Building the Science of Healthcare Public Reporting: Integrating Anecdotal Information to Enhance Sensemaking

Anecdotal information about a healthcare consumers\u27 interaction with care providers and hospital facilities is becoming increasingly available to the public in the form of YouTube videos and as discussion posts on peer-support groups. This form of information can potentially jeopardize the utility of reports generated by Federal entities as it potentially diverts consumer attention from more reliable measures of quality. This dissertation investigates how a health consumer\u27s choice of care is influenced by anecdotal information on the care process available on YouTube. This research then investigates the effect of information presentation methods such as narratives and active engagement with quality metrics to support the consumer\u27s ability to comprehend public report information. An initial study investigated the characteristics of information healthcare consumers are searching for on a peer-support group. By analyzing the discussions available on the support community of a major ovarian cancer support group, the Ovarian Cancer National Alliance (OCNA), this study investigated the type of information that newly diagnosed ovarian cancer patients and their supporters seek. Using content analysis, 206 publicly available discussions exchanged on OCNA were analyzed by two researchers. Each discussion point was classified into one of the three broad themes that emerged: ovarian cancer-specific, treatment-related, or coping information. The discussion points were further analyzed using a multinomial logit model to predict the type of the desired information based on the role of the person looking for the information, the disease phase in which the information was sought, the emotional status of the information seeker, and the stage of the cancer. Treatment-related material was the most sought-after information by patients, while coping information was most sought by supporters. When forum posts were negative in tone, the information seekers were more likely to be looking for ovarian cancer-specific information than either treatment-related information or coping information. The second study investigated the effect of the role of the sequence in which such public report statistics and anecdotal information are viewed by health consumers during the sensemaking process. The study used the scenario of a patient looking for health facility-related information and employed a 2 (anecdotal information presented as videos supporting and contradicting public report information) * 2 (phase of introduction of anecdotal information: early, late) between-subjects experimental design. The results found that when the phase of introduction of anecdotal information changed from early to late, and when the anecdotal information contradicted the public reports, the probability of choosing the correct facility changed from 0.41 to 0.69. The probability of choosing the correct facility was reduced by more than half, changing from 0.85 to 0.41, when contradicting, rather than supporting, anecdotal information was presented before the public reports. Participants placed significant emphasis on this initial information and found it difficult to change their initial perceptions when presented with the more reliable public reports. The third study investigated ways to enhance consumer understanding by integrating standardized quality metrics with anecdotal information using user experience design methodologies. Two-hundred individuals participated in this study. This study employed a 2 (public report information presented in the standard way, presented within an anecdote) * 2 (engagement with each quality metric: none, active) between-subjects experimental design. The results of the study found that the probability of choosing the correct facility changes from 0.71 to 0.88 when information was presented within a narrative rather than with the standard public report format. A final study evaluated whether the influential nature of inaccurate anecdotal videos could be attenuated by presenting public report information within a narrative with active engagement. The study used the scenario of a patient looking for dialysis facility-related information and employed between-subjects experimental design - inaccurate anecdotal information was presented either early or late in the sensemaking process. Ninety-eight individuals participated in the study. The results found no significant differences in the choice of the dialysis facility and level of confidence in the choice. Given that narratives have the power to impact choice and comprehension, there exists a need to conduct further investigation to develop comprehensive guidelines for the presentation of narratives that support the use of public report information

Remote Usability Testing - A New Approach Facilitated By Virtual Worlds

Synchronous remote usability testing, involves a facilitator conducting a usability test in real time, interacting with a participant who is remote. This study proposes a new methodology for conducting these studies using a three-dimensional virtual world, Wonderland, and compares it with two other commonly used synchronous usability test methods: the traditional lab approach and WebEx, a web-based conferencing and screen sharing approach. The study involved 48 participants in total, 36 test subjects and 12 test facilitators. These 36 were equally divided among the three environments with the 12 test facilitators being paired with one participant in each of the environments. The participants completed 5 tasks on an e-commerce website. The three methodologies were compared with respect to the dependent variables, the time taken to complete the tasks; the usability defects identified; the severity of these usability issues; and the subjective ratings from the NASA-TLX, the presence and post-test subjective questionnaires. Most importantly, the three methodologies agreed closely in terms of the total number defects identified, number of high severity defects identified and the time taken to complete the tasks. However, there was a significant difference in the workload experienced by the test participants and facilitators, with the traditional lab condition being the least and the Wonderland and the WebEx conditions being almost the same. It was also found that both test participants and test facilitators experienced better involvement and immersive experiences in the Wonderland condition, than the WebEx condition and almost the same for traditional lab condition. The results of this study suggest that participants were productive and enjoyed the Wonderland condition, indicating the potential of a virtual world based approach as an alternative to the conventional approaches

Investigating the Factors Affecting an Older Adult\u27s Dental Care Provider Choice

The percentage of patients relying on information provided by other patients in form of online reviews over the information from federal agencies as healthcare reports is expected to increase. To increase the use of these healthcare reports, which contains data from a more representative sample, several researchers have suggested incorporating online reviews into these physician comparison websites. Therefore, it’s important to understand the factors in these online reviews that affect the healthcare consumers decisions. To do so, we recruited 310 participants through Qualtrics Research Suite to participate in a 3*2*2*2 within-subjects study. Specifically, we used the dentistry domain to test the effect of the nature of the review, the staff rating, the cleanliness rating and the bedside manner rating on patient\u27s trust in the review, the decision to choose a dentist and confidence in the decision. The findings suggest that nature of the review, the bedside manner rating and the cleanliness rating significantly influence a healthcare consumer’s decision and trust in the information. Since the staff rating does not provide data about the doctor as it focuses on the staff members, it was seen regarded as the least important decision aid. When the review and the ratings were consistent (both high or both low), the participants reported a higher level of trust and confidence in their decision than when this information was inconsistent (e.g., a positive review with low ratings)

Understanding Consumers\u27 Decision Making: Effect of Anecdotal Comments Integrated with Public Reports

Public reports provided by the Centers for Medicare & Medicaid Services provide information on the performance and quality of the healthcare professionals and hospitals, as a way to help consumers make informed decisions about their healthcare choices. However, only limited evidence has been recorded in terms of their use by consumers of healthcare facilities. Report comprehensibility, complexity and inter-face design are some of the barriers that prevent users form using these reports. User engagement can be improved by integrating these reports with patient-generated anecdotal information. However, there has been limited research focused on the specific role of integrating such feedback into healthcare public reports, and its effect on the consumers’ decision making process. Using a between subjects design, 362 participants completed this study. The independent variables were, anecdotal information: supporting or criticizing facilities presented; and performance of healthcare facility based on public report: below average, average and above average. Participants primarily made their decisions based on public report information. However, when the anecdotal information was negative, they had higher reliance on anecdotal information while making their decisions. These results suggest the importance of providing authentic and moderated anecdotal information

An Investigation of Information Sought by Caregivers of Alzheimer’s Patients on Online Peer-Support Groups

Alzheimer’s caregivers seek social support through online communities to deal with their issues. The research team conducted a content analysis of ALZConnected.org to investigate the characteristics of information searched by caregivers and responses received. Two-hundred fifty posts and related responses were randomly selected and analyzed using a classification tool derived from the analysis of 500 posts and related responses spanning a yearlong period. The Linguistic Inquiry and Word Count (LIW C) generated an average tone rating of 25.94 for the posts and 52.69 for the responses. The findings highlighted the caregiver’s need for emotional support (59.6%), and confusion about Alzheimer’s symptoms (12%). Most responses suggested informational resources (40.16%) and advised to seek professional assistance (21.31%). One of the key needs identified to inform future design of an Alzheimer’s Caregiver Forum was a design sensitive to the capabilities of its elder user audience

Task, Usability, and Error Analyses of Ambulance-based Telemedicine for Stroke Care

Past research has established that telemedicine improves stroke care through decreased time to treatment and more accurate diagnoses. The goals of this study were to 1) study how clinicians complete stroke assessment using a telemedicine system integrated in ambulances, 2) determine potential errors and usability issues when using the system, and 3) develop recommendations to mitigate these issues. This study investigated use of a telemedicine platform to evaluate a stroke patient in an ambulance with a geographically distributed caregiving team comprised of a paramedic, nurse, and neurologist. It first determined the tasks involved based on 13 observations of a simulated stroke using 39 care providers. Based on these observational studies, a Hierarchical Task Analysis (HTA) was developed, and subsequently, a heuristic evaluation was conducted to determine the usability issues in the interface of the telemedicine system. This was followed by a Systematic Human Error Reduction and Prediction Approach (SHERPA) to determine the possibility of human error while providing care using the telemedicine work system. The results from the HTA included 6 primary subgoals categorizing the 97 tasks to complete the stroke evaluation. The heuristic evaluation found 123 unique violations to heuristics, with an average severity of 2.38. One hundred and thirty-one potential human errors were found with SHERPA, the two most common being miscommunication and selecting an incorrect option. Several recommendations are proposed, including improvement of labeling, consistent formatting, rigid or suggested formatting for data input, automation of task structure and camera movement, and audio/visual improvements to support communication

CA2VES Digital Learning Solutions

In this video presentation, Dr. Kapil Chalil Madathil introduces the Center for Aviation and Automotive Technology Education using Virtual E-Schools (CA2VES) and discusses their virtual reality modules that support advanced technical education in 2-year colleges. Dr. Chalil Madathil covers topics including the history of VR development, the CA2VES VR simulations, and the many different applications for VR technology in advanced technical education. This video runs for 1:01:01 minutes in length

An empirical study investigating the user acceptance of a virtual conversational agent interface for family health history collection among the geriatric population

Critical for the early diagnosis of genetic disorders, a Family Health History (FHx) can be collected in several ways including electronic FHx tools, which aid easy editing and sharing by linking with other information management portals. The user acceptance of such systems is critical, especially among older adults experiencing motor and cognitive issues. This study investigated two types of FHx interfaces, standard and Virtual Conversational Agent (VCA), using 30 young (between 18 and 30) and 24 older participants (over 60). Workload, usability and performance data were collected. Even though participants required less time to complete three of five tasks on the standard interface, the VCA interface performed better in terms of subjective workload and usability. Additionally, 67% of the older adults preferred the VCA interface since it provided context-based guidance during the data collection process. The results from this study have implications for the use of virtual assistants in FHx and other areas of data collection