# A Systematic Review of the Usability of Telemedicine Interface Design for Older Adults  
[PERSON] Centre for Sustainable and Smart Manufacturing, Department of Mechanical Engineering, Faculty of Engineering, University Malaya, Kuala Lumpur 50603, Malaysia; $[EMAIL_ADDRESS]. Telemedicine is transforming the dynamics of patient-provider relationships by adopting a patient-centered approach that eliminates the barriers of time and location [4]. This mode of healthcare delivery enables patients to actively participate in their care while integrating audio, video, and monitoring features to enhance remote observation and maintain the continuity of healthcare without the need for physical visits [5]. As a result, telemedicine reduces travel and wait times for medical appointments, improving healthcare accessibility [6]. Telemedicine effectively facilitates patient triage, problem diagnosis, and both pre- and post-treatment care, increasing the efficiency of offline doctors. It offers a wide range of applications for the elderly, including chronic disease management, vital sign monitoring, and medical consultations [6]. Additionally, it delivers high-quality medical advice at lower costs through telephone consultations and video conferencing, resulting in greater benefits and higher patient satisfaction [7]. However, despite these advantages, the acceptance and use of telemedicine among older adults remain low, as many platforms do not adequately consider their unique characteristics, preferences, and abilities [8]. Compared to younger individuals, older adults experience declines in mental perception, motor coordination, physical health, memory, attention, vision, and hearing [7]. This situation is further aggravated by a shortage of specialized medical care providers [6; 9]. [PERSON] [10] found that the usability issues encountered by older adults mainly stem from motivational barriers and cognitive impairments, followed by perceptual and physical ability barriers. These challenges hinder the elderly's ability to use internet technology, impede the effective communication of information, and negatively affect their daily lives. Moreover, many older adults have limited experience with the Internet and smartphones, which can obstruct their ability to utilize telemedicine unless they are aware of its benefits [11] or have the capability and capacity to engage. The health status and habits of the elderly can significantly influence the usability of telemedicine, especially when designers fail to recognize them as potential users and overlook usability issues in the interface design [7], for example, the use of technical jargon or unfamiliar medical terminology, which may hinder comprehension [12]. Older adults often face difficulties when using mobile apps due to complex menu structures, small font sizes, and various other usability barriers [13]. Therefore, it is necessary to gain an in-depth understanding of the causes and impacts of the usability issues encountered by older adult patients, and to adapt the design of telemedicine interfaces to meet the needs and characteristics of patients [10]. It is essential to design telemedicine interfaces that consider the physical coordination as well as the psychological and emotional needs of the elderly to enhance their quality of life and support sustainable healthy aging. Usability refers to the degree to which a product can effectively, efficiently, and satisfactorily achieve specific goals within a given usage environment [14; 15]. Usability goals provide interaction designers with a specific method to evaluate interactive products and user experience through dimensions such as effectiveness, efficiency, safety, utility, learnability, memorability, and satisfaction [16]. The MOLD-US framework identifies several barriers to usability for the elderly, including perception, cognition, motivation, and physical abilities. These barriers encompass aspects such as vision, memory, digital literacy, and fine motor skills [17].