title: Designing Telemedicine Systems for Geriatric Patients: A Review of the Usability Studies.
abstract: One area where telemedicine may prove to be highly effective is in providing medical care to the geriatric population, an age group predicted to account for 20% of the population in the near future. However, even though telemedicine has certain advantages, the usability of these systems with this population merits investigation.
  
  
  
  This article reviews the literature published from 2000 to 2016 with the goal of analyzing the characteristics of usability-related studies conducted using geriatric participants and the subsequent usability challenges identified. Articles were found using Web of Knowledge and PubMed citation indexing portals using the keywords (1) Telemedicine* AND Geriatrics* (2) Telemedicine* AND Usability* (3) Telemedicine* AND Usability* AND Older Adults*.
  
  
  
  A total of 297 articles were obtained from the initial search. After further detailed screening, 16 articles were selected for review based on the inclusion criteria. Of these, 60% of the studies focused on the overall usability of telemedicine systems; 6.25% focused on the usability of a telepresence robot; 12.5% compared a face-to-face medical consultation with the use of telemedicine systems, and 25% focused on the study of other aspects of telemedicine in addition to its usability. Findings reported in the studies included high patient satisfaction with telemedicine in 31.25%, whereas another 31.25% indicated a high acceptance of this method of medical consultation. Care coordination in 6.25% of the studies; confidence in telemedicine in 6.25%; trust, privacy, and reliability in 6.25%; and increased convenience when compared to personal visits in 18.75% were also reported.
  
  
  
  This review suggests limited research providing scientifically valid and reproducible usability evaluation at various stages of telemedicine system development. Telemedicine system designers need to consider the age-related issues in cognition, perception, and behavior of geriatric patients while designing telemedicine applications. Future directions for research were developed based on the limitations as well as other results found in this systematic review.
authors.affiliation: 1 Department of Industrial and Civil Engineering, Clemson University , Clemson, South Carolina.
authors.forename: Shraddhaa
authors.initials: S
authors.lastname: Narasimha
authors.affiliation: 1 Department of Industrial and Civil Engineering, Clemson University , Clemson, South Carolina.
authors.forename: Kapil Chalil
authors.initials: KC
authors.lastname: Madathil
authors.affiliation: 1 Department of Industrial and Civil Engineering, Clemson University , Clemson, South Carolina.
authors.forename: Sruthy
authors.initials: S
authors.lastname: Agnisarman
authors.affiliation: 1 Department of Industrial and Civil Engineering, Clemson University , Clemson, South Carolina.
authors.forename: Hunter
authors.initials: H
authors.lastname: Rogers
authors.affiliation: 2 Department of Public Health Sciences, Medical University of South Carolina , Charleston, South Carolina.
authors.forename: Brandon
authors.initials: B
authors.lastname: Welch
authors.affiliation: 1 Department of Industrial and Civil Engineering, Clemson University , Clemson, South Carolina.
authors.forename: Aparna
authors.initials: A
authors.lastname: Ashok
authors.affiliation: 1 Department of Industrial and Civil Engineering, Clemson University , Clemson, South Carolina.
authors.forename: Aswathi
authors.initials: A
authors.lastname: Nair
authors.affiliation: 3 Department of Pediatrics, Medical University of South Carolina , Charleston, South Carolina.
authors.forename: James
authors.initials: J
authors.lastname: McElligott
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003201:Computers; D003219:Confidentiality; D014943:Global Health; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D020407:Internet; D017060:Patient Satisfaction; D019114:Remote Consultation / Q000458:organization & administration; D012371:Robotics; D017216:Telemedicine / Q000295:instrumentation / Q000706:statistics & numerical data*; D013686:Telemetry / Q000295:instrumentation / Q000379:methods; D013689:Telephone; D014584:User-Computer Interface
keywords: geriatrics; systematic review; telemedicine; usability