An Example of Bad Design: This App’s Interface for Entering Blood Pressure

Screen Shot 2014-04-14 at 7.24.01 PM

Here’s a design approach that I really, really dislike: the scrolling wheel that is often used for number entry in iOS apps:

I find that the scrolling wheel makes it very tiresome to enter numbers, and much prefer apps that offer a number pad, or another way to touch the number you need. (Or at least decrease the number at hand in sensible increments.)

You may think I’m being too picky, but I really think our ability to leverage technology will hinge in part on these apps and devices being very usable.

And that usability has to be considered for everyone involved: patients, caregivers, and clinicians.

Why am I looking at an app to enter blood pressure?

Let me start by saying that ideally nobody should be entering vitals data manually. (Not me, not the patient, not the caregivers, not the assisted-living facility staff.)

Instead, we should all be surrounded by BP machines that easily send their data to some computerized system, and said system should then be able to display and share the data without too much hassle.

But, we don’t yet live in this world, to my frequent mild sorrow. This means that it’s still a major hassle to have regular people track what is probably the number one most useful data for us in internal medicine and geriatrics: blood pressure (BP) & pulse.

Why is BP and pulse data so useful, so often?

To begin with, we need this data when people are feeling unwell, as it helps us assess how serious things might be.

And of course, even when people aren’t acutely ill, we often need this data. That’s because most of our patients are either:

  • Taking medication that affects BP and pulse (like cardiovascular meds, but many others affect as well)
  • Living with a chronic condition that can affect BP and pulse (such as a-fib)
  • All the above

As we know, the occasional office-based measurement is a lousy way to ascertain usual BP (which is relevant for chronic meds), and may not capture episodic disturbances.

So clearly, giving people the tools to measure at home is the way to go. And along with that measurement, we need to make it easy for them to record and share the data. Preferably in forms that allow graphical views. (I get hand-written BP logs all the time. They are a major pain.)

For a while now, I’ve been looking for a good BP monitor — one that facilitates data tracking and sharing –to recommend to my older patients…and I haven’t yet found it. (This is a problem I’ve been meaning to blog about and I will try to do so soon, as I’d like to explain why I consider options such as the Withings blood pressure monitor and the iHealth monitor unsuitable.)

The next best thing would be an app that makes it easy to enter and then share data. Now, I don’t like to use apps to solve this problem, because many of my frail older patients are not comfortable with smartphones and tablets.

Still, for those who can easily use a smartphone or tablet, using an app to track BP data could be easier than entering it into a spreadsheet in a computer.

Provided, of course, that one finds the right app. Because I can tell you, if I were faced with the scrolling wheel every time I was supposed to log my BP (or my mother’s BP), I’d give up pretty quickly.

Maybe that’s why people keep sending me handwritten logs?

Have you found a blood pressure tracker you like?

Ok, if you’ve found an app — or better yet, a tech-enhanced BP machine — that you like for easy tracking and sharing of BP and pulse, let me know in the comments please.

Bonus points if you’ve actually used, or witnessed someone using, your recommendation on a daily basis for at least a week.

Triple bonus points if that user was older and not terribly tech-savvy…I am looking for “universal” design here, as opposed to tools designed for the quantified-selfers and wellness junkies. Thanks!

Leslie Kernisan, MD MPH (@GeriTechBlog) is a practicing geriatrician, cautious techno-optimist, and enthusiastic caregiver educator. She hopes to someday be surrounded by cool tools and innovations that will make great geriatric care totally doable for all, especially primary care providers and family caregivers. She is a regular THCB contributor, and blogs at Geritech.org and at drkernisan.net.

8 replies »

  1. Sounds like you don’t find the scrolling wheel a hassle. Well, it would be interesting to survey boomers and Medicare beneficiaries on the topic.

    According to Pew’s recent report, only 18% of people aged 65+ own a smartphone, so we likely don’t have enough data on what this demographic finds usable.

  2. I use BP Companion on iPhone (not my fried, just my companion!) It uses 3 scroll wheels on a single screen, 1 for BP, 2 for systolic/diastolic, in singular increments: 123, 124, 125., etc over 75, 76, 77, etc. Easy to use even for an old school IT manager. A BlueTooth cuff could send info as long as app was running on phone (or store readings and send as a batch.) Has charting and graphs (which it will save as a snapshot to send to my doctor) with week/month/year time spans.

  3. Ironic that this particular interface wrinkle was brought into the world by Apple

    Given Apple’s reputation for design …