Smart Blood Pressure Monitor Study 2013

Qualitative insights into the purchase of a smart blood pressure monitor, the out-of-the-box experience and using the device over 10 days

Digital health and wellness

• More and more, patients are becoming consumers, spending more time monitoring their own health and well being and taking increased responsibility for themselves

• There is a whole new genre of Apps and devices that support and encourage this movement

• Electronic blood pressure monitors fit into this

• UX alliance partners set out to understand some of the short term factors which could impinge on the usefulness of these device

Our problem statement

Catarina’s father Jacque has high blood pressure (BP); Jacque’s doctor has suggested that he get a home blood pressure monitor to take his blood pressure daily. 

Catarina wants to keep close track of the BP in case he needs to go see the doctor.

One challenge is Catarina does not live in the same city and would like to find a BP monitor that has the cuff and can also provide data to a smartphone app.

Catarina wants to research, shop for, buy, configure it and send it to Jacque.  He will open it and get it set up.

The study – 3 stages

Purchasing the device

Out-of-the-box experience

Using the device

The study – 3 stages

Purchasing the device

Out-of-the-box experience

Using the device

UX professionals purchase the device and record the experience

Observe and record the participant’s out-of-the-box experience

Participants measure their blood pressure and complete a survey daily, for 10 days

What the study specified

Participants

• Within the age groups: middle aged adults (43-62 years) or young-old adults (63-72)

• Any gender• Has a need to monitor

their blood pressure e.g. family history, embarking on a fitness journey

• Participants were to be colleagues, friends or family

• They needed to have a smart phone or tablet to use

Monitor

• The monitor needed to be ‘smart’ meaning it connected to a smart phone or tablet

• No specific type of monitor was specified

• Price range was to be approximately $100-$150

• The monitor package was not to be opened before the participant did

21 participants from 17 countries

21 participants

17 males aged 27-754 females aged 44-61

Motivation to

participate

Likes technology

Family history

Has (or had) blood pressure related issues

Request by an employer/doctor

Gaining weight

Desire to be healthy

General interest/curiosity

21 participants from 17 countries

BrazilCanadaJapanNew ZealandItaly

IndiaPolandDenmarkSwitzerland AustraliaUSA

FranceFinlandRussiaIrelandGermanyUK

Purchasing the device Using the

deviceOut-of-the-box

experience

Purchasing decision - research

65%

30%

5%

Online

In store

Phone

 • Most participants did their own research• Many felt that they did not have

sufficient information such as device specifications in order to make informed choices

Channel of purchase

“I wasn't sure just by checking the information on the website.”

“Minimum information and not encouraging enough for a medical purchase.”

Purchasing decisions - influencers Price was a major influencing factor

Others included:

Choice

Availability

Convenience

Time

Advice from another

Website

Language

Reviews

Compatibility

Brand/reputation

$$

Purchasing decisions – local challenges

 • Monitors were not available in local stores in

Italy and Germany so their only option was to purchase online

• In India, Poland and Brazil, monitors were not available ₋ India tweeted Withings and were sent one free

of charge₋ Poland purchased through a German website₋ Brazil were sent one from partners in Canada

• Language support in terms of instructions, contact with suppliers and the monitor interface were issues for Poland, Finland and Brazil

• Could not purchase online in New Zealand

• Sales representatives lacked expertise around the monitors in Australia

“The search phase was hard. I had to buy the item on German websites, exchange a lot of emails. Patience is advised if planning to buy the device internationally.”

Overall purchase experience

45%

40%

15% Good expe-

rience

Ok experience

Bad experience

Main recommendations

• Ensure plain language information about product details are available on the site and on packaging

• Make it easy to determine why one product is same/different from another

• Localise the language for countries that can access the site

• Ideally, make products available to all countries

Out-of-the-box experience

Using the device

Purchasing the device

Out-of-the-box experience

 • 55% of participants had very good first

impressions of the packaging

• Almost half the participants needed to purchase adapters. Specifically for the latest iPhones and android devices. This was frustrating as many assumed ‘smart’ meant it would be compatible with all smart devices

• The majority of participants said the clarity of instructions was good; some had a poor experience due to the instructions being in a foreign language

• 70% rated the experience of assembling the device as good

“Reading on the package I realised that it wasn't iPhone 5 compatible. I didn't have [an] adapter though.”

The cuff• 85% of participants were comfortable attaching the

cuff

• 75% felt confident that they had attached it correctly

• Some participants commented that the cuff was ‘bulky’ and straps were too long Reduce the bulk of the cuff and shorten any unnecessary length of the straps

• Some commented about the high strength of the initial pressureLessen the initial pressure of the cuff or provide more information regarding when it will start/stop

• Some participants had a very poor experience attaching the cuff first time

“It was self-evident as to how the cuff should be worn, plus the written instructions were very clear.”

“My arm is almost too short for the cuff… [I’m not] entirely sure if [the] position is good enough; the pressure is very hard.”

The monitor

• Participants found it easy to determine how to start the device and take a reading; 2 participants did not

• Most stated that they understood their reading; 3 did not

 • Majority of participants felt that they had

enough information about their reading. Those with a high reading wanted additional information such as what to do nextProvide information about the reading such as ‘this is a healthy range’

• Many users had trouble charging the device

“It was hard to insert the batteries and there was no explanation about this in the manual.”

“When the participant received a high reading, no information was given to prompt him to consider the cause. He therefore put it down to not being relaxed enough.”

“Relatively easy, gave you the instructions [on] what you should do.”

The app

• The most common app used was Withings 

• The app was suggested to most participants once they had connected the monitor to their smart device

• Some had several apps suggested which caused confusion as to which one to use

• Most participant’s first impression of the app was that it was acceptable to good

Local languages

• There was no interface in Portuguese for the Brazilian participant

 

• There were no instructions in Russian

• The Polish participant struggled to understand the instructions as they were in German

“There was no Russian version of the manual [or] list of languages on the cover so [the] participant had to look through the entire brochure.”

Overall out-of-the-box experience

60%20%

20%

Easy Matched expectation Difficult

Main recommendations

• Move information about charging to one of the first steps in the instructions

• Provide more than one option to charge the monitor for example batteries and cable

• Ensure compatibility with iPhone and android devices is clear on the website and packaging

• Create monitors that are compatible with the latest iPhones and android devices or include necessary adapters in the package

• Ensure instructions are provided in the language of the country purchasing

• Ensure only one app is suggested or provide information as to the advantages/disadvantages of each app

Purchasing the device

Out-of-the-box experience

Using the device

Using the device

Day

Unsure

Learning

Competent

 

0 1 2 3 4 5 6 7 8 9 10

Learning how to use the device “As I used it last night, [it

was] rather easy today. The job was even easier than yesterday”

“Very easy to use the more you use it.”

Participants were competent taking blood pressure readings after day one. They did not need to learn anything further to continue using the device over the following days.

New features

New features discovered in the app were: • Diary function • Average values• Trends• Charging icon• Graph function• Anonymous measurement• Personal details entry• Tutorial

Most of the participants did not discover any new features after day 4, or stopped searching for themConsider providing a tour to show users additional features

Findings

• Participants struggled with the batteries and preferred having a cableOffer alternative ways to charge the monitor such as a cable to a computer

• Participants struggled to get Bluetooth connection where they thought was reasonable distance between their device and the monitor Ensure Bluetooth functionality works in close proximity

Findings continued…

• Some participants tried to put the cuff on with their non-dominant hand and had trouble doing so, some put it on backwardsAllow the cuff to be used on both arms or explicitly state which arm it must go on

• Some users wanted an option to add details around the context of measurement e.g. ‘I had a stressful day at work’Offer the option to enter contextual information into the app

• Some participants experienced failed readings after days of successful ones. They did not understand what they had done differentlyHelp users understand why readings may not work by providing a checklist for correct application

Findings continued…

• Those with a high reading wanted additional information such as healthy rangesProvide information about healthy blood pressure ranges and suggest seeing a medical professional when required

• Despite the issues, many participants reported that they were fairly confident with the accuracy of their readings

“The readings are consistent with the past readings at the doctors, private and at the hospitals.”

“It would be nice to have some more info behind what the reading means as it was my worst reading yet. If you score badly you want to do something about it.”

At the end of 10 days…

• 50% of participants felt more in control of their health  

• Most participants said they would continue to monitor their blood pressure

 

• Most participants did not make any lifestyle changes during the study or planned to afterwards

• The majority of participants found the app easy to use

Other insights

• When purchasing a monitor, many participants mentioned it was hard to compare products against each other in terms of price and features Create a website which offers comparisons on products

• When looking to purchase a monitor in store, a pharmacy was the first place that consultants tried Increase supply of monitors to pharmacies

• A few participants had trouble finding the instructions in the packageMake the instructions visible when opening the package

Conclusion

In order for Catarina, and others who want to purchase a blood pressure monitor, they need to be more accessible.  

It is vital that more information such as healthy blood pressure ranges is provided to users so they can accurately monitor their blood pressure, without consulting a doctor.

Cultural differences

• No Portuguese language for Brazil

• No Brazilian, Finnish or New Zealand website or local contact

• Brazilian and Polish people have the ability to monitor blood pressure in pharmacies or can use non-smart devices at home

• The participant from Denmark, Finland and Poland had only English as a language option

• In Denmark sharing private information on Facebook is not common and this functionality is unlikely to be used

• Foreign terms were unfamiliar to the Russian participant

• French and Japanese translation was clear

• The medical jargon was not clear to the Irish participant

• In Italy, all text except for the instructions was in English

• Te Reo Maori and New Zealand English were not available to New Zealand

• Smart blood pressure monitors were not available in Poland

Cultural differences

Thank you