Designing a Mobile Device for Pre-hospital Care

Peer reviewedPreprin

Improving Antibiotic Resistant Infection Transmission Situational Awareness in Enclosed Facilities with a Novel Interface Design for Tactical Biosurveillance

The implementation of the Electronic Health Record to substantially improve the practice of medicine has not fully reached its projected potential partly due to many barriers to its adoption. There is growing evidence that one of the reasons for the delay in the adoption of EHR has been due to the negative impact of current EHRs on the clinician-patient interaction, clinician workflow and communications. This research studies the usability of the Electronic Health Record for clinicians involved in cardiac care by evaluating various clinician-patient interaction workflows. The aim of the study is to identify inefficiencies by examining the similarities and differences among various clinician-patient interaction workflows. This research is presented as “work in progress”

It is time to talk about people: a human-centered healthcare system

Examining vulnerabilities within our current healthcare system we propose borrowing two tools from the fields of engineering and design: a) Reason's system approach [1] and b) User-centered design [2,3]. Both approaches are human-centered in that they consider common patterns of human behavior when analyzing systems to identify problems and generate solutions. This paper examines these two human-centered approaches in the context of healthcare. We argue that maintaining a human-centered orientation in clinical care, research, training, and governance is critical to the evolution of an effective and sustainable healthcare system

Participatory design:how to engage older adults in participatory design activities

Ongoing advances in mobile technologies have the potential to improve independence and quality of life of older adults by supporting the delivery of personalised and ubiquitous healthcare solutions. The authors are actively engaged in participatory, user-focused research to create a mobile assistive healthcare-related intervention for persons with age-related macular degeneration (AMD): the authors report here on our participatory research in which participatory design (PD) has been positively adopted and adapted for the design of our mobile assistive technology. The authors discuss their work as a case study in order to outline the practicalities and highlight the benefits of participatory research for the design of technology for (and importantly with) older adults. The authors argue it is largely impossible to achieve informed and effective design and development of healthcare-related technologies without employing participatory approaches, and outline recommendations for engaging in participatory design with older adults (with impairments) based on practical experience

What do healthcare professionals need to turn risk models for type 2 diabetes into usable computerized clinical decision support systems? Lessons learned from the MOSAIC project

[EN] Background To understand user needs, system requirements and organizational conditions towards successful design and adoption of Clinical Decision Support Systems for Type 2 Diabetes (T2D) care built on top of computerized risk models. Methods The holistic and evidence-based CEHRES Roadmap, used to create eHealth solutions through participatory development approach, persuasive design techniques and business modelling, was adopted in the MOSAIC project to define the sequence of multidisciplinary methods organized in three phases, user needs, implementation and evaluation. The research was qualitative, the total number of participants was ninety, about five-seventeen involved in each round of experiment. Results Prediction models for the onset of T2D are built on clinical studies, while for T2D care are derived from healthcare registries. Accordingly, two set of DSSs were defined: the first, T2D Screening, introduces a novel routine; in the second case, T2D Care, DSSs can support managers at population level, and daily practitioners at individual level. In the user needs phase, T2D Screening and solution T2D Care at population level share similar priorities, as both deal with risk-stratification. End-users of T2D Screening and solution T2D Care at individual level prioritize easiness of use and satisfaction, while managers prefer the tools to be available every time and everywhere. In the implementation phase, three Use Cases were defined for T2D Screening, adapting the tool to different settings and granularity of information. Two Use Cases were defined around solutions T2D Care at population and T2D Care at individual, to be used in primary or secondary care. Suitable filtering options were equipped with "attractive" visual analytics to focus the attention of end-users on specific parameters and events. In the evaluation phase, good levels of user experience versus bad level of usability suggest that end-users of T2D Screening perceived the potential, but they are worried about complexity. Usability and user experience were above acceptable thresholds for T2D Care at population and T2D Care at individual. Conclusions By using a holistic approach, we have been able to understand user needs, behaviours and interactions and give new insights in the definition of effective Decision Support Systems to deal with the complexity of T2D care.The research leading to these results has received funding from the European Commission under the European Union's Seventh Framework Programme (FP7/2007-2013) grant agreement no 600914.Fico, G.; Hernandez, L.; Cancela, J.; Dagliati, A.; Sacchi, L.; Martinez-Millana, A.; Posada, J.... (2019). What do healthcare professionals need to turn risk models for type 2 diabetes into usable computerized clinical decision support systems? 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Diabetes Care. 2004;27(9):2262–5.Noble D, Mathur R, Dent T, Meads C, Greenhalgh T. Risk models and scores for type 2 diabetes: systematic review. BMJ. 2011;343:d7163.Abbasi A, Peelen LM, Corpeleijn E, van der Schouw YT, Stolk RP, Spijkerman AM, et al. Prediction models for risk of developing type 2 diabetes: systematic literature search and independent external validation study. BMJ. 2012;345:e5900.Zarkogianni K, Litsa E, Mitsis K, Wu P, Kaddi CD, Cheng C, Wang MD, Nikita KS. A review of emerging technologies for the management of diabetes mellitus. IEEE Trans Biomed Eng. 2015;62(12):2735–49.Garg AX, Adhikari NK, McDonald H, Rosas-Arellano M, Devereaux PJ, Beyene J, Sam J, Haynes RB. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review. JAMA. 2005;293(10):1223–38.Roshanov PS, et al. 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How Do Clinical Information Systems Affect the Cognitive Demands of General Practitioners?: Usability Study with a Focus on Cognitive Workload

oai:ojs.hijournal.bcs.org:article/85Background Clinical information systems in the National Health Service do not need to conform to any explicit usability requirements. Poor usability can increase the mental workload experienced by clinicians and cause fatigue, increase error rates and impact the overall patient safety. Mental workload can be used as a measure of usability.Objective To assess the subjective cognitive workload experienced by general practitioners (GPs) with their systems. To raise awareness of the importance of usability in system design among users, designers, developers and policymakers.Methods We used a modified version of the NASA Task Load Index, adapted for web. We developed a set of common clinical scenarios and computer tasks on an online survey. We emailed the study link to 199 clinical commissioning groups and 1,646 GP practices in England. Results Sixty-seven responders completed the survey. The respondents had spent an average of 17 years in general practice, had experience of using a mean of 1.5 GP computer systems and had used their current system for a mean time of 6.7 years. The mental workload score was not different among systems. There were significant differences among the task scores, but these differences were not specific to particular systems. The overall score and task scores were related to the length of experience with their present system. Conclusion Four tasks imposed a higher mental workload on GPs: ‘repeat prescribing’, ‘find episode’, ‘drug management’ and ‘overview records’. Further usability studies on GP systems should focus on these tasks. Users, policymakers, designers and developers should remain aware of the importance of usability in system design.What does this study add?• Current GP systems in England do not need to conform to explicit usability requirements. Poor usability can increase the mental workload of clinicians and lead to errors.• Some clinical computer tasks incur more cognitive workload than others and should be considered carefully during the design of a system.• GPs did not report overall very high levels of subjective cognitive workload when undertaking common clinical tasks with their systems.• Further usability studies on GP systems should focus on the tasks incurring higher cognitive workload.• Users, policymakers, and designers and developers should remain aware of the importance of usability in system design.

Usability Study Methodologies of Electronic Health Record Systems: A Systematic Review

This study is a systematic review of literature on electronic health record systems (EHRs) and the evaluation methods performed to study their usability. The purpose was to identify and review the extent of usability testing methods in their respective clinical environments. Full text review was completed for 121 of 753 titles intentionally identified, and 70 final articles were included. The majority of methodologies reviewed were well established in HCI and the most common was the questionnaire. There was a wide range of study designs in terms of user populations (physicians, nurses, pharmacists, nurse practitioners, physical therapists and others), clinical settings (inpatient and outpatient, ambulatory, pediatric, intensive care units, and others), testing time (pre-implementation or post), and qualitative data analysis. Chosen methodologies and study designs closely depended on study goals, but all of them had large implications for the future of quality healthcare and how to achieve it.Master of Science in Information Scienc

Aiding Difficult and High-Stakes Medical Decision Making - Research on Parental Tracheostomy Decisions for Critically Ill Children

This dissertation illustrated the multiple approaches necessary to improving decision making in applied settings. It consists of three studies that aimed to understand high-stakes pediatric tracheostomy decisions and aid parents’ abilities to make these decisions. Chapter 1 involved an interview study of parents who had recently made a tracheostomy decision for their critically ill child. We found that parents were stressed and worried about future outcomes. They sought and desired information and emotional support for making this difficult decision. Despite these efforts, there seemed to exist opportunities to improve their understanding and forecasting of long-term challenges of a tracheostomy placement. Based on the literature of forecasting errors and narrative-form communication, Chapter 2 involved a survey experiment to test a possible intervention approach. It showed that narratives describing challenges that affect the child’s and/or the family’s quality of life from the point of view of parents who had already experienced them reduced parents’ tendency to choose tracheostomy. The effect was particularly strong when the narratives focused on challenges in the child’s quality of life. These narratives also led to less optimistic forecasting. Based on findings from Chapters 1 and 2, Chapter 3 presented a user-centered design process used to create education materials that were designed to help parents understand major challenges in life after a tracheostomy placement. This dissertation extends the literature on using narrative-form communication to help decision makers anticipate future experiences and reduce forecasting errors. It also demonstrates the multiple types of research needed to develop educational communication that is ready for implementation in clinical settings.PHDPsychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/162973/1/haoyangy_1.pd

Análise da aplicação do design centrado no usuário para melhorias de usabilidade de uma incubadora neonatal.

Visando a competitividade do mercado atual as empresas buscam cada dia mais a satisfação de seus consumidores. Para isso, tornam-se necessárias técnicas que possam ser utilizadas no desenvolvimento de seus produtos focando, principalmente, nas necessidades de seus clientes. Dentre elas destaca-se o Design Centrado no Usuário (DCU), uma filosofia que se baseia nas necessidades e nos interesses dos usuários para garantir o sucesso do produto. No contexto do desenvolvimento de equipamentos médicos é ainda mais importante o envolvimento dos usuários para garantir o desenvolvimento de produtos eficazes e livres de erros. Porém, a abordagem do DCU não é muito utilizada na prática, sendo necessário o desenvolvimento de estudos práticos de sua aplicação que seja a base para novos estudos. Dessa forma, esta pesquisa teve como objetivo a aplicação da abordagem do DCU para melhoria da usabilidade de um equipamento eletromédico, mais especificamente, uma incubadora neonatal. O estudo pode ser caracterizado como uma pesquisa-ação, sendo possível identificar grande semelhança entre suas etapas e do DCU. Para condução da pesquisa foram feitos testes de usabilidade, aplicados os questionários QUIS e SUS, realizadas entrevistas semiestruturadas e observação direta. Com o envolvimento dos usuários, foi possível identificar pontos de melhoria para a incubadora e após a implementação das mudanças, foi possível obter a melhoria da usabilidade do novo conceito