Development and Usability of Mobile-based Healthcare Protocols in Kenya

Healthcare protocols have been shown to improve the quality of health service delivery by offering explicit guidelines and recommendations for clinicians who are uncertain about how to proceed in a given clinical situation. While various modalities are used to implement protocols, few rigorous evaluations of protocol use exist in low-resource clinical settings. This study aimed to develop mobile-based protocols (MBPs) and test their usability against currently used paper-based protocol (PBPs). Satisfaction, efficiency and effectiveness of the protocols were evaluated through a think-aloud usability exercise, in-depth interviews, and through a questionnaire. Compared to PBPs, satisfaction scores were higher with MBPs (83.8 versus 66.8, p=0.0498), number of errors lower with MBPs (2/25 versus 5/25, p=0.1089), with average time for task completion higher with MBPs (23.3s versus21.6s, p=0.7394). MBPs offer more satisfaction and trend towards being more effective as a dissemination modality for healthcare protocols in low-resource settings.