# A Systematic Review of the Usability of Telemedicine Interface Design for Older Adults
## 3 Results
### Factors Affecting the Usability of Interface Design
#### 3.2.1 Functional Framework  
To accommodate the cognitive and navigation limitations of older adults, telemedicine application design should simplify functionality, minimize complex visuals, and optimize touch interface operations to reduce the interference and learning burden [19; 20]. Systems can automatically recommend health topics of interest, including diseases, symptoms, treatments, medications, diet plans, and alternative therapies [13]. Telemedicine services encompass remote consultations, treatment, health management, medication sales, and monitoring, supported by functional frameworks emphasizing medication schedules, dosages, instructions, and disease information analysis [19]. For seniors' behavioral health, telemedicine applications should integrate goal setting, behavior planning, emergency management, data recording, disease information, medical calculators [13; 51], monitoring, feedback mechanisms, social support, reminders, and health outcome tracking [52]. Additionally, these applications facilitate appointment scheduling, status tracking, troubleshooting, exercise reminders, educational resources, dietary advice, social communication [20], and instructional video guidance [53].  
Interaction and reminder functions are critical for medication management applications for older adults, enabling users to display, mark, snooze, skip, and add medications, as well as generate reports [54]. Key features should include medication and risk management, health information sharing, communication tools, stroke components, rapid synchronization, and immediate system modifications upon failure [55; 56]. Essential design attributes include large fonts, simple operations, timely reminders, reliable hardware, WeChat integration for drug instructions, enhanced system sensitivity, and an extended battery life [57]. Although older adults often overlook app instructions [58], messaging features can improve engagement [59], while start or stop reminders help address memory impairments and concerns about polypharmacy [13; 60]. Notifications conveying status changes, combined with confirmation buttons or voice broadcasts [61], along with timer and progress bar functions for the real-time tracking of appointments and tasks [62], further enhance usability. Additionally, sound-effect prompts can assist users in navigating registrations, consultations, and payment confirmations.  
For elderly individuals, especially those living alone, emotional support, cognitive wellness, and motivation are critical. Social interaction features should be prioritized, as they provide older adults with opportunities to connect with others, enhancing their sense  
Figure 2: Telemedicine technology acceptance model for older adults.  
of recognition and encouraging healthier behaviors through praise and rewards [50; 55]. A well-designed app with flexible scheduling and peer interactions, such as those demonstrated in cancer survivor programs, can increase participation in health programs [63]. Additionally, feedback mechanisms, motivation tools, monitoring capabilities, and alarm features have proven effective in engaging older adults with insomnia [59]. Telemedicine applications should incorporate interactive features, voice feedback, automatic monitoring, disease tracking, and visual health reports. Including a home screen icon to explain app functions can enhance user understanding, while the automatic identification of user interests can minimize the manual input [59; 64]. Disease tracking and concise summary reports linking daily mood changes with relevant symptoms and actionable steps will further improve the user experience [60].