Understanding the Acceptance of an eHealth Technology in the Early Stages of Development: An End-User Walkthrough Approach and Two Case Studies

Background Studies that focus on the acceptance of an electronic health (eHealth) technology generally make use of surveys. However, results of such studies hold little value for a redesign, as they focus only on quantifying end-user appreciation of general factors (eg, perceived usefulness). Objective We present a method for understanding end-user acceptance of an eHealth technology, early in the development process: The eHealth End-User Walkthrough. Methods During a walkthrough, a participant is guided by using the technology via a scenario, a persona, and a low-fidelity protoype. A participant is questioned about factors that may affect acceptance during and after the demonstration. We show the value of the method via two case studies. Results During the case studies, participants commented on whether they intend to use a technology and why they would (not) use its main features. They also provided redesign advice or input for additional functions. Finally, the sessions provide guidance for the generation of business models and implementation plans. Conclusions The eHealth End-User Walkthrough can aid design teams in understanding the acceptance of their eHealth application in a very early stage of the design process. Consequently, it can prevent a mismatch between technology and end-users’ needs, wishes and context.

[1]  Richard J. Holden,et al.  The Technology Acceptance Model: Its past and its future in health care , 2010, J. Biomed. Informatics.

[2]  Achmad Nizar Hidayanto,et al.  User acceptance factors of hospital information systems and related technologies: Systematic review , 2018, Informatics for health & social care.

[3]  Peter Trkman,et al.  Analyzing older users' home telehealth services acceptance behavior - applying an Extended UTAUT model , 2016, Int. J. Medical Informatics.

[4]  Nicholas R. Hardiker,et al.  Factors that influence public engagement with eHealth: A literature review , 2011, Int. J. Medical Informatics.

[5]  R. Bias,et al.  Interface-Walkthroughs: efficient collaborative testing , 1991, IEEE Software.

[6]  Olivia R. Liu Sheng,et al.  Examining the Technology Acceptance Model Using Physician Acceptance of Telemedicine Technology , 1999, J. Manag. Inf. Syst..

[7]  L. Faulkner.  Beyond the five-user assumption: Benefits of increased sample sizes in usability testing , 2003, Behavior research methods, instruments, & computers : a journal of the Psychonomic Society, Inc.

[8]  Inder Singh Devendra Kumar Punia,et al.  THE EVOLUTION OF TECHNOLOGY ACCEPTANCE MODEL: A LITERATURE REVIEW , 2013 .

[9]  Gordon B. Davis,et al.  User Acceptance of Information Technology: Toward a Unified View , 2003, MIS Q..

[10]  Fred D. Davis,et al.  User Acceptance of Computer Technology: A Comparison of Two Theoretical Models , 1989 .

[11]  G. Eysenbach.  What is e-health? , 2001, Journal of Medical Internet Research.

[12]  Timo Koivumäki,et al.  Consumer Adoption of Future MyData-Based Preventive eHealth Services: An Acceptance Model and Survey Study , 2017, Journal of medical Internet research.

[13]  Henry Been-Lirn Duh,et al.  A study on Singaporean women's acceptance of using mobile phones to seek health information , 2011, Int. J. Medical Informatics.

[14]  Kenneth R. Stern,et al.  Low vs. high-fidelity prototyping debate , 1996, INTR.

[15]  H. Hermens,et al.  A scenario guideline for designing new teletreatments: a multidisciplinary approach , 2010, Journal of telemedicine and telecare.

[16]  Stephen Sutton,et al.  IDEAS (Integrate, Design, Assess, and Share): A Framework and Toolkit of Strategies for the Development of More Effective Digital Interventions to Change Health Behavior , 2016, Journal of medical Internet research.

[17]  Xitong Guo,et al.  User acceptance of mobile health services from users’ perspectives: The role of self-efficacy and response-efficacy in technology acceptance , 2017, Informatics for health & social care.

[18]  Antonella De Angeli,et al.  Applying user centred and participatory design approaches to commercial product development , 2014 .

[19]  J. Coughlin,et al.  PERSPECTIVE: Older Adults' Adoption of Technology: An Integrated Approach to Identifying Determinants and Barriers , 2015 .

[20]  E. Seydel,et al.  Evaluation of Internet-Based Technology for Supporting Self-Care: Problems Encountered by Patients and Caregivers When Using Self-Care Applications , 2008, Journal of medical Internet research.

[21]  Christian Nøhr,et al.  Clinical simulation: A method for development and evaluation of clinical information systems , 2015, J. Biomed. Informatics.

[22]  Cynthia LeRouge,et al.  User profiles and personas in the design and development of consumer health technologies , 2013, Int. J. Medical Informatics.

[23]  Alexandru Vulpe,et al.  eWALL: An Open-Source Cloud-Based eHealth Platform for Creating Home Caring Environments for Older Adults Living with Chronic Diseases or Frailty , 2017, Wirel. Pers. Commun..

[24]  Jobke Wentzel,et al.  Designing eHealth that Matters via a Multidisciplinary Requirements Development Approach , 2013, JMIR research protocols.

[25]  Margaret Volante.  Qualitative research. , 2008, Nurse researcher.

[26]  L. Walker,et al.  The case for end-user involvement in design of health technologies , 2016, Journal of telemedicine and telecare.

[27]  David Geerts,et al.  Comparing user interaction with low and high fidelity prototypes of tabletop surfaces , 2010, NordiCHI.

[28]  V. Braun,et al.  Using thematic analysis in psychology , 2006 .

[29]  Marie-Pierre Gagnon,et al.  Healthcare professional acceptance of telemonitoring for chronic care patients in primary care , 2012, BMC Medical Informatics and Decision Making.

[30]  Nicol Nijland,et al.  A Holistic Framework to Improve the Uptake and Impact of eHealth Technologies , 2011, Journal of medical Internet research.

[31]  Gregory D. Abowd,et al.  Storyboarding: an empirical determination of best practices and effective guidelines , 2006, DIS '06.

[32]  Kai Wang,et al.  Beyond technology acceptance to effective technology use: a parsimonious and actionable model , 2015, J. Am. Medical Informatics Assoc..

[33]  Sari Kujala,et al.  User involvement: A review of the benefits and challenges , 2003, Behav. Inf. Technol..

[34]  Claudia Pagliari,et al.  Design and Evaluation in eHealth: Challenges and Implications for an Interdisciplinary Field , 2007, Journal of medical Internet research.

[35]  Sandra L. Fisher,et al.  Beyond user acceptance: An examination of employee reactions to information technology systems , 2004 .

[36]  R. Ward.  The application of technology acceptance and diffusion of innovation models in healthcare informatics , 2013 .

[37]  Kok Wei Khong,et al.  Integrating Health Belief Model and Technology Acceptance Model: An Investigation of Health-Related Internet Use , 2015, Journal of medical Internet research.

[38]  Julia E.W.C. van Gemert-Pijnen,et al.  Personas: The Linking Pin in Holistic Design for eHealth , 2012, eTELEMED 2012.

[39]  Joost van Hoof,et al.  Factors influencing acceptance of technology for aging in place: A systematic review , 2014, Int. J. Medical Informatics.

[40]  Andrina Granic,et al.  Technology acceptance model: a literature review from 1986 to 2013 , 2014, Universal Access in the Information Society.

[41]  Mariusz Duplaga,et al.  The acceptance of e-health solutions among patients with chronic respiratory conditions. , 2013, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[42]  John Ingham,et al.  Why do people use information technology? A critical review of the technology acceptance model , 2003, Inf. Manag..