Patient self-management technologies are a critical component of chronic disease care. Although thesetechnologies are intended to support patient activities, low device usability and exclusion of the patientfrom the design process can produce design impediments that may negatively impact patient adherence andhence treatment outcomes. These design risks are compounded if the patient has a disability (vision, mobility,hearing), which is a large percentage of the chronic disease population. We aim to develop a patientcentricdesign method to evaluate self-management technology usability for disabled patients, specificallyfocusing on handheld device use for diabetics. Our goal is to identify modular hardware and software designcomponents (buttons, screen, casing, etc.) that support or hinder use, with the ultimate goal to informdesign decision making. An initial expert usability analysis (hierarchical task analysis, usability heuristics)was performed for 13 glucometers (diabetes self-management technology). The usability analysis informedthe design of an experiment to test disabled user performance and satisfaction for several meter interactiontasks. Prior to performing the study in the diabetes patient population, common diabetes disabilities weresimulated in healthy subjects through the use of glasses (retinopathy, glaucoma) and gloves (arthritis, neuropathy)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. Longtermgoals of this research are to support medical device manufacturers to better design handheld devicesfor high-risk populations and inform Food and Drug Administration handheld medical devices designguidelines.
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