JMIR Publications

ABSTRACT

Background:

Physician-to-physician teleconsultation has increasingly played an essential role in delivering optimum health care services, particularly in orthopaedic practice. The usability of a smartphone application for teleconsultation among orthopaedic specialists is investigated to explore issues informing further recommendations for improvement in the following iterations.

Objective:

This study aims to explore usability issues emerging from users’ interactions with MEDIC application, a smartphone-based patient-centred physician-to-physician teleconsultation system.

Methods:

Five attending physicians in the Department of Orthopedics in a large medical school in Bangkok, Thailand, were recruited and asked to perform five evaluation tasks including group formation, patient registration, clinical data capturing, case record form creation and teleconsultation. In addition, two expert users were recruited as a compared group. Think aloud was adopted while performing the tasks. Semi-structured interviews were conducted after each task and prior to the exit. Quantitative and qualitative measures were used to identify usability issues in 7 domains: effectiveness, efficiency, satisfaction, learnability, memorability, error and cognitive load.

Results:

Several measures indicate various aspects of usability of the app including completion rates, time to completion, number of clicks, number of screens, errors, incidents where participants were unable to perform tasks which had previously been completed and perceived task difficulty. Major and critical usability issues based on participant feedback were rooted from the limitation of screen size and resolution. Errors in data input (eg, typing errors, miscalculation) and misinterpretation of data (i.e., radiography) were the most critical and common issues found in this study. A few participants did not complete assigned tasks mostly due to navigation design and misreading/misunderstanding icons. However, the novice users were quite positive that they would be able to become familiar with the app in a short period of time.

Conclusions:

The usability issues on physician-to-physician teleconsultation systems on smartphones in general are derived from the limitations of smartphones and their operating systems. While some recommendations were devised to handle these usability issues, usability evaluation for additional development should still be further investigated.