Agile eHealth Usability Evaluation: A Triangulative Approach to Promoting the Usability of eHealth Systems.

BACKGROUND: Usability evaluation is difficult to reconcile with agile software development for eHealth systems, because traditional usability evaluation is often complex and cumbersome to implement. However, obtaining prospective users' feedback during agile software development is crucial for improving the usability of eHealth systems, which is why there is an increasing need for agile eHealth usability evaluation. OBJECTIVE: This study investigates whether agile usability evaluations are suitable to evaluate patient-centered eHealth systems being agile developed in health care and are applicable for prospective users, such as older persons suffering from age-related declines. METHODS: A triangulation study was conducted combining iterative expert interviews with an exploratory case study. RESULTS: The triangulation study revealed that the implementation of an agile eHealth usability evaluation with prospective users such as older persons proved to be possible. CONCLUSION: Established eHealth usability evaluation methods must be further evolved to address age-related impairments of older persons.

Agile, Easily Applicable, and Useful eHealth Usability Evaluations: Systematic Review and Expert-Validation.

BACKGROUND: Electronic health (eHealth) usability evaluations of rapidly developed eHealth systems are difficult to accomplish because traditional usability evaluation methods require substantial time in preparation and implementation. This illustrates the growing need for fast, flexible, and cost-effective methods to evaluate the usability of eHealth systems. To address this demand, the present study systematically identified and expert-validated rapidly deployable eHealth usability evaluation methods. OBJECTIVE: Identification and prioritization of eHealth usability evaluation methods suitable for agile, easily applicable, and useful eHealth usability evaluations. METHODS: The study design comprised a systematic iterative approach in which expert knowledge was contrasted with findings from literature. Forty-three eHealth usability evaluation methods were systematically identified and assessed regarding their ease of applicability and usefulness through semi-structured expert interviews with 10 European usability experts and systematic literature research. The most appropriate eHealth usability evaluation methods were selected stepwise based on the experts' judgements of their ease of applicability and usefulness. RESULTS: Of these 43 eHealth usability evaluation methods identified as suitable for agile, easily applicable, and useful eHealth usability evaluations, 10 were recommended by the experts based on their usefulness for rapid eHealth usability evaluations. The three most frequently recommended eHealth usability evaluation methods were Remote User Testing, Expert Review, and Rapid Iterative Test and Evaluation Method. Eleven usability evaluation methods, such as Retrospective Testing, were not recommended for use in rapid eHealth usability evaluations. CONCLUSION: We conducted a systematic review and expert-validation to identify rapidly deployable eHealth usability evaluation methods. The comprehensive and evidence-based prioritization of eHealth usability evaluation methods supports faster usability evaluations, and so contributes to the ease-of-use of emerging eHealth systems.