Though health applications are designed to help patients manage chronic conditions, many can present challenges to the vulnerable populations who are most likely to benefit, including those with low health literacy and low economic status, according to an observational study published by the Commonwealth Fund.
David Bates, MD, chief innovation officer and senior vice president at Brigham and Women's Hospital in Boston, Massachusetts, and authors found that adult patients with chronic conditions could only complete a minority of app tasks without any assistance.
The authors chose 11 popular and well-rated mobile apps and observed how 26 patients interacted with them. Nearly 60 percent of the study participants were African-American, 27 percent were white, 8 percent were Asian, and 8 percent were Latino. Approximately 70 percent had limited health literacy.
Each participant was given condition-specific data entry and data-retrieval tasks, such as recording medication instructions.
The authors found that many participants reported a lack of confidence using the technology and frustration related to design features and navigation. The significant manual data entry and progression through multiple screens and steps made it difficult for patients and caregivers to complete basic tasks, which led to only half of data entry tasks being completed without assistance. Many were confused by unclear explanations of what information needed to be entered.
Participants also struggled with data retrieval, such as information about upcoming appointments that had been entered into caregiving apps, as only 43 percent of tasks (n=79/185) across 11 apps were completed without assistance.
None of the apps had simple interfaces with large buttons and easy instructions and navigation.
"To reduce health disparities, app developers must ensure [that] their products are tailored to the needs of the populations that are likely to benefit the most," the authors concluded. "Developers may need to engage a diverse set of patients in the design and testing of their products. In addition, the apps should be able to remind users of the rationale for each task and should integrate data from other sources, such as pharmacies, to reduce the need for manual data entry."
Source: The Commonwealth Fund, July 29, 2016.