Impact of EHR Usability on Provider Efficiency and Patient Safety in Non-Hospital Settings

Healthcare organizations may reap benefits transitioning to electronic health records (EHRs), such as decreased healthcare costs and better care. However, severe unintended consequences from implementation and design of these systems have emerged. Poorly implemented EHR systems may endanger the integrity of clinical or administrative data. That, in turn, can lead to errors jeopardizing patient safety or quality of care. A literature review of 40 sources identified how EHR implementation and design can impact provider centric, patient centric, and outcomes. These categories provided the basis for a comprehensive EHR impact model that was evaluated in non-hospital settings through focus groups interviews

Use of ICT in Health Care for Rural India: The scenario with Software & Embedded system: the eMedicine way

Health Care sector in India has witnessed significant growth during the last few years, both in quality and capacity. In spite of such developments, heath care facilities in the country remain inadequate to meet the needs of the citizens, particularly in rural areas, where approximately 70% of the people live. To address this problem, the government has launched major national initiatives such as National Rural Health Mission, establishment of six new AIIMS like institutions, up gradation of existing public hospitals and labs, etc. As the health sector is poised for major growth in next decade, the sheer size of healthcare sector in the country will necessitate extensive use of information and communication technology (ICT) infrastructure, services and databases for policy planning and implementation. Such a framework would require services based on inter-operable and sharable technology, connecting various institutions and service providers. This paper states our vision & proposed solution for rural populace of India

Designing a Mobile Device for Pre-hospital Care

Peer reviewedPreprin

Usability Testing of Two Ambulatory EHR Navigators

Despite widespread electronic health record (EHR) adoption, poor EHR system usability continues to be a significant barrier to effective system use for end users. One key to addressing usability problems is to employ user testing and user-centered design

Co-design of human-centered, explainable AI for clinical decision support

eXplainable AI (XAI) involves two intertwined but separate challenges: the development of techniques to extract explanations from black-box AI models, and the way such explanations are presented to users, i.e., the explanation user interface. Despite its importance, the second aspect has received limited attention so far in the literature. Effective AI explanation interfaces are fundamental for allowing human decision-makers to take advantage and oversee high-risk AI systems effectively. Following an iterative design approach, we present the first cycle of prototyping-testing-redesigning of an explainable AI technique, and its explanation user interface for clinical Decision Support Systems (DSS). We first present an XAI technique that meets the technical requirements of the healthcare domain: sequential, ontology-linked patient data, and multi-label classification tasks. We demonstrate its applicability to explain a clinical DSS, and we design a first prototype of an explanation user interface. Next, we test such a prototype with healthcare providers and collect their feedback, with a two-fold outcome: first, we obtain evidence that explanations increase users’ trust in the XAI system, and second, we obtain useful insights on the perceived deficiencies of their interaction with the system, so that we can re-design a better, more human-centered explanation interface

Participatory design for drug-drug interaction alerts

The utilization of decision support systems, in the point of care, to alert drug-drug interactions has been shown to improve quality of care. Still, the use of these systems has not been as expected, it is believed, because of the difficulties in their knowledge databases; errors in the generation of the alerts and the lack of a suitable design. This study expands on the development of alerts using participatory design techniques based on user centered design process. This work was undertaken in three stages (inquiry, participatory design and usability testing) it showed that the use of these techniques improves satisfaction, effectiveness and efficiency in an alert system for drug-drug interactions, a fact that was evident in specific situations such as the decrease of errors to meet the specified task, the time, the workload optimization and users overall satisfaction in the system.Fil: Luna, Daniel Roberto. Instituto Tecnologico de Buenos Aires. Departamento de Investigacion y Doctorado.; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; ArgentinaFil: Otero, Carlos Martin. Instituto Tecnológico de Buenos Aires; Argentina. Hospital Italiano. Departamento de Informática En Salud.; ArgentinaFil: Almerares, Alfredo. Hospital Italiano. Departamento de Informática En Salud.; Argentina. University of Oregon; Estados UnidosFil: Stanziola, Enrique Luis. Hospital Italiano. Departamento de Informática En Salud.; ArgentinaFil: Risk, Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Oregon Health And Science University; . Instituto Tecnologico de Buenos Aires. Departamento de Investigacion y Doctorado.; ArgentinaFil: González Bernaldo De Quirós, Fernán. Hospital Italiano. Departamento de Informática En Salud.; Argentin

Electronic Falls Reporting System Implementation: Evaluating Data Collection Methods and Studying User Acceptance

In this research, we detail the development of a novel, easy-to-use system to facilitate electronic patient falls reporting within a long-term residential care facility (LTRCF) using off-the-shelf technology that can be inexpensively implemented in a wide variety of settings. We report the results of four complimentary system evaluation measures that take into consideration varied organizational stakeholders’ perspectives: 1) System-level benefits and costs, 2) System usability, via scenario-based use cases, 3) A holistic assessment of users’ physical, cognitive, and marcoergonomic (work system) challenges in using the system, and 4) User technology acceptance. We report the viability of collecting and analyzing data specific to each evaluation measure and detail the relative merits of each measure in judging whether the system is acceptable to each stakeholder. The electronic falls reporting system was successfully implemented, with 100% electronic submission rate at 3-months post-implementation period. The system-level benefits and costs approach showed that the electronic system required no initial investment costs aside from personnel costs and significant benefits accrued from user time savings. The usability analysis revealed several fixable design flaws and demonstrated the importance of scenario-based user training. The technology acceptance model showed that users perceived the reporting system to be useful and easy to use, even more so after implementation. Finally, the holistic human factors evaluation identified challenges encountered when nurses used the system as a part of their daily work, guiding further system redesign. The four-pronged evaluation framework accounted for varied stakeholder perspectives and goals and is a highly scalable framework that can be easily applied to Health IT (Information Technology) implementations in other LTRCFs

Systematic Review of Usability Engineering Management Studies for the Aging Population -UEM4Agin

Usability management is one of the core elements of any software to make it efficient and effective. Unfortunately, most of the time usability as well as its management is neglected while developing software that may result as ineffective and inefficient software design. In different eras different researchers performed studies to highlight the management of usability and to show its importance. Due to the increase in the aging population, the concern for the aging population assistances of each equipment becomes to be necessary. Number of Steps has been taken so far to help out the aging population but remained limited to visual considerations, such as stronger contrasts or larger characters on the displays and printing, or such physical characteristics as the ease for pressing buttons. In this paper, our focus is to perform a systematic review (SR) of usability management specifically for the aging population/senior citizens and its limitations. The systematic review aims to address three research questions: 1) What is the current status of usability management/usability engineering management research for the aging population/senior citizen around the globe? As we found that the literature on usability management for the aging population began in 1992 and increased thereafter, there is a lack of organized research teams and dedicated usability management journals for researching the aging population. High-impact theoretical studies are scarce. On the application side, no original and systematic research frameworks have been developed. The understanding and definition of usability and usability management is not well synchronized with international norms. 2) What are the existing methods, approaches, frameworks and practices that are currently being used in usability engineering management for the aging population? 3) What are the limitations of usability engineering management for the aging population/senior citizen? Purpose of this study is to identify the current research problems, existing studies for providing valid solution to these problems and will find out the limitations of existing work for covering the existing problems in usability engineering management specifically for the aging population. This will be done by performing quantitative literature of different databases and all the results will be gathered by analyzing and summarizing the statistical data using “R Studio”. Remedial techniques for handling the limitation of usability engineering management will be planned in future for the aging population

Advancing Critical Care in the ICU: A Human-Centered Biomedical Data Visualization Systems

The purpose of this research is to provide medical clinicians with a new technology for interpreting large and diverse datasets to expedite critical care decision-making in the ICU. We refer to this technology as the medical information visualization assistant (MIVA). MIVA delivers multivariate biometric (bedside) data via a visualization display by transforming and organizing it into temporal resolutions that can provide contextual knowledge to clinicians. The result is a spatial organization of multiple datasets that allows rapid analysis and interpretation of trends. Findings from the usability study of the MIVA static prototype and heuristic inspection of the dynamic prototype suggest that using MIVA can yield faster and more accurate results. Furthermore, comments from the majority of the experimental group and the heuristic inspectors indicate that MIVA can facilitate clinical task flow in context-dependent health care settings

Realizing the Value of EHR Systems: Critical Success Factors

Now that a majority of hospitals and primary care physicians have made the transition to electronic health record (EHR) systems, realizing value from this investment has become a major issue. The issue raises two key questions: Why do so many EHR implementations continue to fall short of achieving intended healthcare outcome goals? What differentiates those that succeed from those that fall short? This article builds on prior research using a systems framework to analyze the EHR implementation process. It focuses on ten common themes (CSFs) that appear to differentiate institutions which achieve positive healthcare outcomes from those that do not. Results are highly relevant for healthcare institutions now seeking to focus on realizing the value of their EHR systems