Tara McCurdie*, Centre for Global eHealth Innovation, University Health Network, Toronto, Canada Anjum Chagpar, Centre for Global eHealth Innovation, University Health Network, Toronto, Canada Melanie Yeung, Centre for Global eHealth Innovation, University Health Network, Toronto, Canada; Department of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada Joseph A Cafazzo*, Centre for Global eHealth Innovation, University Health Network, Toronto, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada; Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada Track: Research Presentation Topic: Usability and human factors on the web Presentation Type: Oral presentation Submission Type: Single Presentation Building: MaRS Centre, 101 College Street, Toronto, Canada Room: CR2 Date: 2009-09-18 01:30 PM – 03:00 PM Last modified: 2009-08-13

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Background
Despite the potential for mobile devices to improve care through increased information provision and decision support, their adoption remains limited, in part due to the usability of the hardware platforms available.

Objectives
This study sought to compare the usability of 3 commercially available smartphones: RIM’s BlackBerry Bold, Apple’s iPhone 3G, Palm’s Treo 680, and 2 Personal Digitial Assistant (PDA) platforms: Nokia’s N810, and HP’s iPAQ 210, for typical nursing tasks. Findings were analysed to provide insights into performance and adoption barriers and enablers.

Methods
Expert heuristic reviews were conducted on each device to determine how well each conformed to commonly held design principles. Following the heuristic evaluations, usability testing was conducted with twenty-four nurses from the Multi-Organ Transplant unit at the Toronto General Hospital to identify issues with the devices' ability to support user goals and expectations. This involved the objective observation of nurses while they performed four typical tasks: composing an email, a BMI calculation, and two online database queries. In addition, subjective user preference data was collected through surveys and debriefing interviews at the end of each evaluation.

Results
Overall, the BlackBerry had the least number of issues identified through the heuristic evaluation. The Nokia had the most overall issues but most of these were low severity. The iPhone and the iPaq had the most number of medium severity issues while the Palm had the least number of issues in total, but the most high severity issues.

With respect to the usability testing, the Nokia performed the best in terms of task completion time and task completion rate for the web query and BMI calculation tasks. For the emailing task, the Palm Treo had the highest performance and perceived ease of use scores while the iPhone performed the worst. When users were asked to rank devices according to preference, more preferred the BlackBerry than any other device.

Conclusions

While the Nokia performed best overall, due to its physical keyboard, clear menu structure and information display, the BlackBerry was preferred by more users. Nurses reported that the Nokia was too heavy as compared to the other devices (223 g as opposed to 132 g for the BlackBerry which was the lightest). Also, the Nokia had the most heuristic violations and while the majority of these were not severe, in sum, they may have contributed to user frustration.

The BlackBerry, on the other hand, had the fewest design principle violations revealed during the heuristic evaluation. In addition, it’s fast browsing speeds and advanced page rendering contributed to it ranking second in overall task performance during the usability testing. It is likely that the BlackBerry’s adherence to good design principles contributed to more nurses choosing it over the Nokia.

The iPhone’s performance closely followed the BlackBerry’s in terms of overall task completion time and rate and was also 3rd most preferred device, after the BlackBerry and Nokia.

The BlackBerry Bold and iPhone 3G were found to be the most appropriate devices to support the clinical tasks evaluated in this study. The Nokia N810 also met or exceeded the performance of these devices, but its form factor and weight could impact adoption by nurses, and its lack of phone functionality limits its application. The Palm Treo 680 and HP iPAQ 210 are not recommended.