JMIR Publications

ABSTRACT

Background:

Pulse oximeters non-invasively measure blood oxygen levels, but devices have rarely been designed for low-resource settings, and are inconsistently available at outpatient clinics.

Objective:

The Phefumla project aims to develop and validate a paediatric smartphone-based pulse oximeter, designed specifically for this context. We present the process of human centred oximeter design with healthcare workers’ (HCWs) in South Africa.

Methods:

We purposively sampled 19 HCWs from five clinics in Khayelitsha township, Cape Town. Employing a human centred design approach, we conducted participatory workshops with four activities: 1) HCWs received 3-D printed prototypes of potential oximeter designs for feedback; 2) HCWs demonstrated on dolls how they would use the novel oximeter; 3) HCWs used pile sorting to rank design features and suggest additional features they desired; 4) HCWs designed their preferred user interface using a whiteboard, marker and magnetized features that could be repositioned. We audio recorded the workshops, took pictures of outputs, and took detailed field notes. Analysis involved iterative review of these data to describe preferences, identify key design updates and modifications.

Results:

Participants expressed a positive sentiment towards the idea of a smartphone pulse oximeter, and that a paediatric device would address an important gap in outpatient care. Specifically, participants expressed a preference for the prototype which they felt enabled more diversity in the way it could be used. There was a strong tendency to prioritise pragmatic design features, such as robustness, which was largely dictated by the HCWs context. They also added features that would allow the oximeter device to serve other clinical functions in addition to oxygen saturation measurement such as temperature and respiration rate.

Conclusions:

Our rapid participatory approach led to tangible design changes and prompted design discussions which the team had not previously considered. Overall, HCWs prioritised pragmatism when it came to device design.