Page - 59 - in Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners

3. Explanation of success or failure of mHealth systems It has previously been emphasised within this chapter that there is a fundamental need to ensure that mHealth interventions demonstrate strong theoretical underpinnings to ensure efficacy, effectiveness and acceptance, as well as other important factors relating to optimum usage. This section firstly provides a brief overview of critical success factors used in mHealth. It then examines the determinant critical success or failure factors that relate to the aforementioned use cases, and how an HCI approach that links AT as a theoretical lens to a UCD framework can help support these factors. Research shows that the: quality; intention to use; efficiency; usability; trust and increased user satisfaction are critical success factors for healthcare systems [28,29,30,31]. However, successful interactive technologies are not simply usable, rather they should provide engaging experiences that are highly sensitive to the use context, particularly the expectations, goals, motivations, and needs to be possessed by their users [32]. Perceived value and ease-of-use are critical factors in the successful adoption of a mHealth system that is used to self-manage health conditions [29]. It is then critical that the mHealth intervention is simple, intuitive and achieves its goal of enabling users to improve self-management of the health condition [33]. End-user involvement in the design and implementation of mHealth systems is an important determinant to the eventual success and for enabling optimum clinical impact [34]. As previously discussed, involving end users throughout the development lifecycle brings new insights for customising the technology to provide a better fit to requirements. Trust in relation to users’ concern over the security of personal data can influence the intention to use [28]. Low acceptance, adoption, end-user levels of technical literacy are also barriers and can impact upon the efficacy of the mHealth system [29]. Lastly, negative perceptions toward mHealth systems can significantly reduce users’ willingness to adopt new technology [29]. Tables 4-5 summarise the critical success factors in each use case. Table 4. The determinant factors for success using AT and UCD in Use Case 1. Critical Success Factor Description within the use case: MHSF Ease-of-use Users rated usability in relation to perceived usefulness and perceived ease-of-use scales and were then able to provide richer feedback via open-ended interviews. AT facilitated an ‘activity-oriented interactive flow’ to the design of the system, which users commented helped contribute to the ease-of-use of the system. The iterative feature of UCD facilitated feedback from users that could be implemented for the next design iteration of MHSF. Given that the system may be required to monitor more serious health conditions, it is essential that the system is designed to ensure ease-of-use to reduce the complexity of user managing these conditions. User satisfaction Using AT provided a richer analysis of user needs and activities, which helped in designing a system that affords increased user satisfaction. MHSF was evaluated by potential end users to ensure that user needs were met. Ease-of-use and user satisfaction are strongly connected. Where optimum ease-of-use is enabled, users are more likely to be satisfied with the system [34]. User satisfaction was also measured during the evaluation of the system design using interviews informed by the constructs AT. A.GoodandO.Omisade /LinkingActivityTheorywithUserCentredDesign 59