Evaluating Usability of a Home Health Tablet Device Among Adult Palliative Care Patients

Abstract

The Covid-19 pandemic hastened the shift towards home-based health management. Although studies have indicated that remote monitoring, digital applications, and telehealth can positively impact quality of life, enhance chronic disease management, and decrease hospital visits, few focus on the experience of palliative care patients with such technologies. Palliative care patients and their informal caregivers face challenges when managing care at home. Augmenting traditional in-office care with virtual technology-supported care in the home can reduce burden for patients and caregivers, while increasing access to resources. The objective of this study was to elicit patient, and/or informal caregiver, perception of usability of a tablet device to facilitate palliative care at home, with the ultimate goal of identifying ways to improve tablet usability. Thispilot study included 22 participants; 10 (45%) palliative care patients; 12 (55%) informal caregivers. All patients were provided tablet devices for home health management, symptom monitoring, and telehealth appointments by the palliative care practice. Participating caregivers utilized these tablets either with, or on behalf of the patient. Participants were interviewed by phone. Interviews included one question regarding access to a personal computer, as well as the Pew Digital Savviness (PDS) Classifier and the System Usability Scale (SUS) survey questions. A usability score was computed for each participant. Within-group and between-group analyses were conducted using independent samples t-tests. Seventy percent of patients and 75 percent of caregivers had SUS scores above 68, indicating above average usability ratings. There was no statistically significant difference in scores among participant subgroups. A positive perception of usability was identified among both patients and caregivers. This suggests that tablets can facilitate access to palliative care services virtually, decreasing burden on patients and caregivers. Further qualitative and observation studies are recommended to obtain valuable insights on the barriers and facilitators to successful use of tablets. This pilot study serves as a foundation for research in the area of tablet usability to improve access to care for clinically vulnerable populations and their caregivers. These findings support the next phase of a larger study to delineate specific tablet functionality adaptations and increase utilization.