User-Centered Design of a National Medical Registry for Tick-Borne Diseases

Tick-borne diseases are increasing in a global perspective, with Lyme disease and tick-borne encephalitis as the most frequent. The Norwegian National Ad-visory Unit on Tick-borne Diseases is preparing the development of a national medical registry for clinical follow-up of patients with tick-borne diseases based on the best practice guidelines and for research purposes. This paper presents the methodological approach of a user-centered design process applied in the in-itial phase of the registry development. A user workshop identified user needs, requirements and proposed a service workflow for the registry operation. As the next step, a simulation of the proposed service workflow was performed in a clinical laboratory together with end-user groups. The main contribution of this paper lies on the methodological descriptions of the user-centered design pro-cess, and how to facilitate the active contribution of end-users in a technical de-velopment process within a health care context.User-Centered Design of a National Medical Registry for Tick-Borne DiseasesacceptedVersionNivå

Exploring the role of trust and expectations in CRI using in-the-wild studies

Studying interactions of children with humanoid robots in familiar spaces in natural contexts has become a key issue for social robotics. To fill this need, we conducted several Child-Robot Interaction (CRI) events with the Pepper robot in Polish and Japanese kindergartens. In this paper, we explore the role of trust and expectations towards the robot in determining the success of CRI. We present several observations from the video recordings of our CRI events and the transcripts of free-format question-answering sessions with the robot using the Wizard-of-Oz (WOZ) methodology. From these observations, we identify children’s behaviors that indicate trust (or lack thereof) towards the robot, e.g., challenging behavior of a robot or physical interactions with it. We also gather insights into children’s expectations, e.g., verifying expectations as a causal process and an agency or expectations concerning the robot’s relationships, preferences and physical and behavioral capabilities. Based on our experiences, we suggest some guidelines for designing more effective CRI scenarios. Finally, we argue for the effectiveness of in-the-wild methodologies for planning and executing qualitative CRI studies

Mobile teleconsultations in acute burn care : acceptance and user-experience among emergency care providers in resource-poor settings

Background: Burn injuries are a global health problem with severe consequences for those affected and nearly 95% of all burns occur in low- and middle-income countries (LMICs). While minor burns can be treated locally such as at the emergency department, severe burns need transfer to a specialist burns centre. However, non-specialists often lack the training and experience to accurately diagnose and manage burns. While smartphones have been shown to be feasible for remote consultations between frontline providers and burns specialists, barriers may impede successful uptake. Aims: The aims of the thesis were to deepen the knowledge about referral patterns of patients with burns in resource poor settings, and to study perceptions and experiences among emergency staff’s use of smartphones as a diagnostic support to improve the assessment, initial care and referrals of patients with burns. Methods: Study I was a retrospective case study of 871 paediatric patients with burns at a trauma unit in Cape Town. Demographic, injury characteristics, and disposition was used to determine whether patients were referred according to local criteria. Study II was a mixedmethods study of the usability of a smartphone app (the Vula app) for burn injury consultations. Twenty-four emergency doctors and four burns specialists were enrolled in the study. A think-aloud study was conducted with all participants and their interaction with the app was video-recorded and later analysed using content analysis. The twenty-four emergency doctors also completed a usability questionnaire. Study III was a qualitative study where semi-structured interviews were conducted with 15 doctors regarding their experiences using the Vula app for burn consultations and referrals. The interview-guide and thematic analysis were informed by the Normalisation Process Theory. In Study IV, fifty-nine frontline health workers completed a questionnaire to assess their intention to use the Vula app. The questionnaire and the analysis were informed by the technology acceptance model (TAM). Results: Study I. Most referred patients fulfilled the referral criteria. However, of those treated and discharged from the trauma unit, 8 out of 10 children also fulfilled the criteria for referral. In Study II, the usability test and questionnaire showed that the doctors perceived the Vula app to be easy to use and useful. However, some problems were identified mainly related to navigation, and understanding of meaning of icon’s terminologies. Some users also said that predefined options in the app limited their ability to express their clinical findings. Study III revealed several barriers and promotors for successful integration of the Vula app. Promotors included the already prevalent practice of using smartphones, that it was easy to use and the learning opportunity that the app offered. Barriers to successful integration included; inconsistent use of the app across specialities and lack of information, policies and infrastructure to support the users. In Study IV, almost all health professionals used smartphones in their work and were positive towards using Vula. Access to wireless internet and access to smartphones was mentioned to be a barrier. Conclusions: Identifying patients with burns who are in need of referral is challenging. Mobile teleconsultations is therefore a way of assisting with diagnosis and initial management. The Vula app was easy to use and perceived to be useful, but several barriers need to be addressed for the app to become an integrated part of the practice in emergency care. In settings with considerably fewer resources, these barriers will likely be even more important to address prior to implementation

Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe