Human Factors Analysis, Design, and Evaluation of Engage, a Consumer Health IT Application for Geriatric Heart Failure Self-Care

Human factors and ergonomics (HFE) and related approaches can be used to enhance research and development of consumer-facing health information technology (IT) systems, including technologies supporting the needs of people with chronic disease. A multiphase HFE study of health IT supporting self-care of chronic heart failure by older adults is described. The study was based on HFE frameworks of patient work and incorporated the three broad phases of user-centered design: study or analysis, design, and evaluation. In the study phase, data from observations, interviews, surveys, and other methods were analyzed to identify gaps in and requirements for supporting heart failure self-care. The design phase applied findings from the study phase throughout an iterative process, culminating in the design of the Engage application, a product intended for continuous use over 30 days to stimulate self-care engagement, behavior, and knowledge. During the evaluation phase, a variety of usability issues through expert heuristic evaluation and laboratory-based usability testing were identified. The implications of our findings regarding heart failure self-care in older adults and the methodological challenges of rapid translational field research and development in this domain are discussed.