SBPM Conclusion

CONCLUSION:

Final Status

Over the course of this semester, we have worked hard in implementing a user interface for our Simplified Blood Pressure Monitor aimed toward novice and/or elderly users. However, due to the workload of all of our classes, the short amount of time in the semester, our lack of expertise in flash, and just our own schedules that were incompatible for meeting and working together often, we were unable to implement all of the features that we had originally planned. Instead, we focused on the features that we thought were the most important for and easily usable and working interface.

The screens in our device that we were able to implement are:

Initial Setup screen – This screen appears when the device is turned on for the very first time. In this screen, the user enters his/her name, an optional second user’s name, doctor’s e-mail address, sets up the time, and allows the user to decide whether or not they want the last reading or their average reading to be displayed on the startup page.

Startup Page – This screen appears when the device is turned on (after the very first startup). This screen shows either the last reading or the average reading depending on what was selected in the initial setup. From this screen, the user can access the graphs, charts, analyses, transfer page, or begin testing which initially goes to the diary page.

Diary Page – This screen appears before the actual reading is taken. Here, the user selects their activity level and mood before taking the test. From this page, the user can begin the test.

Results Page – Before the results are displayed, during the test, a screen appears which shows the progress of the test; at any point during the test, the user can push stop to cancel the test and deflate the cuff. After the test is finished, the result is displayed in a large font on the left side of the screen. From this page, the user can either re-test if he/she thinks the results may be inaccurate, or save the result and return to the startup page.

The test results that are shown on the results page are currently fictitious due to the fact that we do not actually have a cuff or the ability to take an actual reading. Also, our implementation does not yet support the storing of results for each user. One main feature that we were not able to implement was a keyboard that pops up on the initial setup screen. Since users do not always want to hook up the device to a computer to enter information, we wanted to have a keyboard pop up in order to enter the users’ information using the arrow keys. This feature would be beneficial to users who do not have access to a computer, and should be included in later implementations of this device.

Future Work

We realize that we have not fully implemented all of the features that we had originally planned. Therefore, future work obviously would include these features: storing results of the readings, transferring of results via wifi or usb, visual graphs and charts, and analysis of readings. Our interface is still a work in progress so there are also additional modifications to our visual interface that could be made as described earlier from the usability tests that we were not able to fix as of yet.

One feature that we were not able to implement that should be included in this device is the ability to support sound. With the addition of sound, users can get auditory feedback on whether they successfully pushed a button, or when the test is complete, etc. Also, with the ability to support sound, the device could include auditory commands to help users with impaired vision.

During our usability test and in critiques of our report, it was brought to our attention that our device did not have enough memory for what users really needed. Therefore, we think it would be good to allow the device to use memory sticks or some sort of backup memory that would allow the users to store more readings that just 2 months for 2 users or 4 months for one user. This extended memory will allow patients to more visibly track their progress toward their goal blood pressure.

Another improvement to this device would be to make the screen a touch screen. We decided initially not to do this because we thought that it would be too expensive for what we wanted; we wanted a low-cost, simple design that the average person could buy. However, the interface may be less confusing if it had a touch screen as opposed to seeing the options on the screen and pushing the button that correctly matches the intended option.

Acknowledgements

We would like to thank professor Ben Shneiderman for pushing us along all semester while we worked on this project. He and our teaching assistant Georg Apitz were very helpful with their comments and suggestions in our development process. We would also like to thank all the people who volunteered to be test subjects in our usability tests. Finally we would like to thank our classmates who critiqued our final report which helped us get it into the final stage as it is now.

References:

Ernst, Michael E.; Bergus, George R. Ambulatory Blood Pressure Monitoring. Southern Medical Journal, Jun2003, Vol. 96 Issue 6, p563-568.
"Ambulatory measurement of blood pressure using automated devices has also demonstrated benefit in other indications, such as treatment resistance and borderline hypertension, and is recommended by the Joint National Committee for the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure in a number of clinical scenarios."

Home BP Monitoring: AUTOMATED AND ANEROID DEVICES ARE BOTH RELIABLE. Geriatrics, Aug97, Vol. 52 Issue 8, pp16-17.
States that a fully automated oscillometric devices and calibrated aneroid sphygmomanometers are equally reliable in predicting average daytime ambulatory blood pressure. Comments of William B. White, professor of medicine and chief of the division of hypertension and vascular disease on home blood pressure (BP) monitoring; Advantage of automated devices; Importance of home BP monitoring.

Eoin O'Brien; Bernard Waeber; Gianfranco Parati; Jan Staessen; Martin G Myers. Blood pressure measuring devices: recommendations of the European Society of Hypertension. BMJ 2001 (3 March) ;322:531-536.
There is a large market for blood pressure measuring devices not only in clinical medicine but also among the public where the demand for self measurement of blood pressure is growing rapidly.

Haensel, A; Utech, K; Langewitz, W. Validation of TONOPORT V blood-pressure measuring monitor in adults. Journal of human hypertension, 2005 Sep, 19(9):745-9.
A new automatic blood-pressure (BP) measuring device TONOPORT V was evaluated according to the International Protocol for Validation of Blood Pressure Measuring Devices in adults by the European Society of Hypertension. The accuracy of the device did not vary according to BP values or other patient characteristics.

Beales, D. How accurate are automated blood pressure monitors? British journal of community nursing, 2005 Jul, 10(7):334-8.
Increasingly, automated blood pressure devices are replacing mercury sphygmomanometers to monitor blood pressure in primary care settings. The review demonstrates that 'accuracy' of the new devices does not equate to the accustomed accuracy of the mercury sphygmomanometer.

Peng, J; Peng, C; Wu, B. The development of a pocket blood pressure holter based on handhold personal computer. Journal of biomedical engineering, 2003 Mar, 20(1):129-31.
This paper introduces a kind of pocket blood pressure holster based on handhold personal computer. The hardware is made up of three units: simulation circuit unit, intelligent control unit and interface circuit unit. The system possesses the characters of portability, intelligence, convenience, high precision, ultra-low power consumption and stable capability. It is possible to become an ideal blood pressure monitor in family.

Your guide to lowering high blood pressure, National Heart, Lung, and Blood Institute - http://www.nhlbi.nih.gov. "... be sure that the person who will use the device reads the instructions before taking blood pressure readings. Your doctor, nurse, or pharmacist can help you check the device and teach you how to use it..." -A well written instruction is a must.

An Introduction to Human Factors in Medical Devices, FDA, http://www.fda.gov/cdrh/humfac/doit.html" An emerging concern of great importance to the Agency is the implementation of good human factors practices in the design of medical devices. If device operation is overly complex or counter-intuitive, safe and efficient use of a medical product can be compromised." -The operation of our device will be very simple and safe. It will consist of only a few buttons which can be easily located and operated

My Blood Pressure Software by Great Mind Software "Additional features include emailing your blood pressure report, creating a webpage report of your readings, and calculating averages of your readings." -We can try to make use of this (or similar) software by having our interface able to connect to computers.

Diabetes and Visual Impairment: Are Home Blood Pressure Monitors Accessible? by Steven Taylor, Darren Burton, and Mark Uslan, http://www.afb.org/afbpress/pub.asp?DocID=aw050503 "...We found the manuals for the non-talking monitors only in print and in PDF computer files. The PDF files were not designed to be accessible using a screen reader, such as JAWS or Window-Eyes, ... " -This finding helps us to keep in mind about usability for visual impaired users. We can do manuals in html format for screen readers.

Wearable feedback systems for rehabilitation, Journal of Neuroengineering and Rehabilitation, http://www.jneuroengrehab.com/content/2/1/17#IDAYG2RK "...doctors can obtain more context specific information directly, instead of relying on a patient's recollection of past events and symptoms, which tend to be vague, incomplete, and error prone." -Our device should be made in such a way that it can send data directly to a physician. The whole idea of monitoring is to provide doctors with information. Therefore sending data to doctors is very important.

Managing Diabetes on your mobile: http://www.sci-tech-today.com/story.xhtml?story_id=38140
"Patients monitor their blood sugars as they would normally, but the blood sugar meter communicates through their mobile phone to give them immediate graphical feedback," said Dr. Jeremy Wheeler, who helped develop the system. Our device monitors blood pressure, but can use similar features. Blood pressure can be entered into a program on a cell phone to receive quick visual feedback on progress.

My Blood Pressure Tracker 1.1: http://www.pocketgear.com/software_detail.asp?id=15003&associateid=459&afsrc=1 . The program is focused on fast entry into a database and convenient summaries of your Blood Pressure and pulse rates. The ability to add, delete, and modify records in the database is a useful feature. However, to improve this device, it should provide more than just a summary of results; perhaps suggestions for improvement or the ability to send information to a doctor.

Medline Plus:
http://search.nlm.nih.gov/medlineplus/ . The monitor may help your doctor find out if you have white-coat hypertension (only has high blood pressure when you are at the doctor's office). Being able to monitor blood pressure every 15-30 minutes throughout the day on a personal device may determine if you have white coat hypertension and save you from having to take medicine to lower blood pressure.

Home monitoring of High Blood Pressure http://www.americanheart.org/presenter.jhtml?identifier=576 This model has automatic inflation and deflation systems; large, easy-to-read digital display and error indicator; reading printouts; and built-in pulse (heart rate) measurement. One possible improvement is to allow the user to be able to choose if they want automatic or manual inflation and deflation systems in order to allow for more comfort.

| ©2005 SBPM