# A Systematic Review of the Usability of Telemedicine Interface Design for Older Adults
## 4 Discussion
This process should involve exploring user requirements and conducting usability testing, as user participation is crucial for successful information technology design, ultimately improving satisfaction and usage. Although many studies emphasize simplicity to reduce complexity, this principle benefits users of all ages, including younger individuals. To ensure these design principles effectively enhance the usability, systematic evaluation methods must be employed to validate their effectiveness and refine the interface based on user needs. Currently, most studies assess interface design usability using questionnaires, while only a few employ experimental evaluations. Although questionnaires allow for a multidimensional assessment, they are inevitably influenced by testers' subjectivity. In contrast, experimental evaluations, despite being time-consuming and labor-intensive, provide greater objectivity and accuracy. Only a few studies have suggested the need for more comprehensive evaluations of health information systems using mixed methods, including user interface design and user experience, semi-structured interviews, observation, and think-aloud methods [51]. [PERSON]'s heuristic evaluation suggests providing step-by-step assistance and documentation for elderly users to facilitate their understanding of system instructions [13; 66; 89]. This article presents six usability recommendations aimed at improving the interface design, namely, intuitive and simplified navigation, timely multi-sensory feedback, information visualization, personalized settings, social interaction, and enhanced health literacy. The usability of telemedicine interface design is vital for improving the user experience and medical service quality for the elderly, while also impacting economic policy and investment decisions. Firstly, better interface usability reduces healthcare costs by improving elderly users' operational efficiency, minimizing errors and misdiagnoses. Enhanced usability also promotes broader adoption, alleviating healthcare pressures from an aging population, increasing service supply, easing resource shortages, and stimulating growth in related industries. Secondly, the aging population creates a large market for elderly telemedicine services. Investors should focus on companies with strong interface designs, as these can quickly capture the market share. User-friendly designs attract elderly users and enhance engagement, encouraging long-term service use. However, despite the promising prospects and benefits, designing highly usable telemedicine interfaces for the elderly still faces several critical challenges that must be addressed. The main challenges in mobile app design include the timing of stakeholder involvement, overcoming designer assumptions, adapting to end users, and managing stakeholder diversity [88]. To improve telemedicine usability for the elderly, it is essential to focus on key design aspects. The following recommendations are proposed to enhance the interface design for usability for elderly users:  
_(1) Intuitive navigation:_ Implement a concise navigation system with clear text labels or icons, progressive guidance, and dynamic prompts to help elderly users understand functions and operation processes [13; 73]. Simplify input methods, increase fault tolerance, and provide a touch-friendly design that includes multiple input options such as text, voice, and image recognition to minimize reliance on buttons [69]. Navigation should prioritize primary functions, minimize secondary features to reduce the cognitive load, and ensure responsive feedback mechanisms to enhance accessibility and usability [72]. _(2) Multi-sensory feedback:_ Enable user feedback for continuous interface improvements and service quality enhancement.