JMIR Publications

ABSTRACT

Background:

Heart failure (HF) causes significant economic and humanistic burden for patients and their families, especially those who are low-income, partly due to high hospital readmission rates. Optimal self-care is considered an important nonpharmacological aspect of HF management that can improve health outcomes. The emerging evidence suggests that self-care assisted by smartphone applications provides an opportunity to reduce re-hospitalization and improve quality of life for patients. We developed a virtual-human assisted, patient-centered mobile health app ("iHeartU") for HF patients to enhance their engagement in self-management and strengthen their communications with their care providers and family caregivers. iHeartU will help HF patients in their self-management to reduce the technical knowledge and usability barrier in the use of information and communication technology, while maintaining low cost and natural affective social interaction with the user.

Objective:

With a standardized systematic usability assessment, the objectives of this study are two-folded: 1) to determine the obstacles to effective and efficient use of iHeartU with HF patients; and 2) to evaluate HF patients’ adoption of iHeartU, use of supplemental devices (blood pressure monitor and weight scale), satisfaction, and engagement.

Methods:

The basic methodology to develop iHeartU systems consists of a user centric design, development, and mixed methods formative evaluation. The iterative design and evaluation are based on the guidelines of the Heart Failure Society of America and the validated “Information, Motivation, and Behavioral skills” (IMB) behavior change model.3 Our hypothesis is that this method of user centric design will generate a more usable, useful and easy to use mHealth system for patients, caregivers and practitioners (all stakeholders of the system).

Results:

The prototype of iHeartU has been developed and is under the usability testing. As of September 2018, the first-round of usability testing data has been collected. The final data collection and analysis will be completed in the fall of 2019.

Conclusions:

The main contribution of this project is the development of a patient-centered self-management network to support HF patients’ self-care at home and aid in the communication between patients and their health care providers in a more effective and efficient way. Widely available cell phones serve as care coordination and “no-cost” continuum of care. For low-income HF patients, mobile self-care tool expands their accessibility to care and reduce the cost incurred due to emergency visits or readmissions. The user-centered design can be attributable to an improved level of engagement of patients and will ultimately lead to better health outcomes. Developing and testing a novel mobile system for HF patients that incorporates chronic disease management is critical for advancing research and clinical practice of care for HF patients. This research fills in the gap of user-centric design and lays the groundwork for a large-scale population study in the next phase.