title: A cognitive framework for understanding barriers to the productive use of a diabetes home telemedicine system.
abstract: Telemedicine has the potential to transcend geographic and socio-cultural barriers to the delivery of high quality health care to the medically underserved populations. However, there are significant cognitive and usability barriers. This paper presents a multifaceted cognitive evaluation of the IDEATel diabetes education and telemedicine program. The evaluation included a cognitive walkthrough analysis to characterize task complexity and identify potential problems as well as field usability testing in patients' homes. The study revealed dimensions of the interface that impeded optimal access to system resources. In addition, we found significant obstacles corresponding to perceptual-motoric skills, mental models of the system, and health literacy. The objective of this work is to contribute to a design framework so that participants with a wide range of skills can better manage their chronic illnesses.
authors.affiliation: College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Kaufman
authors.forename: Justin
authors.initials: J
authors.lastname: Starren
authors.forename: Vimla L
authors.initials: VL
authors.lastname: Patel
authors.forename: Philip C
authors.initials: PC
authors.lastname: Morin
authors.forename: Charlyn
authors.initials: C
authors.lastname: Hilliman
authors.forename: Jenia
authors.initials: J
authors.lastname: Pevzner
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Weinstock
authors.forename: Robin
authors.initials: R
authors.lastname: Goland
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
mesh_terms: D000368:Aged; D001292:Attitude to Computers; D003071:Cognition; D003197:Computer Literacy; D003920:Diabetes Mellitus / Q000628:therapy*; D006801:Humans; D020407:Internet; D009518:New York; D012648:Self Care; D017216:Telemedicine / Q000706:statistics & numerical data*; D014584:User-Computer Interface