Evaluating the Usability of a Patient Portal: Insights from Older Migrant Adults

The growing popularity of eHealth services highlights the importance of ensuring their usability for users with diverse needs, characteristics, and abilities. One key group is older migrant adults, who may be at risk of digital exclusion due to economic, cultural, or social backgrounds. Thus, this study aims to gain a deeper understanding of the usability challenges that might occur when migrant older adults use eHealth services. As a case study, we conducted qualitative usability testing on Maisa, a public patient portal in Finland, with six older migrant adults. The research methods were think-aloud, observation, and a background survey. A qualitative content analysis was used. We found that participants faced seven types of usability issues with Maisa, unclear or non-descriptive labels and icons, hidden information and functionalities, and language-related issues were the most critical ones. We recommend several practical design guidelines, including enhancing the visibility and accessibility of information and functions through large enough font sizes, color contrast, and intuitive placement with clear labels and icons. Additionally, using simple language, integrating AI-based translation tools, and providing function-based instructions. This study highlights the need for broader research with migrants from diverse backgrounds and usability testing of both the mobile and web versions of various eHealth platforms to promote an inclusive society.