Evaluating Patient Usability of an Image-Based Mobile Health Platform for Postoperative Wound Monitoring
Open accessAbstract
BACKGROUND: Surgical patients are increasingly using mobile health (mHealth) platforms to monitor recovery and communicate with their providers in the postdischarge period. Despite widespread enthusiasm for mHealth, few studies evaluate the usability or user experience of these platforms. OBJECTIVE: Our objectives were to (1) develop a novel image-based smartphone app for postdischarge surgical wound monitoring, and (2) rigorously user test it with a representative population of vascular and general surgery patients. METHODS: A total of 9 vascular and general surgery inpatients undertook usability testing of an internally developed smartphone app that allows patients to take digital images of their wound and answer a survey about their recovery. We followed the International Organization for Standardization (ISO) 9241-11 guidelines, focusing on effectiveness, efficiency, and user satisfaction. An accompanying training module was developed by applying tenets of adult learning. Sessions were audio-recorded, and the smartphone screen was mirrored onto a study computer. Digital image quality was evaluated by a physician panel to determine usefulness for clinical decision making. RESULTS: The mean length of time spent was 4.7 (2.1-12.8) minutes on the training session and 5.0 (1.4-16.6) minutes on app completion. 55.5% (5/9) of patients were able to complete the app independently with the most difficulty experienced in taking digital images of surgical wounds. Novice patients who were older, obese, or had groin wounds had the most difficulty. 81.8% of images were sufficient for diagnostic purposes. User satisfaction was high, with an average usability score of 83.3 out of 100. CONCLUSION: Surgical patients can learn to use a smartphone app for postoperative wound monitoring with high user satisfaction. We identified design features and training approaches that can facilitate ease of use. This protocol illustrates an important, often overlooked, aspect of mHealth development to improve surgical care.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Some [51] did not disclose the proportion of responders.
“some [51] did not disclose the proportion of responders.”
From Usability of Mobile Health Apps for Postoperative Care: Systematic Review (2020) · cites this paper as [51]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Usability Evaluation In Industry
(1996) · CRC Press eBooks · doi:10.1201/9781498710411 · Cited by 4,400 · see citing works
A mathematical model of the finding of usability problems
Nielsen, J., & Landauer, T. K. (1993) · Proceedings of the SIGCHI conference on Human factors in computing systems - CHI '93 · doi:10.1145/169059.169166 · Cited by 1,961 · see citing works
A Reengineered Hospital Discharge Program to Decrease Rehospitalization
Jack, B. W., Chetty, V. K., Anthony, D., Greenwald, J. L., Sanchez, G. M., Johnson, A. E., Forsythe, S. R., O'Donnell, J. K., Paasche‐Orlow, M. K., Manasseh, C., et al. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-150-3-200902030-00007 · Cited by 1,595 · see citing works
(2000) · doi:10.1093/oso/9780195122657.001.0001 · Cited by 1,340 · see citing works
Refining the Test Phase of Usability Evaluation: How Many Subjects Is Enough?
Virzi, R. A. (1992) · Human Factors The Journal of the Human Factors and Ergonomics Society · doi:10.1177/001872089203400407 · Cited by 1,237 · see citing works
Beyond the five-user assumption: benefits of increased sample sizes in usability testing
Faulkner, L. (2003) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03195514 · Cited by 1,053 · see citing works
Galitz, W. O. (1996) · Cited by 680 · see citing works
Spacing Effects in Learning: A Temporal Ridgeline of Optimal Retention
Cepeda, N. J., Vul, E., Rohrer, D., Wixted, J. T., & Pashler, H. (2008) · Psychological Science · doi:10.1111/j.1467-9280.2008.02209.x · Cited by 631 · see citing works
Enhancing adult motivation to learn : a comprehensive guide for teaching all adults
Wlodkowski, R. J. (2008) · Cited by 624 · see citing works
Feasibility, Acceptability, and Preliminary Efficacy of a Smartphone Intervention for Schizophrenia
Ben-Zeev, D., Brenner, C. J., Begale, M., Duffecy, J., Mohr, D. C., & Mueser, K. T. (2014) · Schizophrenia Bulletin · doi:10.1093/schbul/sbu033 · Cited by 493 · see citing works
<i>mHealth Consumer Apps</i> : The Case for User-Centered Design
McCurdie, T., Taneva, S., Casselman, M., Yeung, M., McDaniel, C., Ho, W., & Cafazzo, J. (2012) · Biomedical Instrumentation & Technology · doi:10.2345/0899-8205-46.s2.49 · Cited by 478 · see citing works
Carpenter, S. K., Cepeda, N. J., Rohrer, D., Kang, S. H. K., & Pashler, H. (2012) · Educational Psychology Review · doi:10.1007/s10648-012-9205-z · Cited by 469 · see citing works
Sample sizes for usability studies: Additional considerations
Lewis, J. R. (1994) · Human Factors: The Journal of the Human Factors and Ergonomics Society · doi:10.1177/001872089403600215 · Cited by 341 · see citing works
Validation of the System Usability Scale (SUS)
Peres, S. C., Pham, T. M. T., & Phillips, R. G. (2013) · Proceedings of the Human Factors and Ergonomics Society Annual Meeting · doi:10.1177/1541931213571043 · Cited by 274 · see citing works
Current Use of Telemedicine for Post-Discharge Surgical Care: A Systematic Review
Gunter, R. L., Chouinard, S., Fernandes‐Taylor, S., Wiseman, J. T., Clarkson, S., Bennett, K. M., Greenberg, C. C., & Kent, K. C. (2016) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2016.01.062 · Cited by 264 · see citing works
Self-citationViers, B. R., Lightner, D. J., Rivera, M. E., Tollefson, M. K., Boorjian, S. A., Karnes, R. J., Thompson, R. H., O’Neil, D. A., Hamilton, R. L., Gardner, M. R., et al. (2015) · European Urology · doi:10.1016/j.eururo.2015.04.002 · Cited by 252 · see citing works
Hwa, K., & Wren, S. M. (2013) · JAMA Surgery · doi:10.1001/jamasurg.2013.2672 · Cited by 202 · see citing works
Sathiyakumar, V., Apfeld, J. C., Obremskey, W. T., Thakore, R. V., & Sethi, M. K. (2014) · Journal of Orthopaedic Trauma · doi:10.1097/bot.0000000000000189 · Cited by 184 · see citing works
Parry, C., Coleman, E. A., Smith, J. D., Frank, J. C., & Kramer, A. M. (2003) · Home Health Care Services Quarterly · doi:10.1300/j027v22n03_01 · Cited by 180 · see citing works
McGillicuddy, J. W., Weiland, A. K., Frenzel, R. M., Mueller, M., Brunner-Jackson, B. M., Taber, D. J., Baliga, P. K., & Treiber, F. A. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2284 · Cited by 173 · see citing works
The Relationship Between Timing of Surgical Complications and Hospital Readmission
Morris, M. S., Deierhoi, R. J., Richman, J., et al. (2014) · JAMA Surgery · doi:10.1001/jamasurg.2013.4064 · Cited by 162 · see citing works
Methods for identifying surgical wound infection after discharge from hospital: a systematic review
Petherick, E., Dalton, J., Moore, P. J., & Cullum, N. A. (2006) · BMC Infectious Diseases · doi:10.1186/1471-2334-6-170 · Cited by 160 · see citing works
The influence of age in usability testing
Sonderegger, A., Schmutz, S., & Sauer, J. (2016) · Applied Ergonomics · doi:10.1016/j.apergo.2015.06.012 · Cited by 152 · see citing works
Sanger, P. C., Hartzler, A. L., Han, S. M., Armstrong, C. A. L., Stewart, M. R., Lordon, R. J., Lober, W. B., & Evans, H. L. (2014) · PLoS ONE · doi:10.1371/journal.pone.0114016 · Cited by 136 · see citing works
Wiseman, J. T., Fernandes‐Taylor, S., Barnes, M. L., Saunders, R. S., Saha, S. A., Havlena, J. A., Rathouz, P. J., & Kent, K. C. (2015) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2015.04.453 · Cited by 117 · see citing works
Self-citationPost-discharge surveillance: can patients reliably diagnose surgical wound infections?
Whitby, M., McLaws, M., Collopy, B. T., Looke, D. F. M., Doidge, S., Henderson, B., Selvey, L. A., Gardner, G. E., Stackelroth, J., & Sartor, O. A. (2002) · Journal of Hospital Infection · doi:10.1053/jhin.2002.1275 · Cited by 114 · see citing works
Kind, A., Jensen, L. L., Barczi, S., Bridges, A. J., Kordahl, R., Smith, M. A., & Asthana, S. (2012) · Health Affairs · doi:10.1377/hlthaff.2012.0366 · Cited by 111 · see citing works
A pilot study of telemedicine for post-operative urological care in children
Canon, S., Shera, A., Patel, A. S., et al. (2014) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x14555610 · Cited by 91 · see citing works
General and Vascular Surgery Readmissions: A Systematic Review
Wiseman, J. T., Guzman, A. M., Fernandes‐Taylor, S., et al. (2014) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2014.05.007 · Cited by 77 · see citing works
Self-citationPostoperative Care Using a Secure Online Patient Portal: Changing the (Inter)Face of General Surgery
Broman, K. K., Oyefule, O. O., Phillips, S. E., Baucom, R. B., Holzman, M. D., Sharp, K. W., Pierce, R. A., Nealon, W. H., & Poulose, B. K. (2015) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2015.08.429 · Cited by 75 · see citing works
Telemedicine—An efficient and cost‐effective approach in parathyroid surgery
Urquhart, A. C., Antoniotti, N. M., & Berg, R. L. (2011) · The Laryngoscope · doi:10.1002/lary.21812 · Cited by 74 · see citing works
Wiseman, J. T., Fernandes-Taylor, S., Barnes, M. L., Tomsejova, A., Saunders, R. S., & Kent, K. C. (2015) · Journal of Surgical Research · doi:10.1016/j.jss.2015.05.011 · Cited by 70 · see citing works
Self-citationSanger, P. C., Hartzler, A. L., Lordon, R. J., Armstrong, C. A., Lober, W. B., Evans, H. L., & Pratt, W. (2016) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocv183 · Cited by 67 · see citing works
Long-term cued recall of tasks in senile dementia.
Bird, M. J., & Kinsella, G. (1996) · Psychology and Aging · doi:10.1037//0882-7974.11.1.45 · Cited by 60 · see citing works
Vanderheiden, G. C. (1998) · Assistive Technology · doi:10.1080/10400435.1998.10131958 · Cited by 58 · see citing works
Mental workload during brain–computer interface training
Felton, E. A., Williams, J. C., Vanderheiden, G. C., & Radwin, R. G. (2012) · Ergonomics · doi:10.1080/00140139.2012.662526 · Cited by 57 · see citing works
Dual Task Performance in Normal Aging: A Comparison of Choice Reaction Time Tasks
Vaportzis, E., Georgiou‐Karistianis, N., & Stout, J. C. (2013) · PLoS ONE · doi:10.1371/journal.pone.0060265 · Cited by 56 · see citing works
Eisenberg, D., Hwa, K., & Wren, S. M. (2015) · JSLS : Journal of the Society of Laparoendoscopic Surgeons · doi:10.4293/jsls.2014.00205 · Cited by 55 · cited 2× · see citing works
“Additionally, much of the prior research of telemedicine protocols for surgical patients have focused on routine procedures that already have a low base rate of postoperative and postdischarge complications [1,2,17].”
BackgroundSaunders, R. S., Fernandes‐Taylor, S., Rathouz, P. J., et al. (2014) · Surgery · doi:10.1016/j.surg.2014.06.041 · Cited by 53 · see citing works
Self-citationZimmermann, G., & Vanderheiden, G. C. (2007) · Universal Access in the Information Society · doi:10.1007/s10209-007-0108-6 · Cited by 47 · see citing works
Chen, D. W., Davis, R. W., Balentine, C. J., Scott, A. R., Gao, Y., Tapia, N. M., Berger, D. H., & Suliburk, J. W. (2014) · Journal of Surgical Research · doi:10.1016/j.jss.2014.04.028 · Cited by 46 · see citing works
Armbrüster, C., Sutter, C., & Ziefle, M. (2007) · Ergonomics · doi:10.1080/00140130601127885 · Cited by 45 · see citing works
Long-term cued recall of tasks in senile dementia.
Bird, M., & Kinsella, G. (1996) · Psychology and Aging · doi:10.1037/0882-7974.11.1.45 · Cited by 45 · see citing works
Finkelstein, S. M., MacMahon, K., Lindgren, B. R., Robiner, W. N., Lindquist, R. A., VanWormer, A. M., & Hertz, M. I. (2011) · Journal of Telemedicine and Telecare · doi:10.1258/jtt.2011.110413 · Cited by 32 · see citing works
Effects of Aging on Visual Attentional Focusing
Pesce, C., Guidetti, L., Baldari, C., et al. (2005) · Gerontology · doi:10.1159/000085123 · Cited by 30 · see citing works
Bravo, C., O’Donoghue, C., Kaplan, C. P., Luce, J. A., & Ozanne, E. M. (2014) · PubMed · Cited by 29 · see citing works
Take Two and Text Me in the Morning
Rao, R., Shukla, B. M., Saint‐Cyr, M., Rao, M., & Teotia, S. S. (2012) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0b013e3182547d63 · Cited by 26 · see citing works
Goldstein, M. M., & Jane, H. T. (2010) · PubMed · Cited by 20 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [54]Tullis T Albert W Measuring the user experience: collecting, analyzing, and presenting usability metrics, second edition 2013 San Diego Morgan Kaufmann
Cited by
Sorted by citations
Usability of Mobile Health Apps for Postoperative Care: Systematic Review
Patel, B., & Thind, A. (2020) · JMIR Perioperative Medicine · doi:10.2196/19099 · Cited by 64 · see citing works
Mbamalu, O., Bonaconsa, C., Nampoothiri, V., Surendran, S., Veepanattu, P., Singh, S., Dhar, P., Carter, V., Boutall, A., Pennel, T., et al. (2021) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2021.07.039 · Cited by 29 · see citing works
Patient-Generated Health Photos and Videos Across Health and Well-being Contexts: Scoping Review
Ploderer, B., Rezaei Aghdam, A., & Burns, K. (2022) · Journal of Medical Internet Research · doi:10.2196/28867 · Cited by 18 · see citing works
- Authors
- Gunter, R., Fernandes-Taylor, S., Mahnke, A., Awoyinka, L., Schroeder, C., Wiseman, J., Sullivan, S., Bennett, K., Greenberg, C., & Kent, K. C.
- Affiliations
- University of Wisconsin–Madison (US)
- Marshfield Clinic (US)
- Corresponding author
- Gunter, Rebecca
- ORCID
- Venue
- JMIR mHealth and uHealth
- Publisher
- JMIR Publications Inc.
- Published
- 2016-09-28
- Volume
- 4
- Issue
- 3
- Pages
- e113
- ISSN
- 2291-5222 (ISSN-L)
- PMC
- PMC5062001
- OpenAlex
- W2526066647
- Cited by
- 77
- References
- 49
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 7 · 2023: 11 · 2022: 8 · 2021: 4 · 2020: 11 · 2019: 17 · 2018: 6 · 2017: 4
- FWCI
- 16.77
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR mhealth and uhealth (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Heart, Lung, and Blood Institute (T32HL110853)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Physical Sciences › Computer Science › Human-Computer Interaction › Usability and User Interface Design
- Health Sciences › Health Professions › Health Information Management › Health, Technology, Consumer Behavior
- Keywords
- mobile health, mobile application, usability, user experience, post-discharge care, vascular surgery, general surgery, user satisfaction, adult learning, image quality
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review