Usability evaluation of an innovative virtual care platform with remote monitoring functionalities for residential aged care homes: A cognitive walkthrough study

This is the authors' abstract. We don't add key points for this paper.

Background: Virtual care (VC) can improve timely access to general practitioners (GPs) for residents in residential aged care homes (RACHs). However, despite rapid implementation, little empirical work has examined the learnability and task-level usability of these systems in aged care settings, where staff operate under time pressure and residents often have complex needs. Objective: This study aimed to evaluate the usability of a virtual care platform used to connect residents in RACHs with GPs, using a cognitive walkthrough (CW) approach to examine system learnability and safety-critical task performance within GP and nursing workflows. Methods: Together with a doctor, nurse and an older adult advisor, two human factors experts walked through 10 clinician tasks (GP=4, nurse=6) and 44 subtasks (GP=13, nurse=31) using the VC technologies, and identified problems, directed by four established CW prompts. Using the problems list, we rated problem severity based on clinician workflow prior to descriptive analysis. Results: A total of 45 usability problems were identified, over half affecting task learnability. Most learnability problems occurred during nursing tasks associated with vital-sign capture, where required actions and system feedback were frequently unclear to users. Several problems were rated as major or catastrophic, with implications for nursing workflow reliability, task interruption and patient safety. Additional issues related to inadequate error prevention and recovery by design. Conclusion: This study provides one of the first applications of cognitive walkthrough to evaluate a virtual care platform in a residential aged care context. By revealing safety-critical learnability and error-prone design issues that are often missed by satisfaction-based evaluations, the findings demonstrate the value of task-level usability assessment for supporting safe and effective virtual care delivery in aged care settings. This research has implications for improving user experience, preventing unintended consequences, and enhancing the quality-of-care delivery.