Currently submitted to: JMIR Formative Research
Date Submitted: Apr 13, 2026
Open Peer Review Period: May 11, 2026 - Jul 6, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A Participatory Heuristic Evaluation of a Digital Mental Health Intervention: The Case of Telma-PSYK
ABSTRACT
Background:
Digital mental health interventions (DMHIs) can reduce geographical constraints, stigma, and offer cross-sectoral care for patients with severe mental illness. Despite the obvious advantages associated with DMHIs, utilizing its potential in clinical practice can be challenging. User involvement plays a particularly crucial role in ensuring the successful development and implementation of DMHIs. However, involving users and particularly clinicians during the development process of DMHIs can be challenging and time-consuming, hampering the success and utilization of DMHIs in clinical practice.
Objective:
The aim of this study is to apply heuristics for evaluating Telma-PSYK, a cross-sectoral telemonitoring application, targeting patients with severe mental illness, and to inform future development iterations.
Methods:
A Participatory Heuristic Evaluation (PHE) consisting of 15 heuristics was applied to evaluate Telma-PSYK. A 5-point severity scale to rate the severity of the heuristic violation was applied. Work-domain experts, i.e., clinicians working in mental health services (n=5) as well as usability experts (n=4), were recruited as usability inspectors.
Results:
Inspectors who participated in the PHE identified nine heuristic violations. The most frequently violated heuristic was Aesthetic and Minimalist Design, accounting for 44.44 % (4/9) of the total violations. Severity ratings ranged from 1 to 5, with the most critical violations related to the Aesthetic and Minimalist Design heuristic, where usability problems in monitoring individual patient mental health status were identified.
Conclusions:
Usability problems reported by clinicians and usability experts can guide and inform the next development iteration, ensuring that it is grounded in clinical needs and requirements, thereby increasing the potential for successful uptake and implementation of Telma-PSYK in clinical practice. By applying the PHE method, this study shows how clinicians can be meaningfully involved as decision makers, shaping and guiding the development of DMHIs. The findings further highlight that usability challenges are closely linked to the presentation and interpretation of clinical data, which may be critical for successful implementation in practice. Clinical Trial: N.A
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