Complementing a Clinical Trial With Human-Computer Interaction: Patients' User Experience With Telehealth.

BACKGROUND: The use of telehealth to monitor patients from home is on the rise. Telehealth technology is evaluated in a clinical trial with measures of health outcomes and cost-effectiveness. However, what happens between a technology and the patients is not investigated during a clinical trial-the telehealth technology remains as a "black box." Meanwhile, three decades of research in the discipline of human-computer interaction (HCI) presents design, implementation, and evaluation of technologies with a primary emphasis on users. HCI research has exposed the importance of user experience (UX) as an essential part of technology development and evaluation. OBJECTIVE: This research investigates the UX of patients with type 2 diabetes mellitus (T2D) with a telehealth in-home monitoring device to manage T2D from home. We investigate how the UX during a clinical trial can be researched and what a clinical trial can learn from HCI research. METHODS: We adopted an ethnographic philosophy and conducted a contextual inquiry due to time limitations followed by semistructured interviews of 9 T2D patients. We defined the method as Clinical User-experience Evaluation (CUE). The patients were enrolled in a telehealth clinical trial of T2D; however, this research was an independent study conducted by information technologists and health researchers for a user-centered evaluation of telehealth. RESULTS: Key analytical findings were that patients valued the benefits of in-home monitoring, but the current device did not possess all functionalities that patients wanted. The results include patients' experiences and emotions while using the device, patients' perceived benefits of the device, and how patients domesticated the device. Further analysis showed the influence of the device on patients' awareness, family involvement, and design implications for telehealth for T2D. CONCLUSIONS: HCI could complement telehealth clinical trials and uncover knowledge about T2D patients' UX and future design implications. Through HCI we can look into the "black box" phenomenon of clinical trials and create patient-centered telehealth solutions.

A meta-synthesis of behavioral outcomes from telemedicine clinical trials for type 2 diabetes and the Clinical User-Experience Evaluation (CUE).

A worldwide demographic shift is in progress and the aged population proportion is projected to more than double across the next four decades. Our current healthcare models may not be adequate to handle this shift in demography, which may have serious consequences for the ageing population who are more prone to chronic diseases. One proposed remediation is to provide in-home assisted healthcare with technology-intervened approaches. Telemedicine, telehealth, e-health are paradigms found in scientific literature that provide clinical treatment through a technology intervention. In evidence-based medical science, these technology interventions are evaluated through clinical trials, which are targeted to measure improvements in medical conditions and the treatment's cost effectiveness. However, effectiveness of a technology also depends on the interaction pattern between the technology and its' users, especially the patients. This paper presents (1) a meta-synthesis of clinical trials for technology-intervened treatments of type 2 diabetes and (2) the Clinical User-Experience Evaluation (CUE). CUE is a recommendation for future telemedicine clinical trials that focuses on the patient as the user from Human-Computer Interaction (HCI) perspective and was developed as part of this research. The clinical trials reviewed were interpreted from a technology perspective and the non-medical or non-biological improvements of the users (patients) rather than the medical outcome. Results show that technology-intervened treatments provide positive behavior changes among patients and are potentially highly beneficial for chronic illness management such as type 2 diabetes. The results from the CUE method show how it complements clinical trials to capture patients' interaction with a technology.

Effects of body height, notebook computer size, and workstation height on recommended adjustments for proper work posture when operating a notebook computer.

Factors which are likely to affect recommended workstation and notebook computer (NBC) adjustments to obtain ergonomic work posture during NBC operation are investigated. They are: (1) body height, (2) NBC size, and (3) workstation height (i.e., seat and work surface heights). Six recommended adjustments which are evaluated include: (1) footrest height, (2) seat support height, (3) NBC base support height, (4) distance between the user's body and NBC (or user-NBC distance), (5) tilt angle of NBC base, and (6) screen angle. It is found that body height has a significant effect on footrest height and user-NBC distance while NBC size has a significant effect on user-NBC distance, tilt angle of NBC base, and screen angle. Workstation height, on the other hand, does not show any effect on the six recommended adjustments. However, the results suggest that there are interactions between body height and NBC size, and between body height and workstation height when evaluating their effects on footrest height, tilt angle of NBC base, and screen angle.