Appl Clin Inform 2021; 12(05): 1014-1020
DOI: 10.1055/s-0041-1736628
Research Article

Heuristic Evaluation of a Top-Rated Diabetes Self-Management App

Linda Harrington
1  Harris College of Nursing & Health Sciences, Texas Christian University, Fort Worth, Texas, United States
Cheryl Parker
2  College of Nursing and Health Sciences, The University of Texas at Tyler, Texas, United States
Kathleen Ulanday
3  Texas Children's Hospital, Houston, Texas, United States
Craig Harrington
4  Independent Informatics Consultant, Chapel Hill, North Carolina, United States
› Author Affiliations


Objective The purpose of this study was to evaluate the usability of a top-rated diabetes app. Such apps are intended to markedly support the achievement of optimal health and financial outcomes by providing patients with substantive and continual support for self-management of their disease between periodic clinician visits. Poor usability can deter use which is especially concerning in patients with diabetes due to prevalence of the disease and impact of self-management on long-term prognosis.

Methods A diabetes app was selected due to the prevalence and seriousness of the disease. A heuristic evaluation was then performed to collect and analyze data on the usability of the app based on Nielsen's heuristics. Pareto analysis was used to illustrate the contribution of each type of heuristic violation, augmented by a stacked bar chart illuminating associated severity.

Results There were 51 heuristic violations on the opening screen, violating 6 of Nielsen's 10 heuristics. Pareto analysis revealed 29 (57%) of the heuristic violations involved a match between system and real world and 8 (16%) aesthetic and minimalist design. Severity ratings ranged from 1.0 to 4.0 (mean: 3.01) with 80% comprising a major usability problem and 6% a usability catastrophe.

Conclusion Studies show that people with diabetes are more likely to receive greater benefit from a diabetes app if they are easy to use. The number and severity of heuristic violations in this study suggest that the commercialization of mobile health apps may play a factor in bypassing experts in clinical informatics during the design phase of development. Usability and associated benefits received from mobile health apps can be enhanced by debugging the user interface of identified heuristic violations during design. Waiting to correct ongoing usability issues while apps are in production can result in patients disengaging from use of digital health tools engendering poorer outcomes.

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects, and was deemed exempt by Texas Christian University, Institutional Review Board Chair.

Publication History

Received: 21 June 2021

Accepted: 13 September 2021

Publication Date:
03 November 2021 (online)

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