some usability issues in healthcare interactive systems

1 World Usability Day – Louvain-la-Neuve, 8 November 2007

Some Usability Issues inHealthcare Interactive Systems

Jean Vanderdonckt

Université catholique de Louvain (UCL)Louvain School of Management (LSM)

Information Systems Unit (ISYS)Belgian Laboratory of Computer-Human Interaction (BCHI)

http://www.isys.ucl.ac.be/bchi


BCHI:Belgian Lab. of Computer-Human Interaction

• Couvrir le cycle de vie de développement de l’interface homme-machine d’un système– Multi-device, multi-modal, multi-user

• Projets régionaux– Arthur, Destine, ReQuest, Salamandre (Région Wallonne)– DefiMedia, TEC Namur-Luxembourg

• Projets nationaux– Dexia, Namahn (Fortis), Office du Tourisme, Smals-MvB

• Projets européens– FP4 (Syrecos), FP5 (Cameleon), FP 6 (Similar), FP 7 (Human)

• Projets internationaux– Harmonia (USA), RedWhale Soft Corp. (USA), OASIS


Presentation outline

• Our working definition of usability• Case study #1: Abrumet web portal• Case study #2: Arthur multi-platform system• Conclusion


What is usability? (1/3)

• Ergonomics in general– Goal: to design any system so that it can be used effectively and

efficiently by a given population of users– Means: to rely on efficient work procedures respecting health and

well-being of end users• Software ergonomics = Usability• Our working definition

– Utility• Adequacy of user interface with respect to functional

requirements of the system• Is independent of the end user

– Usability• Adequacy of user interface with respect to operational needs

of the end user• Is dependent of the end user



• Utilité– assure un grand nombre de fonctions utiles pour l'utilisateur, pour un traitement de

texte :• créer une table des matières• avoir un correcteur orthographique• déplacer des blocs d'un endroit à un autre

• Utilisabilité :– facilité d'usage– accepte les erreurs de l'utilisateur– offre la possibilité de les corriger– ne bloque pas en cas d'erreur– facilité d'accès aux fonctions– commandes, messages, icônes compréhensibles

• Certains logiciels sont riches en fonctions (utilité), mais difficiles à exploiter (utilisabilité)

• Utilité :– les utilisateurs intensifs préfèrent parfois utiliser un outil riche, mais difficile à utiliser

plutôt qu'un outil facile à utiliser, mais pauvre• Utilisabilité :

– pour les utilisateurs novices ou épisodiques, la facilité d'emploi est un critère prioritaire– l'attitude de l'utilisateur vis-à-vis de l'outil dépend de son interface



• Is this web page usable?


Case study #1: Abrumet web portal

• What is ABRUMET?– ASBL located in Brussels– Main project:

• To introduce a regional network between hospitals in Brussels• To facilitate exchange of medical patient data across hospitals

– Members• CHIREC, Clinique de l’Europe, Hopital Erasme, C. de Paepe,

Sanatia, Saint Jean, UCL Saint Luc, UZ Brussel• IRIS


ABRUMET PORTAL

ARF X

IdentifAdmin

SUMEHR

ATRs

Keys

AMPIAccesscontrol

AAA

Physician G2: Access granted

B HOSPITALABRUMETOFFICE

A HOSPITAL

Medical recordof patient Xin A Hospital

A Hospital Physicians B Hospital Physician H

1: Physicianlogging in

3: Physicianlogged in

4: Search patient X in AMPI

5: Patient X is in AMPIand has a medical record in A

7: Access themedicalrecord ofpatient X in A

6: Request for accessingthe medical record(breaking glass)

8:Medical record of patient X in A accessed by H

10:Notification of breaking glassto ABruMeT

Generalist Physician G

9:Notification of breaking glass by H

Administration agent

Case study #1: Abrumet web portal

• Example: Access the Abrumet Medical Date of a Patient by a Hospital Physician in Emergency (Breaking Glass)

[Abrumet 2006]


Browse ABruMeT Medical Data (AMD)

ABruMeT Portal Enter Text

Home

Search : EN –

Browse AMD screen (1/6)

Help

FR – NL

Advanced search

Register Contact Site map

Privacy policy– Terms and conditions–

Date: 04/12/23Welcome Dr. Jean Dupont

Go

Select a patient to browse her AMD or search a patient:

Browse Cancel

By SIS card

Enter TextFirstname:

Lastname:

By search criteria

City:

Zip code:

Enter Text

Enter No

Bertrand ArmandAlice ChevalierPatrick DupontFlorence RigoFrançoise RigoAlain TérieurAlex TérieurJan VandierendonckFrans Van Piperzeel

By phonetic search (Soundex):

Enter Text

Create an ABruMeT References File (ARF)

Update my profile

Approval management

Renew my approvalTerminate my approval

Patient management

Insert an ABruMeT Therapeutic Relation (ATR)Delete an ABruMeT Therapeutic Relation (ATR)

Enter a Breaking glass procedure

Electronic mail

Send an e-mail to a hospital

Access e-mailsManage e-mail preferences

Access an ABruMeT References File (ARF)

Transfer patients momentarily

Send an e-mail to an AAP

Add an AAP in my group

Renew an ABruMeT Therapeutic Relation (ATR)

[Abrumet 2006]




Home

Search : EN –


Help

FR – NL

Advanced search




Go

AMD of Florence Rigo:

Personal information SUMEHR Medical data at Hospital A Medical data at Hospital B

Address

Enter TextEnter Text

Lastname:

Legal address:

Street: Enter Text No:

City: Zip code:

Enter No

Enter Text Enter No

Phone number: Enter Text Mobile number: Enter Text

E-mail: Enter Text

AddressResidence address:Street: Enter Text No:

City: Zip code:

Enter No

Enter Text Enter No

NISS number: Enter Text SIS Card number: Enter Text

SIS Card validity: Enter Text

Contact person: Enter Text

Mutuality Affiliation: Enter Text Mutuality ID: Enter No

Mutuality period: Start date: End date: Enter NoEnter No

Update Cancel


Update my profile

Approval management


Patient management



Electronic mail








[Abrumet 2006]




Home

Search : EN –


Help

FR – NL

Advanced search




Go



Update Cancel

Adverse drug reaction: Enter Text

Allergy: Allergie au pollen.

Social risk: Enter Text

Other risks: Enter Text

Global medicaldata manager:

Not to be ressuscitated: Blood transfusion refusal:

Vaccinations: Enter Text

Current medications: Enter Text

Other medical information: Enter Text

Antecedent information: Enter Text


Update my profile

Approval management


Patient management



Electronic mail








History

[Abrumet 2006]




Home

Search : EN –

Browse AMD History screen (4/6)

Help

FR – NL

Advanced search




Go



Update Cancel

Allergies:


Update my profile

Approval management


Patient management



Electronic mail








Return

EventPollen allergy revealedHeavy pollen reactionAcarian allergy

Date02/06/0603/06/0623/08/06

ServiceEmergency care Hospital AEmergency care Hospital ARadiology service Hospital B

PhysicianDr. StamateDr. StamateDr. Radio

[Abrumet 2006]




Home

Search : EN –


Help

FR – NL

Advanced search




Go



Cancel

EventHospital admissionEmergency careEchography

Date02/05/0602/05/0603/05/06

ServiceEmergency careEmergency careRadiology service

PhysicianDr. StamateDr. StamateDr. Radio

Select link

Browse


Update my profile

Approval management


Patient management



Electronic mail








[Abrumet 2006]




Home

Search : EN –


Help

FR – NL

Advanced search




Go



EventEchography

Date03/05/06

ServiceRadiology service

PhysicianDr. Radio

Close Return to AMD

The patient has been admitted to the emergency care with heavy stomach pain, probably after gastro-entiritis. Since the pain persists, an echography revealed the start of an appendicitis.

Attached documents: Plain radiographic image of the abdomen revealing an appendicolithTransverse ultrasound image of the right lower quadrant of the abdomen

Download


Update my profile

Approval management


Patient management



Electronic mail








[Abrumet 2006]




Home

Search : EN –

Documents attached to AMD

Help

FR – NL

Advanced search




Go



EventEchography

Date03/05/06


PhysicianDr. Radio

Close Return to AMD

Attached document: Plain radiographic image of the abdomen revealing an appendicolith (arrow)Create an ABruMeT References File (ARF)

Update my profile

Approval management


Patient management



Electronic mail








[Abrumet 2006]




Home

Search : EN –

Why is it usable?

Help

FR – NL

Advanced search




Go



EventEchography

Date03/05/06


PhysicianDr. Radio

Close Return to AMD


Update my profile

Approval management


Patient management



Electronic mail








[Abrumet 2006]


Physicpression de la touche [Ctrl]+ [D]suivie de [6]

AlphabeticD, 6

Lexicalcommande [DELETE], chiffre [6]

SyntacticDELETE 6

Semantic Supprimer un certain nombre de lignes

Pragmatic Supprimer les 6 lignes du texte édité formant le paragraphe

Usability decomposed by Linguistic level

Task

[Nielsen86]

Supprimer un paragraphe de ma lettre




Home

Search : EN –

Why is it usable?

Help

FR – NL

Advanced search




Go



EventEchography

Date03/05/06


PhysicianDr. Radio

Close Return to AMD


Update my profile

Approval management


Patient management



Electronic mail








Physical level

Alphabetic levelLexical level

Syntactic level

Semantic level

Pragmatic level


Case study #2: ARTHUR

• What is ARTHUR?– Architecture de Télécommunications des Hôpitaux en Situation

d’Urgence– Projet inter-universitaire (FUNDP, UCL,…)


Multi-platform for Emergency

[Amouh et al.,2005]



• Three platforms– Pocket PC– Desktop PC– Wall Screens



• Model and method– Design the reference screen first– Refine the others screens later

• By applying graceful degradation• By applying transformation techniques


Graceful degradation

[Florins & Vanderdonckt,2004]


Transformation rules



Add all >>

Add >

<< Remove all

< Remove

>>

>

<<

<

>

<

Group box

Item 1Item 2Item 3Item 4

Item 5Item 6Item 7Item 8

Item 1Item 2Item 3Item 4Item 5Item 6Item 7

Item 1

Item 1

Item 2

Item 3

Item 4

Item 5

Item 6

Item 7


Conclusion

• Usability applyies everywhere– Most known form: web sites– Towards Accessibility of web sites– Towards Healthcare systems

Source: J. Jacko et al., Framework for Usability: healthcare professionals and the Internet


Thank you very much for your attention

For more information and downloading,http://www.isys.ucl.ac.be/bchi

http://www.usixml.orgUser Interface eXtensible Markup Language

http://www.similar.ccEuropean network on Multimodal UIs

Special thanks to all members of the team!

http://www.isys.ucl.ac.be/bchi

http://www.usixml.org/

http://www.similar.cc/

some usability issues in healthcare interactive systems

Technology

abrumet office

abrumet medical date

abrumet web portal example

abrumet web portal case

search patient x

approval patient management

medical record breaking

hospital physician