# A Systematic Review of the Usability of Telemedicine Interface Design for Older Adults
## 5 Conclusions  
Extensive research indicates that mobile app design significantly improves usability for the elderly. This article provides a systematic review of the factors affecting the usability of telemedicine interface design for older adults, identifying key elements of effective interface design. Through thematic analysis, the elements are organized into four key areas affecting the usability of interface design, namely, the functional framework, interaction logic, visual design, and user experience. Given the close relationship between the interface design, acceptance, and usability, this study is the first to integrate the four key elements of interface design with the Technology Acceptance Model (TAM) to develop a new conceptual framework for elderly telemedicine acceptance. Future research can validate this framework by formulating hypotheses and analyzing data. It also summarizes usability evaluation methods and offers recommendations to enhance the interface usability for future design initiatives. Most studies prioritize the System Usability Scale (SUS) for the usability evaluation, while relatively few rely on experimental assessments. Furthermore, many studies do not conduct usability evaluations on telemedicine applications. Although this design elements checklist does not guarantee perfect usability, it aims to support user-centered design and help bridge the digital divide. It can be used to develop design guidelines and guide designers and developers. These design elements and usability evaluation have an important reference value for governments in formulating telemedicine policies and for entrepreneurs investing in telemedicine. It is noted that this paper mainly explores the universal design elements of mobile telemedicine. Remote medical applications for specific diseases may require differentiated adjustments. For example, for people with visual impairments, more voice guidance may be needed. For users with cognitive impairments, functions such as technical literacy and social interaction should be emphasized. And fall prevention applications need to provide health guidance and intervention. Further studies ought to concentrate on examining the particular effects and results linked to every kind of telemedicine, thereby facilitating a more refined comprehension of their individual merits and drawbacks. Future research can also focus on comparing telemedicine interface designs across different countries and conducting a comprehensive market evaluation. In subsequent studies, we will develop a telemedicine interface design guideline for the elderly based on this literature review, and explore the priority and importance of each design element. We will also verify the effectiveness of the design guideline through controlled experiments. Promoting accessible and user-friendly telemedicine platforms for the elderly is crucial for fair healthcare access, digital inclusion, and aligns with the United Nations' Sustainable Development Goals for 2030. This analysis fosters interdisciplinary studies and guides designers and policymakers in developing sustainable telemedicine solutions that improve healthcare services and the quality of life for the aging demographic worldwide. It also encourages ongoing research to guarantee the inclusivity and efficacy of these systems. The following supporting information can be downloaded at: [[https://www.mdpi.com/article/10.3390/app15105458/s1](https://www.mdpi.com/article/10.3390/app15105458/s1)]([https://www.mdpi.com/article/10.3390/app15105458/s1](https://www.mdpi.com/article/10.3390/app15105458/s1)). H.H. : Conceptualization, Methodology, Writing--Original Draft, Data curation, Formal Analysis, Visualization. R.A.R.G. : Supervision, Methodology, Writing--Review and Editing. S.H.A.-R.: Supervision, Conceptualization, Writing--Reviewing and Editing. All authors have read and agreed to the published version of the manuscript.