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. UX alliance partners set out to understand some of the short term factors which could impinge on the usefulness of a smart blood pressure monitor. For this study, UXalliance members from 16 countries participated to understand some of the short term factors which could impinge on the user experience of the blood pressure monitor.

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

9. Purchasing
the device
Out-of-the-box
experience
Using the
device

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

15. Purchasing the
device
Out-of-the-box
experience
Using the
device

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.”

21. Overall out-of-the-box experience
Easy
20%
20%
60%
Matched expectation
Difficult

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

34. Thank you