Developing an easy-to-use tablet computer application for assessing patient-reported outcomes in patients with cancer

Background In order to be practically useful, computer applications for patients with cancer must be easily usable by people with limited computer literacy and impaired vision or dexterity. We describe the usability development process for an application that collects quality of life and symptom information from patients with cancer. Methods Usability testing consisted of user testing with cancer patients to identify initial design problems and a survey to compare the computer application's ease of use between elderly and younger patients. Results In user-testing phase, seven men aged 56 to 77 with prostate cancer were observed using the application and interviewed afterwards identifying several usability concerns. Sixty patients with breast, gastrointestinal, or prostate cancer participated in the ease of use survey, with 40% (n=24) aged 65 or older. Younger patients reported significantly higher scores than elderly patients (14.0 vs. 10.8, p=.001), even when prior computer and touch screen use was controlled. Conclusion Elderly users reported lower ease of use scores than younger users; however, their average rating was quite high-10.8 on a scale of-16 to +16. It may be unrealistic to expect elderly or less computer literate users to rate any application as positively as younger, more computer savvy users-perhaps it is enough that they rate the application positively and can use it without undue difficulties. We hope that our process can serve as a model for how to bridge the fields of computer usability and healthcare.