to (1) develop a novel image-based smartphone app for postdischarge surgical wound monitoring, and (2) rigorously user test it with a representative population of vascular and general surgery patients.
A total of 9 vascular and general surgery inpatients undertook usability testing of an internally developed smartphone app that allows patients to take digital images of their wound and answer a survey about their recovery. We followed the International Organization for Standardization (ISO) 9241-11 guidelines, focusing on effectiveness, efficiency, and user satisfaction. An accompanying training module was developed by applying tenets of adult learning. Sessions were audio-recorded, and the smartphone screen was mirrored onto a study computer. Digital image quality was evaluated by a physician panel to determine usefulness for clinical decision making.
The mean length of time spent was 4.7 (2.1-12.8) minutes on the training session and 5.0 (1.4-16.6) minutes on app completion. 55.5% (5/9) of patients were able to complete the app independently with the most difficulty experienced in taking digital images of surgical wounds. Novice patients who were older, obese, or had groin wounds had the most difficulty. 81.8% of images were sufficient for diagnostic purposes. User satisfaction was high, with an average usability score of 83.3 out of 100.
Surgical patients can learn to use a smartphone app for postoperative wound monitoring with high user satisfaction. We identified design features and training approaches that can facilitate ease of use. This protocol illustrates an important, often overlooked, aspect of mHealth development to improve surgical care.