Systematic Review of Usability Factors, Models, and Frameworks with Blockchain Integration for Secure Mobile Health (mHealth) Applications

Irum Feroz ,
Irum Feroz
Nadeem Ahmad Orcid logo
Nadeem Ahmad

Published: 16.12.2024.

Biochemistry

Volume 7, Issue 3 (2024)

https://doi.org/10.30953/bhty.v7.357

Abstract

This systematic review examines critical usability factors that influence the adoption of mobile health (mHealth) applications among older adults and identifies gaps in current usability models, including ISO 9241-11, Nielsen’s heuristics, and PACMAD. This review also explores the potential role of blockchain technology in enhancing multimodal medical data systems within mHealth applications. A comprehensive search across six databases yielded 1,073 studies, with 60 meeting inclusion criteria. Studies were analyzed through thematic synthesis to identify key success factors (RQ1) and comparative analysis to assess limitations in existing frameworks (RQ2). Key factors promoting mHealth adoption included ease of use, efficiency, error prevention, learnability, memorability, and user satisfaction. Blockchain integration emerged as a promising approach to improve data security, interoperability, and user trust, particularly for older adults who engage with complex, multimodal health data. Findings from RQ2 highlighted gaps in usability models, such as the lack of age-specific guidance for multimodal interaction, error recovery, and data privacy. These results underscore the need to define a new usability framework and incorporate blockchain to meet the unique needs of older adults in mHealth applications, supporting both secure and accessible healthcare management.

Keywords

References

1.
Pires IM, Marques G, Garcia NM, Flórez-Revuelta F, Ponciano V, Oniani S. A Research on the Classification and Applicability of the Mobile Health Applications. Journal of Personalized Medicine. 2020;10(1):11.
2.
Asadzadeh A, Kalankesh LR. A scope of mobile health solutions in COVID-19 pandemics. Informatics in Medicine Unlocked. 2021;23:100558.
3.
Drew DA, Nguyen LH, Steves CJ, Wolf J, Spector TD, Chan AT. Rapid implementation of mobile technology for real-time epidemiology of COVID-19. Cold Spring Harbor Laboratory; 2020.
4.
Istepanian R, Alanzi T. Mobile Health (m-Health): evidence-based progress or scientific retrogression biomedical information technology. 2020;
5.
Feroz I, Ahmad N. Usability based rating scale (UBRS) for evaluation of mobile health (mHealth) applications. HCI and beyond: advances towards smart and interconnected environments.
6.
Marques ICP, Ferreira JJM. Digital transformation in the area of health: systematic review of 45 years of evolution. Health and Technology. 2019;10(3):575–86.
7.
Vinay K, Vishal K. Smartphone applications for medical students and professionals. Nitte Univ J Health Sci. 2013;(1):59–62.
8.
Jebraeily M, Fazlollahi Z, Rahimi B. The Most Common Smartphone Applications Used By Medical Students and Barriers of Using Them. Acta Informatica Medica. 2017;25(4):232.
9.
Mohapatra D, Mohapatra M, Chittoria R, Friji M, Kumar S. The scope of mobile devices in health care and medical education. International Journal of Advanced Medical and Health Research. 2015;2(1):3.
10.
by services (monitoring services, diagnosis services), by participants, by region, and segment forecasts. 2024;
11.
Sezgin E, Özkan-Yildirim S, Yildirim S. Investigation of physicians’ awareness and use of mHealth apps: A mixed method study. Health Policy and Technology. 2017;6(3):251–67.
12.
Ahmad N, Feroz I, Ahmad F. Creating synthetic test data by Generative Adversarial Networks (GANs) for Mobile Health (mHealth) applications. 2024;322–32.
13.
Tomlinson M, Rotheram-Borus MJ, Swartz L, Tsai AC. Scaling Up mHealth: Where Is the Evidence? PLoS Medicine. 2013;10(2):e1001382.
14.
Nouri R, R Niakan Kalhori S, Ghazisaeedi M, Marchand G, Yasini M. Criteria for assessing the quality of mHealth apps: a systematic review. Journal of the American Medical Informatics Association. 2018;25(8):1089–98.
15.
Slade M, Oades L, Jarden A. Wellbeing, recovery and mental health. 2017;
16.
Costa V, Rodrigues S, Agostini A, Machado L, Darley M, N, et al. The potential of user experience (UX) as an approach of evaluation in tangible user interfaces (TUI). 2019;30–48.
17.
Ventola C. Mobile devices and apps for health care professionals: uses and benefits. P T. 2014;(5):356–64.
18.
Burke LE, Ma J, Azar KMJ, Bennett GG, Peterson ED, Zheng Y, et al. Current Science on Consumer Use of Mobile Health for Cardiovascular Disease Prevention. Circulation. 2015;132(12):1157–213.
19.
News I. IMS health study: Patient adoption of mHealth. Health IT answers. 2015;(6).
20.
Barton AJ. The regulation of mobile health applications. BMC Medicine. 2012;10(1).
21.
Istepanian R, Pattichis C, Laxminarayan S. Ubiquitous M-health systems and the convergence towards 4G mobile technologies. 2007;3–14.
22.
Martínez-Pérez B, de la Torre-Díez I, López-Coronado M. Mobile Health Applications for the Most Prevalent Conditions by the World Health Organization: Review and Analysis. Journal of Medical Internet Research. 2013;15(6):e120.
23.
Global Diffusion of EHealth: making universal health coverage achievable: report of the third global survey on EHealth. 2017;
24.
Khan K, Donthula S. Investigating motivational and usability issues of mHealth wellness apps for improved user experience. :573–87.
25.
Craven M, Lang A, Martin J. Developing mHealth apps with researchers: multi-stakeholder design considerations. In: Design, user experience, and usability. User experience design for everyday life applications and services. 2014;15–24.
26.
Schnall R, Rojas M, Bakken S, Brown W, Carballo-Dieguez A, Carry M, et al. A user-centered model for designing consumer mobile health (mHealth) applications (apps). Journal of Biomedical Informatics. 2016;60:243–51.
27.
Feroz I, Ahmad N, Iqbal M. Usability based rating scale for mobile health applications. 2019;
28.
Ahmad N. People centered HMI’s for deaf and functionally illiterate users.
29.
Wildenbos G, Peute L, Jaspers M. A framework for evaluating mHealth tools for Older Patients on Usability. Stud Health Technol Inform. 2015;783–7.
30.
Gupta D, Ahlawat A, Sagar K. A critical analysis of a hierarchy based Usability Model. 2014;
31.
Amanda G, Layman CV. Examining the Intention to Use Mobile Health Applications Amongst Indonesians. Milestone: Journal of Strategic Management. 2022;2(2):103.
32.
Heinz M, Martin P, Margrett J, Yearns M, Franke W, Yang HI. Perceptions of technology among older adults. J Gerontol Nurs. 2013;(1):42–51.
33.
Nielsen J. Usability engineering. 1994;
34.
Pfeil U, Zaphiris P, Wilson S. Older adults’ perceptions and experiences of online social support. Interacting with Computers. 2009;21(3):159–72.
35.
SELWYN N, GORARD S, FURLONG J, MADDEN L. Older adults’ use of information and communications technology in everyday life. Ageing and Society. 2003;23(5):561–82.
36.
Sixsmith A, Sixsmith J. Ageing in Place in the United Kingdom. Ageing International. 2008;32(3):219–35.
37.
Feroz I, Good A, Omisade O. Identification of critical success factors in adoption of health IT services from older people’s perspective. Paper presented at. 2023;
38.
Kaplan K. Usability 101: Introduction to usability. Nielsen Norman Group. 2024;
39.
Shneiderman B. Designing the user interface: strategies for effective human-computer interaction. 1992;
40.
Preece J, Benyon D. 1993;
41.
Preece J. Citizen Science: New Research Challenges for Human–Computer Interaction. International Journal of Human-Computer Interaction. 2016;32(8):585–612.
42.
Tahir R, Arif F. Framework for evaluating the usability of mobile educational applications for children. Society of Digital Information and Wireless Communications. 2014;156–70.
43.
Alzahrani A, Gay V, Alturki R. The evaluation of usability in mobile applications. 2022;23–4.
44.
Brown W, Yen PY, Rojas M, Schnall R. Assessment of the Health IT Usability Evaluation Model (Health-ITUEM) for evaluating mobile health (mHealth) technology. Journal of Biomedical Informatics. 2013;46(6):1080–7.
45.
Feroz I. Developing a usability guidance framework for design and evaluation of mHealth apps for aging populations. 2023;
46.
Georgsson M, Staggers N. Quantifying usability: an evaluation of a diabetes mHealth system on effectiveness, efficiency, and satisfaction metrics with associated user characteristics. Journal of the American Medical Informatics Association. 2015;23(1):5–11.
47.
Feroz I.
48.
Green Paper on Mobile Health ('m-Health). 2014;
49.
Informatics I. Patient apps for improved healthcare: from novelty to mainstream. 2013;
50.
Streitenberger W. Pécs: Hungarian Academy of Sciences. 2013;36–45.
51.
Kay M, Santos J, Takane M, Mhealth. New horizons for health through mobile technologies. 2011;(7):66–71.
52.
Preece J, Rogers Y, Sharp H. Interaction design: beyond human-computer interaction. 2002;
53.
Adibi S, Ed. Mobile health: a technology road map. 2015;
54.
Condos C, James A, Every P, Simpson T. Ten usability principles for the development of effective WAP and m‐commerce services. Aslib Proceedings. 2002;54(6):345–55.
55.
Caldiera V, Rombach H. The goal question metric approach. Encyclopedia of software engineering. 1994;528–32.
56.
Hussain A, Kutar M. Usability metric framework for mobile phone application. 2009;978–82.
57.
Harrison R, Flood D, Duce D. Usability of mobile applications: literature review and rationale for a new usability model. Journal of Interaction Science. 2013;1(1):1.
58.
Bertini E, Catarci T, Dix A, Gabrielli S, Kimani S, Santucci G. Appropriating Heuristic Evaluation for Mobile Computing. International Journal of Mobile Human Computer Interaction. 2009;1(1):20–41.
59.
Kaufman D, Roberts WmD, Merrill J, Lai TY, Bakken S. Applying an Evaluation Framework for Health Information System Design, Development, and Implementation. Nursing Research. 2006;55(Supplement 1):S37–42.
60.
van Gemert-Pijnen JE, Nijland N, van Limburg M, Ossebaard HC, Kelders SM, Eysenbach G, et al. A Holistic Framework to Improve the Uptake and Impact of eHealth Technologies. Journal of Medical Internet Research. 2011;13(4):e111.
61.
Halim M. The eHealth usability matrix: developing a usability evaluation framework for patient-facing ehealth technologies. 2019;
62.
Yen P, Wantland D, Bakken S. Development of a Customizable Health IT Usability Evaluation Scale. AMIA Annu Symp Proc. :917–21.
63.
Yen PY, Bakken S. Review of health information technology usability study methodologies. Journal of the American Medical Informatics Association. 2011;19(3):413–22.
64.
Cho H, Yen PY, Dowding D, Merrill JA, Schnall R. A multi-level usability evaluation of mobile health applications: A case study. Journal of Biomedical Informatics. 2018;86:79–89.
65.
Wildenbos G, Peute L, Jaspers M. Ageing barriers influencing mobile health usability for older adults: a literature based framework (MOLD-US). Int J Med Inf. 2018;66–75.
66.
Hussain A, Ferneley E. Usability metric for mobile application: a goal question metric (GQM) approach. 2008;
67.
Vollmer Dahlke D, Ory M. mHealth applications use and potential for older adults, overview of. Encyclopedia Geropsychology. 2015;1–9.
68.
Zhang J, Walji MF. TURF: Toward a unified framework of EHR usability. Journal of Biomedical Informatics. 2011;44(6):1056–67.
69.
Kim S, Choudhury A. Comparison of Older and Younger Adults’ Attitudes Toward the Adoption and Use of Activity Trackers. JMIR mHealth and uHealth. 2020;8(10):e18312.
70.
Ahmad NA, Mat Ludin AF, Shahar S, Mohd Noah SA, Mohd Tohit N. Willingness, perceived barriers and motivators in adopting mobile applications for health-related interventions among older adults: a scoping review protocol. BMJ Open. 2020;10(3):e033870.
71.
Saparamadu AADNS, Fernando P, Zeng P, Teo H, Goh A, Lee JMY, et al. User-Centered Design Process of an mHealth App for Health Professionals: Case Study. JMIR mHealth and uHealth. 2021;9(3):e18079.
72.
Duque E, Fonseca G, Vieira H, Gontijo G, Ishitani L. A systematic literature review on user centered design and participatory design with older people. 2019;
73.
Helbostad J, Vereijken B, Becker C, Todd C, Taraldsen K, Pijnappels M, et al. Mobile Health Applications to Promote Active and Healthy Ageing. Sensors. 2017;17(3):622.
74.
Suastika K, Dwipayana P, Siswadi M, Tuty R. Age is an important risk factor for type 2 diabetes mellitus and cardiovascular diseases. 2012;
75.
Saleh A, Ismail R. Usability evaluation frameworks of mobile application: a mini-systematic literature review. Global Summit on Education GSE. 2015;
76.
Liew MS, Zhang J, See J, Ong YL. Usability Challenges for Health and Wellness Mobile Apps: Mixed-Methods Study Among mHealth Experts and Consumers. JMIR mHealth and uHealth. 2019;7(1):e12160.
77.
Li C, Neugroschl J, Zhu CW, Aloysi A, Schimming CA, Cai D, et al. Design Considerations for Mobile Health Applications Targeting Older Adults. Journal of Alzheimer’s Disease. 2021;79(1):1–8.
78.
Hussain A, Kutar M. Usability evaluation of SatNav application on mobile phone using mGQM. Int J Comp Inf Syst Ind Manag Appl. 2012;92–100.
79.
Ahmad N, Shoaib U, Prinetto P. Usability of Online Assistance From Semiliterate Users’ Perspective. International Journal of Human-Computer Interaction. 2014;31(1):55–64.

Citation

Copyright

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 

Article metrics

Google scholar: See link

The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Most read articles