Table 1.

Key user-centred considerations for mobile application design for hypertension management in low/middle-income country programmes

Minimise data entry	Set targets for speed and usability, for example, less than 80 s for new patient registration and initial clinical visit and less than 20 s for follow-up patient visits Resist temptation to add features or data requirements unless speed and ease-of-entry targets can be maintained
Offline-first	Faster and more reliable, with less chance of patients not being registered or follow-up information not updated because of slow or absent connectivity Minimise data elements to be stored and avoid large data components, for example, photos or scans, to ensure capacity for storing data offline on mobile devices
Use QR codes for patient identification	This low-tech approach can cut more than 20 s off patient look-up time and reduce errors
Maximise usability	Design screens and interfaces based on actual user testing, not what programme experts or engineers think staff will want Use straightforward information design to provide providers and programme managers with visualisation of the most important indicators of programme progress The design and accessibility for Simple follow best-in-class standards, such as the US Digital.gov guidelines (https://digital.gov/resources) Prioritise usability for front-line staff over interoperability across different platforms
Easy to train in clinic	Training in 1 hour in clinics supports rapid scale-up and allows for healthcare workers to train each other, given high staff turnover in public facilities
Data governance and security	A local or national government agency (eg, Ministry of Health) owns the data The system must have clear and ethical data governance from an early stage and address ownership transparently, such as through Memorandum of Understanding agreements outlining governance with each country’s Ministry of Health Mobile device data are encrypted both in transit and at rest using industry-standard security best practices Patients should have control of their own data, allowing them to monitor and improve their health, and must opt in at enrolment to consent to have their data collected
Enable mobile device use	A device that is always with providers is more likely to be charged, have up-to-date software, connect with the internet at least periodically and be used by healthcare workers
Enable patient registers for recall to care	This can improve patient adherence to treatment by facilitating tracking of progress and patient outreach to the entire patient panel by programme staff
Build for scale	Build to maintain speed and performance with successful scale-up to handle large numbers of patients