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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

UX professionals
purchase the device
and record the
experience

Out-of-the-box
experience

Observe and record
the participant’s outof-the-box
experience

Using the
device

Participants measure
their blood pressure
and complete a survey
daily, for 10 days
What the study specified
Monitor

Participants

• 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

• 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
21 participants from 17 countries
21 participants
17 males aged 27-75
4 females aged 44-61
Request by an
employer/doctor
Desire to
be healthy

Family history
Motivation
to
participate

Gaining weight
Has (or had)
blood pressure
related issues

General
interest/curiosity

Likes
technology
21 participants from 17 countries

Brazil
Canada
Japan
New Zealand
Italy

India
Poland
Denmark
Switzerland
Australia
USA

France
Finland
Russia
Ireland
Germany
UK
Purchasing
the device

Out-of-the-box
experience

Using the
device
Purchasing decision - research
“I wasn't sure just by
checking the
information on the
website.”

• 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
5%

Online
30%

In store
65%

Phone

“Minimum
information and
not encouraging
enough for a
medical
purchase.”
Purchasing decisions - influencers
$$ Price was a major influencing factor
Others included:

Advice from another
Convenience

Reviews
Compatibility

Brand/reputation

Choice

Website

Availability

Language

Time
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

15%

Good experience

45%
40%

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
Purchasing the
device

Out-of-the-box
experience

Using the
device
Out-of-the-box experience
• 55% of participants had very good first
impressions of the packaging
“Reading on the
package I realised
that it wasn't
iPhone 5
compatible. I
didn't have [an]
adapter though.”

• 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
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
pressure
Lessen the initial pressure of the cuff or provide more
information regarding when it will start/stop

•

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

•

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

“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 next
Provide 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.”

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

“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.”
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

Easy

20%

20%

60%

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
Using the device
Purchasing the
device

Out-of-the-box
experience
Using the device
Learning how to use the
device
Competent

“As I used it last night, [it
was] rather easy today.
The job was even easier
than yesterday”

Learning

Unsure
0

1

2

3

4

5

6

7

8

9 10

Day
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.

“Very easy to
use the more
you use it.”
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 them
Consider providing a tour to show users
additional features
Findings
• Participants struggled with the batteries and
preferred having a cable
Offer 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 backwards
Allow 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 differently
Help 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 ranges
Provide 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
package
Make 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
Cultural differences
• 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
Thank you

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Global study of smart blood pressure monitors user experience

  • 1. 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
  • 2. 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
  • 3. 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.
  • 4. The study – 3 stages Purchasing the device Out-of-the-box experience Using the device
  • 5. The study – 3 stages Purchasing the device UX professionals purchase the device and record the experience Out-of-the-box experience Observe and record the participant’s outof-the-box experience Using the device Participants measure their blood pressure and complete a survey daily, for 10 days
  • 6. What the study specified Monitor Participants • 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 • 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
  • 7. 21 participants from 17 countries 21 participants 17 males aged 27-75 4 females aged 44-61 Request by an employer/doctor Desire to be healthy Family history Motivation to participate Gaining weight Has (or had) blood pressure related issues General interest/curiosity Likes technology
  • 8. 21 participants from 17 countries Brazil Canada Japan New Zealand Italy India Poland Denmark Switzerland Australia USA France Finland Russia Ireland Germany UK
  • 10. Purchasing decision - research “I wasn't sure just by checking the information on the website.” • 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 5% Online 30% In store 65% Phone “Minimum information and not encouraging enough for a medical purchase.”
  • 11. Purchasing decisions - influencers $$ Price was a major influencing factor Others included: Advice from another Convenience Reviews Compatibility Brand/reputation Choice Website Availability Language Time
  • 12. 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.”
  • 13. Overall purchase experience 15% Good experience 45% 40% Ok experience Bad experience
  • 14. 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
  • 16. Out-of-the-box experience • 55% of participants had very good first impressions of the packaging “Reading on the package I realised that it wasn't iPhone 5 compatible. I didn't have [an] adapter though.” • 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
  • 17. 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 pressure Lessen the initial pressure of the cuff or provide more information regarding when it will start/stop • “It was self-evident as to how the cuff should be worn, plus the written instructions were very clear.” • Some participants had a very poor experience attaching the cuff first time “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.”
  • 18. 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 next Provide 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.” “Relatively easy, gave you the instructions [on] what you should do.” “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.”
  • 19. 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
  • 20. 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.”
  • 22. 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
  • 23. Using the device Purchasing the device Out-of-the-box experience
  • 24. Using the device Learning how to use the device Competent “As I used it last night, [it was] rather easy today. The job was even easier than yesterday” Learning Unsure 0 1 2 3 4 5 6 7 8 9 10 Day 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. “Very easy to use the more you use it.”
  • 25. 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 them Consider providing a tour to show users additional features
  • 26. Findings • Participants struggled with the batteries and preferred having a cable Offer 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
  • 27. Findings continued… • Some participants tried to put the cuff on with their non-dominant hand and had trouble doing so, some put it on backwards Allow 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 differently Help users understand why readings may not work by providing a checklist for correct application
  • 28. Findings continued… • Those with a high reading wanted additional information such as healthy ranges Provide 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.”
  • 29. 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
  • 30. 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 package Make the instructions visible when opening the package
  • 31. 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.
  • 32. 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
  • 33. Cultural differences • 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