Introduction: Cardiac rehabilitation improves outcomes for patients with ischemic heart disease or heart failure, but is underused. New strategies to improve delivery of cardiac rehabilitation are needed. We developed a mobile application for technology-facilitated home cardiac rehabilitation and sought to determine its usability.
Methods: We recruited patients eligible for cardiac rehabilitation who had access to a smartphone, tablet, or computer with internet access to participate in usability testing of the mobile application. The mobile application includes physical activity goal setting, logs for physical activity and health measures, health education, reminders, and feedback (Figure). Participants were introduced to the mobile application and then observed while completing pre-specified tasks with the mobile application. Participants completed the System Usability Scale (0-100), rated likelihood to use the mobile application (0-100), and participated in a semi-structured interview. Based on participant feedback, we made iterative revisions to the mobile application.
Results: We conducted usability testing in 13 participants. The first version of the mobile application was used by the first 5 participants, and revised versions were used by the final 8 participants. From the first version to revised versions, task completion success rate improved from 44% to 78% (p=0.05), System Usability Scale improved from 54% to 76% (p=0.04), and rated likelihood of using the mobile application remained high at 76% and 87% (p = 0.30). Interview responses revealed a need for introductory training (“Initially, training with a technical person, instead of me relying on myself”) and on-demand help (“If I had problems I’d try to find out how to fix it on this or call you”). Additionally, many participants were interested in sharing data with providers (“I can show my doctor what I’ve been working on”).
Conclusions: With participant feedback and iterative revisions, we significantly improved the usability of a mobile application for cardiac rehabilitation. Patient expectations for using a mobile application for cardiac rehabilitation include introductory training, on-demand help, and sharing data with providers. Iterative mixed-method evaluation may be useful for improving the usability of health technology.