Glucometer Design for Patients with Vision and Mobility Impairments

Abstract

Patient self-management technologies are a critical component of chronic disease care. Although these technologies are intended to support patient activities, low device usability and exclusion of the patient from the design process can produce design impediments that may negatively impact patient adherence and hence treatment outcomes. These design risks are compounded if the patient has a disability (vision, mo-bility, hearing), which is a large percentage of the chronic disease population. We aim to develop a patient-centric design method to evaluate self-management technology usability for disabled patients, specifically focusing on handheld device use for diabetics. Our goal is to identify modular hardware and software de-sign components (buttons, screen, casing, etc.) that support or hinder use, with the ultimate goal to inform design decision making. An initial expert usability analysis (hierarchical task analysis, usability heuristics) was performed for 13 glucometers (diabetes self-management technology). The usability analysis informed the design of an experiment to test disabled user performance and satisfaction for several meter interaction tasks. Prior to performing the study in the diabetes patient population, common diabetes disabilities were simulated in healthy subjects through the use of glasses (retinopathy, glaucoma) and gloves (arthritis, neu-ropathy) to evaluate the experimental protocol. Results suggested a preference of participants for large text, large protruding buttons, and contrast color between case and buttons to facilitate locating buttons. Long-term goals of this research are to support medical device manufacturers to better design handheld devices for high-risk populations and inform Food and Drug Administration handheld medical devices design guidelines.