title: A Human-Centered Design Methodology to Enhance the Usability, Human Factors, and User Experience of Connected Health Systems: A Three-Phase Methodology.
abstract: BACKGROUND
  Design processes such as human-centered design, which involve the end user throughout the product development and testing process, can be crucial in ensuring that the product meets the needs and capabilities of the user, particularly in terms of safety and user experience. The structured and iterative nature of human-centered design can often present a challenge when design teams are faced with the necessary, rapid, product development life cycles associated with the competitive connected health industry.
  
  
  OBJECTIVE
  We wanted to derive a structured methodology that followed the principles of human-centered design that would allow designers and developers to ensure that the needs of the user are taken into account throughout the design process, while maintaining a rapid pace of development. In this paper, we present the methodology and its rationale before outlining how it was applied to assess and enhance the usability, human factors, and user experience of a connected health system known as the Wireless Insole for Independent and Safe Elderly Living (WIISEL) system, a system designed to continuously assess fall risk by measuring gait and balance parameters associated with fall risk.
  
  
  METHODS
  We derived a three-phase methodology. In Phase 1 we emphasized the construction of a use case document. This document can be used to detail the context of use of the system by utilizing storyboarding, paper prototypes, and mock-ups in conjunction with user interviews to gather insightful user feedback on different proposed concepts. In Phase 2 we emphasized the use of expert usability inspections such as heuristic evaluations and cognitive walkthroughs with small multidisciplinary groups to review the prototypes born out of the Phase 1 feedback. Finally, in Phase 3 we emphasized classical user testing with target end users, using various metrics to measure the user experience and improve the final prototypes.
  
  
  RESULTS
  We report a successful implementation of the methodology for the design and development of a system for detecting and predicting falls in older adults. We describe in detail what testing and evaluation activities we carried out to effectively test the system and overcome usability and human factors problems.
  
  
  CONCLUSIONS
  We feel this methodology can be applied to a wide variety of connected health devices and systems. We consider this a methodology that can be scaled to different-sized projects accordingly.
authors.affiliation: Electrical & Electronic Engineering, School of Engineering & Informatics, National University of Ireland Galway, Galway, Ireland.|HUMAN MOVEMENT LABORATORY CÚRAM SFI Centre for Research in Medical Devices, NUI Galway, Galway, Ireland.
authors.forename: Richard
authors.identifier: http://orcid.org/0000-0002-6208-4049
authors.initials: R
authors.lastname: Harte
authors.affiliation: General Practice, School of Medicine, National University of Ireland Galway, Galway, Ireland.
authors.forename: Liam
authors.identifier: http://orcid.org/0000-0002-6153-9363
authors.initials: L
authors.lastname: Glynn
authors.affiliation: Electrical & Electronic Engineering, School of Engineering & Informatics, National University of Ireland Galway, Galway, Ireland.
authors.forename: Alejandro
authors.identifier: http://orcid.org/0000-0002-9678-2654
authors.initials: A
authors.lastname: Rodríguez-Molinero
authors.affiliation: Georgia Institute of Technology, Center for Advanced Communications Policy (CACP), Atlanta, GA, United States.
authors.forename: Paul Ma
authors.identifier: http://orcid.org/0000-0002-6649-3309
authors.initials: PM
authors.lastname: Baker
authors.affiliation: Irish Centre for Social Gerontology, National University of Ireland Galway, Galway, Ireland.
authors.forename: Thomas
authors.identifier: http://orcid.org/0000-0003-4909-1487
authors.initials: T
authors.lastname: Scharf
authors.affiliation: HUMAN MOVEMENT LABORATORY CÚRAM SFI Centre for Research in Medical Devices, NUI Galway, Galway, Ireland.|Physiology, School of Medicine, NUI Galway, Galway, Ireland.
authors.forename: Leo R
authors.identifier: http://orcid.org/0000-0002-4011-6732
authors.initials: LR
authors.lastname: Quinlan
authors.affiliation: Electrical & Electronic Engineering, School of Engineering & Informatics, National University of Ireland Galway, Galway, Ireland.|HUMAN MOVEMENT LABORATORY CÚRAM SFI Centre for Research in Medical Devices, NUI Galway, Galway, Ireland.
authors.forename: Gearóid
authors.identifier: http://orcid.org/0000-0002-1885-814X
authors.initials: G
authors.lastname: ÓLaighin
keywords: connected health; human factors; human-centered design; mHealth; usability testing; user interface design; user-centered design