The popularity of mobile health apps continues to grow, creating new opportunities for people to change behaviours that impact health. The researchers at the Eriksholm Research Centre explored how this hunger for eHealth support might be used to improve patient outcomes with eHealth-assisted rehabilitation solutions.

For the first time , the research team engaged hearing aid users, significant others, and audiologists in the design process to gain user-centred insights for developing a hearing healthcare app.

Applying User-Centered Innovation in eHealth

In this study, participants – hearing aid users, significant others and audiologists – were the innovators, with the Eriksholm research team expertly facilitating the process of gaining information.

This human-centered approach empowered the study participants to take on roles as informants, design partners, testers and users. This enabled researchers to uncover important elements that contributed to the design of eHealth solutions and to user acceptance.

The study employed an iterative design process in which continual improvements are made based on participant feedback, focus groups, preliminary prototypes and system architecture.

Three rounds of focus groups were conducted over seven months in order to find out what the stakeholders (patients, their significant others and audiologists) would want from a hearing healthcare app.

The focus groups were run from November 2016 to April 2017 and involved 36 hearing aid users, 10 significant others and 8 audiologists. 

November 2016:

The first focus group was used to outline user requirements for an eHealth app and to obtain a detailed vision for how an app might be used in a future patient hearing loss journey.

That patient journey was envisioned in a graphic that looked at the many ways the app might benefit hearing aid users and audiologists in the delivery of eHealth-assisted hearing rehabilitation.

Interestingly, the significant others involved in the study expressed a desire for access to the same eHealth information as the individuals with hearing loss.

The audiologists voiced the need for a solution that enabled them to efficiently communicate with users and that empowered users to take responsibility for their own rehabilitation.

March 2017:

The second focus group was conducted with hearing aid users to address attendee visions for future eHealth solutions and entailed the co-design of some concrete solutions. The group employed the various visions and requirements detailed in the first focus group to produce design solutions and prioritised them using wireframes - a way to layout potential app screen.

The wireframes illustrated app solutions content for three themes:

• My information
• My hearing
• My development

April 2017:

In the third and final focus group, the participants worked with mock-up research apps on iPads to provide further insight and evaluation of the three themes.

Additional sub-features and descriptions for each theme were identified and that lead to the reframing of the original three themes into the new themes: “My expectations”, “My personal hearing coach” and “My development”.

Watch video about the App(etite) for life project

Aptitude and Interest in eHealth Solutions

The study showed that when developing content for eHealth solutions it is necessary to consider the needs of all stakeholders and that successful delivery of personalised information via an eHealth app requires the right timing, timely on-demand communication, and opportunity for on-going learning about hearing, hearing aids, new technology and self-management.

The research also identified four factors that would motivate seniors to use a digital (eHealth) solution:

• Open-ended training with no fixed schedule and the option to begin at any training level
• Automated hearing aid updates and fine-tuning, and the option for voice commands to adjust hearing aids.
• Quick and easy access to self-monitoring and information such as FAQ lists.
• Personalised support for daily hearing related problems.

The less tech-savvy seniors were most interested in the “Automatisation” and quick and easy access, along with a desire for social support and a partnership with their hearing care professionals for problem solving, while tech-savvy seniors were most interested in options to obtain personalised support, problem solving and self-management.

Future App(lications) for Hearing Healthcare

There is little doubt that the presence of eHealth apps will continue to increase over time. We must hope that, as in this work, they are developed in such a way as to have a positive impact on life, healthy behaviours and health management.

As the researchers at Eriksholm demonstrate, involving the user in the app design process will increase the likelihood that eHealth tools meet the real world needs of people with hearing loss.