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The 21st century has brought forth unprecedented technological advances, such as the advent of portable digital devices [1]. This trend has also permeated the health care sector, with the introduction of digital health services, like providing citizens with access to their online laboratory (lab) results. This qualitative study will illustrate the patient journey, namely participant 16 (P16), to address the research question: what phases does a person go through when accessing their lab results online? The findings revealed that lab results were accessed from two types of devices a tablet (e.g., portable computer) when at home and a mobile phone when away from home. We also found that interpretation of results can be a challenge and it was unclear if P16 was able to understand her lab results. To illustrate the complexity of interpreting and accessing online lab results, the authors created a Customer Journey Map to contextualize the experiences of P16. The journey map depicts a combination of factors such as: eHealth literacy, limited access to providers, difficulty interpreting lab test results. Additionally, recommendations for online lab portal functionality enhancements were discovered through the mapping exercise. This study demonstrated that along with providing citizens with access to digital health technologies and services, considerations to eHealth literacy, the digital divide and health equity are paramount. As evidenced by the visualization, journey maps hold promise to serve as efficient tools to build empathy and identify the unique needs and perspectives of citizens.

Usability problems in the interaction between patients and telemedicine platforms has been recognized as a deterrent in the public's acceptance and use of this alternative healthcare delivery method. Therefore, evaluating the usability of telemedicine provider websites, with a focus on potential patients' first interaction with telemedicine, is a critical research inquiry. To this end, a novel survey was developed to conduct an unmoderated remote usability test (URUT) of the Teladoc website. Teladoc is one of the largest providers of Direct-to-Consumer (DTC) telemedicine. The Teladoc Website Usability Survey (TWUS) instrument collected both objective task completion success metrics and subjective user feedback. A codebook was developed to categorize design features and user interface aspects that affected usability. The TWUS and codebook demonstrated value in identifying usability problems with the Teladoc interface and can be applied in other telemedicine or Health Information Technology (HIT) usability studies. Identifying and addressing usability issues is an important approach to increase the widespread acceptance and adoption of these healthcare delivery technologies.

Simulations offer a safe environment for health professional training and the opportunity to predictably and consistently introduce events or variables that may be rare or dangerous in a live setting. Exposing trainees to unanticipated events during simulations can improve their ability to adapt and improvise. The COVID-19 pandemic accelerated the adoption of telehealth worldwide and highlighted the need for better training in health professional schools. In the United States, the Association of American Medical Colleges (AAMC) published new telehealth competency standards in 2021. The AAMC stated that health care providers should be aware of the risks of technology failures, capable of troubleshooting them, and lead systems interventions to improve safety. However, the AAMC does not provide guidance on the specific failures or solutions. In this study, we developed a set of technology failures that can be simulated in a telehealth curriculum. We incorporated one technology failure into a simulated telehealth encounter and gathered students' (N = 53) feedback on the exercise. Students' feedback was overwhelmingly positive. They agreed that integrating technology failures into telehealth simulations provides important practice managing these events during clinical encounters. While telehealth is an important healthcare delivery modality that can improve access-to-care, it is imperative to train medical students to navigate technology failures so that can adeptly manage these issues in clinical practice.

We developed a teledermatology simulation to give medical and physician assistant students practice with live videoconferencing and store-and-forward workflows. The simulation included (1) pre-session reading; (2) a brief teledermatology didactic; (3) a simulated encounter with a standardized patient; and (4) faculty-led debriefs. The faculty observed students during the simulation and distributed a post-session learner satisfaction survey. Although students had mixed feelings about the simulation, 88% said the workshop met or exceeded expectations.

Adhering to user experience (UX) and eHealth literacy principles when developing consumer health information systems (HISs) can not only improve a user's experience but can also have implications on patient safety. Methods exist to explore these dimensions independently, but few methods are available for evaluating consumer (i.e., citizen) health information systems for their adherence to usability and eHealth literacy design principles simultaneously. In this paper, we compared two inspection (i.e., expert review) tools and identified the strengths and weaknesses of each. The findings from this comparison can assist researchers, consumer health information system developers, and evaluators choosing between the two alternatives. Moreover, our comparison revealed the shortcomings in both tools and the need for a novel, purpose-built tool that is more comprehensive than either of the existing tools that assess UX and eHealth literacy and more adequately address design guidelines for the mobile environment.

People are increasingly able to access their laboratory (lab) results using patient-facing portals. However, lab reports for citizens are often identical to those for clinicians; without specialized training they can be near impossible to interpret. In this study, we inspected a mobile health application (app) that converts traditional lab results into a citizen-centred format. We used the Health Literacy Online (HLO) checklist to inspect the app. Our inspection revealed that most of the app's strengths were related to its Organization of Content and Simple Navigation and most of its weaknesses were related to Engage Users. We also identified several usability and user experience (UX) issues that were beyond the purview of the HLO checklist. Although this app represents an important step towards making lab results universally accessible, we identified several opportunities for improvements that could increase its value to citizens.

The usability of telemedicine provider websites is an essential component of increasing the public's awareness of, understanding of, and safe and effective use of telemedicine. A newly developed usability data collection tool was used to conduct a usability assessment of the Teladoc website pre- and post- a redesign. The results suggest that the Teladoc website had better usability prior to the redesign. The Teladoc Website Usability Survey (TWUS) developed for the Teladoc website usability assessment can be modified and used in future usability studies of telemedicine provider interfaces. Usability research that takes place in specific context of use settings is more valuable to identify usability problems.

The usability of telemedicine provider websites is an essential component of increasing the public’s awareness of, understanding of, and safe and effective use of telemedicine. A newly developed usability data collection tool was used to conduct a usability assessment of the Teladoc website pre- and post- a redesign. The results suggest that the Teladoc website had better usability prior to the redesign. The Teladoc Website Usability Survey (TWUS) developed for the Teladoc website usability assessment can be modified and used in future usability studies of telemedicine provider interfaces. Usability research that takes place in specific context of use settings is more valuable to identify usability problems.

Many people take prescription medications and need information about the risks and benefits associated with taking them. Citizens are increasingly turning to the internet for health information and medication information is no exception. There are a variety of websites that offer Online Medication Information for Citizens (OMIC). This study compared six such websites using the Health Literacy Online (HLO) Checklist as a framework. Additionally, we conducted a detailed analysis of the individual content in each OMIC for three different medications. We identified several strengths and weaknesses of the different websites in terms of how they were designed and written and their appropriateness for users with limited eHealth literacy.

In the absence of a pan-Canadian electronic health record, unnecessary duplicate diagnostic imaging (DI) examinations are sometimes ordered when a physician is not aware of prior DI or prior DI is not available. Research suggests that physicians may ask their patient to recall their DI history; however, patient recall of DI can be unreliable. As a potential solution, a patient-facing mobile health application (app) prototype was developed for users to record their DI. The app was designed to be usable and inclusive to users of all health literacy levels. The aim of this paper is to demonstrate how eHealth literacy and usability heuristics can be used during the design phases of app development.

Mobile phones are used in conjunction with mobile eHealth software applications. These mobile software applications can be used to access, review and document clinical information. The objective of this research was to explore the relationship between mobile phones, usability and safety. Clinical simulations and semi-structured interviews were used to investigate this relationship. The findings revealed that mobile phones may lead to specific types of usability issues that may introduce some types of errors.

Derived from overlapping concepts in consumer health, a consumer health information system refers to any of the broad range of applications, tools, and educational resources developed to empower consumers with knowledge, techniques, and strategies, to manage their own health. As consumer health information systems become increasingly popular, it is important to explore the factors that impact their adoption and success. Accumulating evidence indicates a relationship between usability and consumers' eHealth Literacy skills and the demands consumer HISs place on their skills. Here, we present a new model called the Consumer Health Information System Adoption Model, which depicts both consumer eHealth literacy skills and system demands on eHealth literacy as moderators with the potential to affect the strength of relationship between usefulness and usability (predictors of usage) and adoption, value, and successful use (actual usage outcomes). Strategies for aligning these two moderating factors are described.

Heuristic evaluations have proven to be valuable for identifying usability issues in systems. Commonly used sets of heuritics exist; however, they may not always be the most suitable, given the specific goal of the analysis. One such example is seeking to evaluate the demands on eHealth literacy and usability of consumer health information systems. In this study, eight essential heuristics and three optional heuristics subsumed from the evidence on eHealth/health literacy and usability were tested for their utility in assessing a mobile blood pressure tracking application (app). This evaluation revealed a variety of ways the design of the app could both benefit and impede users with limited eHealth literacy. This study demonstrated the utility of a low-cost, single evaluation approach for identifying both eHealth literacy and usability issues based on existing evidence in the literature.

The use of mobile devices and healthcare applications is increasing exponentially worldwide. This has lead to the need for the healthcare industry to develop a better understanding of the impact of the usability of mobile software and hardware upon consumer and health professional adoption and use of these technologies. There are many methodological approaches that can be employed in conducting usability evaluation of mobile technologies. More obtrusive approaches to collecting study data may lead to changes in study participant behaviour, leading to study results that are less consistent with how the technologies will be used in the real-world. Alternatively, less obstrusive methods used in evaluating the usability of mobile software and hardware in-situ and laboratory settings can lead to less detailed information being collected about how an individual interacts with both the software and hardware. In this paper we review and discuss several innovative mobile usability evaluation methods on a contiuum from least to most obtrusive and their effects on the quality of the usability data collected. The strengths and limitations of methods are also discussed.