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Critical for the early diagnosis of genetic disorders, a Family Health History (FHx) can be collected in several ways including electronic FHx tools, which aid easy editing and sharing by linking with other information management portals. The user acceptance of such systems is critical, especially among older adults experiencing motor and cognitive issues. This study investigated two types of FHx interfaces, standard and Virtual Conversational Agent (VCA), using 30 young (between 18 and 30) and 24 older participants (over 60). Workload, usability and performance data were collected. Even though participants required less time to complete three of five tasks on the standard interface, the VCA interface performed better in terms of subjective workload and usability. Additionally, 67% of the older adults preferred the VCA interface since it provided context-based guidance during the data collection process. The results from this study have implications for the use of virtual assistants in FHx and other areas of data collection.

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Background and Introduction: Telemedicine, the process of providing healthcare remotely using communication devices, has the potential to be useful for the geriatric population when specifically designed for this age group. This study explored the design of four video telemedicine systems currently available and outlined issues with these systems that impact usability among the geriatric population. Based on the results, design suggestions were developed to improve telemedicine systems for this population. MATERIALS AND METHODS: Using a between-subjects experimental design, the study considered four telemedicine systems used in Medical University of South Carolina. The study was conducted at a local retirement home. The participant pool consisted of 40 adults, 60 years or older. The dependent measures used were the mean times for telemedicine session initiation and video session, mean number of errors, post-test satisfaction ratings, the NASA-Task Load Index (NASA-TLX) workload measures, and the IBM-Computer Systems Usability Questionnaire measures. RESULTS: Statistical significance was found among the telemedicine systems' initiation times. The analysis of the qualitative data revealed several issues, including lengthy e-mail content, icon placement, and chat box design, which affect the usability of these systems for the geriatric population. DISCUSSION: Human factor-based design modifications, including short, precise e-mail content, appropriately placed icons, and the inclusion of instructions, are recommended to address the issues found in the qualitative study.

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Caregivers of Alzheimer's patients find respite in online communities for solutions and emotional support. This study aims to understand the characteristics of information caregivers of Alzheimer's patients are searching for and the kind of support they receive through Internet-based peer support communities. Using a Web crawler written in Python Web programming language, we retrieved publicly available 2,500 random posts and their respective solutions from April 2012 to October 2016 on the solutions category of the Caregiver's Forum on ALZConnected.org . A content analysis was conducted on these randomly selected posts and 4,219 responses to those posts based on a classification system were derived from initial analyses of 750 posts and related responses. The results showed most posts (26%) related to queries about Alzheimer's symptoms, and the highest percentage of responses (45.56%) pertained to caregiver well-being. The LIWC analyses generated an average tone rating of 27.27 for the posts, implying a negative tone and 65.17 for their responses, implying a slightly positive tone. The ALZConnected.org Web site has the potential of being an emotionally supportive tool for caregivers; however, a more user-friendly interface is required to accommodate the needs of most caregivers and their technological skills. Solutions offered on the peer support groups are often subjective opinions of other caregivers and should not be considered professional or comprehensive; further research on educating caregivers using online forums is necessary.

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BACKGROUND: Telemedicine is the use of technology to provide and support health care when distance separates the clinical service and the patient. Home-based telemedicine systems involve the use of such technology for medical support and care connecting the patient from the comfort of their homes with the clinician. In order for such a system to be used extensively, it is necessary to understand not only the issues faced by the patients in using them but also the clinician. OBJECTIVES: The aim of this study was to conduct a heuristic evaluation of 4 telemedicine software platforms-Doxy.me, Polycom, Vidyo, and VSee-to assess possible problems and limitations that could affect the usability of the system from the clinician's perspective. METHODS: It was found that 5 experts individually evaluated all four systems using Nielsen's list of heuristics, classifying the issues based on a severity rating scale. RESULTS: A total of 46 unique problems were identified by the experts. The heuristics most frequently violated were visibility of system status and Error prevention amounting to 24% (11/46 issues) each. Esthetic and minimalist design was second contributing to 13% (6/46 issues) of the total errors. CONCLUSIONS: Heuristic evaluation coupled with a severity rating scale was found to be an effective method for identifying problems with the systems. Prioritization of these problems based on the rating provides a good starting point for resolving the issues affecting these platforms. There is a need for better transparency and a more streamlined approach for how physicians use telemedicine systems. Visibility of the system status and speaking the users' language are keys for achieving this.

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BACKGROUND: Telemedicine systems are gaining attention nationwide as a means for providing care in remote areas and allowing a small number of providers to impact a large geographic region. We systematically reviewed the literature to identify the efficacy and implementation challenges of telemedicine systems in ambulances. METHODS: A search for published studies on Web of Science and PubMed was completed. Studies were selected if they included at least a pilot study and they focused on feasibility or implementation of telemedicine systems in ambulances. RESULTS: A total of 864 articles were used for title and abstract screening. Full text screening was completed for 102 articles, with 23 being selected for final review. Sixty-one percent of the studies included in the review focused on general emergency care, while 26% focused on stroke care and 13% focused on myocardial infarction care. The reviewed studies found that telemedicine is feasible and effective in decreasing treatment times, report a high diagnosis accuracy rate, show higher rates of positive task completion than in regular ambulances, and demonstrate that stroke evaluation is completed with comparable accuracy to the standard way of delivering care. CONCLUSIONS: Although this review identified life-saving benefits of telemedicine, it also showed the paucity of the scientifically sound research in its implementation, prompting further studies. Further research is needed to analyze the capabilities and challenges involved in implementing telemedicine in ambulances, especially studies focusing on human-system integration and human factors' considerations in the implementation of telemedicine systems in ambulances, the development of advanced Internet connectivity paradigms, additional applications for triaging, and the implications of ambulance location.

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At-home telemedicine visits are quickly becoming an acceptable alternative for in-person patient visits. However, little work has been done to understand the usability of these home-based telemedicine solutions. It is critical for user acceptance and real-world applicability to evaluate available telemedicine solutions within the context-specific needs of the users of this technology. To address this need, this study evaluated the usability of four home-based telemedicine software platforms: Doxy.me, Vidyo, VSee, and Polycom. Using a within-subjects experimental design, twenty participants were asked to complete a telemedicine session involving several tasks using the four platforms. Upon completion of these tasks for each platform, participants completed the IBM computer system usability questionnaire (CSUQ) and the NASA Task Load Index test. Upon completing the tasks on all four platforms, the participants completed a final post-test subjective questionnaire ranking the platforms based on their preference. Of the twenty participants, 19 completed the study. Statistically significant differences among the telemedicine software platforms were found for task completion time, total workload, mental demand, effort, frustration, preference ranking and computer system usability scores. Usability problems with installation and account creation led to high mental demand and task completion time, suggesting the participants preferred a system without such requirements. Majority of the usability issues were identified at the telemedicine initiation phase. The findings from this study can be used by software developers to develop user-friendly telemedicine systems.

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BACKGROUND: One area where telemedicine may prove to be highly effective is in providing medical care to the geriatric population, an age group predicted to account for 20% of the population in the near future. However, even though telemedicine has certain advantages, the usability of these systems with this population merits investigation. MATERIALS AND METHODS: This article reviews the literature published from 2000 to 2016 with the goal of analyzing the characteristics of usability-related studies conducted using geriatric participants and the subsequent usability challenges identified. Articles were found using Web of Knowledge and PubMed citation indexing portals using the keywords (1) Telemedicine* AND Geriatrics* (2) Telemedicine* AND Usability* (3) Telemedicine* AND Usability* AND Older Adults*. RESULTS: A total of 297 articles were obtained from the initial search. After further detailed screening, 16 articles were selected for review based on the inclusion criteria. Of these, 60% of the studies focused on the overall usability of telemedicine systems; 6.25% focused on the usability of a telepresence robot; 12.5% compared a face-to-face medical consultation with the use of telemedicine systems, and 25% focused on the study of other aspects of telemedicine in addition to its usability. Findings reported in the studies included high patient satisfaction with telemedicine in 31.25%, whereas another 31.25% indicated a high acceptance of this method of medical consultation. Care coordination in 6.25% of the studies; confidence in telemedicine in 6.25%; trust, privacy, and reliability in 6.25%; and increased convenience when compared to personal visits in 18.75% were also reported. CONCLUSIONS: This review suggests limited research providing scientifically valid and reproducible usability evaluation at various stages of telemedicine system development. Telemedicine system designers need to consider the age-related issues in cognition, perception, and behavior of geriatric patients while designing telemedicine applications. Future directions for research were developed based on the limitations as well as other results found in this systematic review.

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