Usability of online symptom checkers

Authors

• Ville D Liu University of Helsinki, Helsinki, Finland
• Lasse Sellgren Nokia Health Center, Nokia; Tampere University, Tampere
• Minna Kaila Faculty of Medicine, University of Helsinki, Helsinki
• Tuomas Koskela Faculty of Medicine and Health Technology, Tampere University, Tampere

DOI: https://doi.org/10.23996/fjhw.97020

Keywords:

qualitative research [http://www.yso.fi/onto/yso/p11782], omaolo, triage, user experience, user interface design, Symptom Assessment, Self Care

Abstract

Municipalities are reforming their health and social care services and creating online services to support patient self-treatment and self-care (The Omaolo-project). These include 15 symptom checkers which provide triage. As a result of the completed individual symptom assessment, the patient receives an assessment of the need for treatment of the corresponding symptom, instructions for a treatment site and, if necessary, self-care instructions. This study examines the usability of symptom checkers from the perspective of the patient and the study assistant.

This is a mixed methods study that used data collected in the Omaolo project’s validation of symptom checkers study. Data were collected from 18 primary health care emergency centers throughout Finland. The user answered the questions posed by the symptom checker, after which a nurse familiar with triage assessed the need for treatment of the symptom of the user. The study assistant monitored the completion of the study user's symptom checker. The findings of 350 patient users, nurses, and study assistants were analyzed based on separate completed research forms. Thematic analysis was used to create research themes from the recorded observations of the individuals followed by the preparation of a thematic summary.

The usability of symptom checkers was mainly assessed as good. However, there were challenges in usability. Relevant concepts (codes) describing the challenges were formed from the free text observations of the research forms. 59 codes were classified under two main themes; user-related challenges and issues related to the symptom checkers. The user-related challenges were divided into a) difficulties in understanding the symptom checkers and their questions, b) poor competence to use online tools, and c) ability to assess one’s health. The issues related to the symptom checkers were divided into a) a need to clarify the terms and questions used in the symptom checker, and b) a need to improve the visual layout and provide better instructions for the user.

Symptom checkers are acceptable, easy to use, and understandable to most patients. The study identified themes that may impair the availability of symptom checkers. Improving the availability of symptom checkers is likely to improve the process of triage as well as its success. In addition, usability issues can impair a patient's willingness to use symptom checkers.