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Les dispositifs en sante connectee utilises au domicile du patient sont en pleine expansion. Pourtant, lors de leur conception, des evaluations holistiques de l’utilisabilite – cruciales pour la securite du patient – ne sont pas systematiquement standardisees. Afin de pallier ces lacunes, nous proposons dans cette these un modele d’evaluations iteratives et cumulatives de l’utilisabilite (HANDLED - Home medicAl coNnected Devices usabiLity Evaluation moDel). Nous avons eprouve puis valide ce modele a travers 5 etudes portant sur la conception et l’evaluation d’un dispositif connecte en sante (Smart Angel) pour le suivi des patients sortant de chirurgie ambulatoire. Ce modele theorique permet in fine d’assister la conception de dispositifs en sante connectee.

Background The Smart Angel home medical device allows ambulatory surgery patients to monitor their own health by taking their blood pressure and oxygen levels and answering a health questionnaire from home. Currently, this device is a prototype in the design phase, and no usability evaluation has been performed. This preventive device must be usable by patients with different profiles; however, it is important to select patients carefully to ensure their safety when using the device. As such, it would be interesting to know how to select or exclude patients. However, the links between user characteristics and the usability of this home medical device remain unclear. Objective This study aims to better understand the links between certain characteristics of potential patients (ie, age, education, technophilia, and health literacy) and the usability (ie, effectiveness, efficiency, and satisfaction) of Smart Angel, as defined by the ISO 9241-11. Methods We conducted an experimental study involving 36 participants investigating the effects of 4 patient characteristics (ie, age, education, technophilia, and health literacy) on usability, measured in terms of effectiveness, efficiency, and satisfaction. A mixed methods approach (subjective vs objective) using a variety of standard instruments was adopted (direct observation, video analysis, and questionnaires). First, to help participants project themselves into the real use of the Smart Angel device, they watched a scenario in a video. Second, the participants completed a set of questionnaires to show the extent of their health literacy level (Newest Vital Sign [NVS] and the Health Literacy Survey [HLS]) and then operated Smart Angel devices. Efficiency (ie, handling time) and effectiveness (ie, number of handling errors) measures were collected by video analysis. Satisfaction measures were collected by a questionnaire (System Usability Scale [SUS]). The qualitative observational data were coded using inductive analysis by 2 independent researchers specialized in cognitive psychology and cognitive ergonomics. Results The results show a moderate and positive correlation between age and effectiveness (r=0.359; P=.03) and efficiency (r=0.357; P=.03). There is strong correlation between health literacy scored by the NVS and effectiveness (r=0.417; P=.01), efficiency (r=-0.38; P=.02), and satisfaction (r=0.45; P=.006). However, there is a weak correlation between technophilia and usability and no relationship between education level and usability. Conclusions Our results show that literacy level and age are 2 important factors to consider when selecting future users of the Smart Angel device to ensure patient safety. This study also serves as an example promoting mixed methodologies in assessments of medical device usability that cannot be performed under real-world conditions.

20th Congress of the International-Ergonomics-Association (IEA), Florence, ITALY, AUG 26-30, 2018; International audience; EHealth appears to be both an economic solution and a way to overcome the increase in health needs due to the ageing of the population and the increase of diseases. The presented project is aimed at developing individualized monitoring of patients who have undergone surgery and have been supported by a medical information system and connected devices. These connected systems have many benefits for healthcare system, but they also have disadvantages, relating to the complexity of their use. Their evaluation must be done in real work situations with health professionals and patients with different profiles (age, needs, skills, literacy, pathology, and expert/novice in technologies.). The aim of this work is to propose an integrative theoretical and methodological framework for a standardized evaluation of usability (including efficiency, effectiveness, satisfaction and understanding) in e-health in a user-centered design context. To do this, below is presented a state-of-the-art on usability evaluation. Finally, this work presents insights on how ergonomics and cognitive psychology approaches can contribute to greater understanding and the use of these devices in healthcare (patients, caregivers, family careers).