An Example of an Application of the Semiotic Inspection Method in the Domain of Computerized

Patient Record SystemWeronika Tancredi, Olof Torgersson

Department of Applied ITChalmers University of Technology and University of Gothenburg

ESSIQ AB, Gothenburg, Sweden

Oral presentation at MedInfo2013, August 22 Copenhagen, Denmark

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The System

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A Closer Look• What?

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Study Context• Computerized Patient Record System for dental care

– Widely used by public dental care in Sweden

• Major upgrade caused a lot of confusion

• Evaluation– Work place studies – University of Skövde– Expert evaluation – Chalmers

• Heuristic evaluation x 2• Enhanced cognitive walkthrough• Predictive use error analysis• Semiotic inspection method

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Semiotic Engineering• Clarisse Sieckenius de Souza, 2005

• Focus on signs and their meaning• Interface message from designer to user

– Designers communicate through the interface to users• Communicability

“Here is my understanding of who you are, what I’ve learned you want or need to do, in which preferred ways, and why. This is the system that I have therefore designed for you, and this is the way you can or should use it in order to fulfil a range of purposes that fall within this vision.”

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Semiotic Engineering

• When users do not understand the message a communication breakdown takes place

You do not care about icons, so therefore I use only one

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Semiotic Inspection Method• Analyze 3 types of signs

– (1) Metalinguistic signs– (2) Static signs– (3) Dynamic signs

• Contrastive comparison of results from 1-3– Identify problems & lack of consistency

• Summarize – describe the message– Conclusive appreciation of the quality of the

designer-to-user communication

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Procedure• Observation• Scenario

– Anna is a fifty years old dentist who works in a bigger dental clinic…. Anna has many patients booked for each day and she needs to work quickly to be able to examine and treat the patient as well as to insert the data about the current and future treatment into the CPR system…

• Describe tasks to evaluate (10)– Opening the medical record of a specific patient.– Making a new health declaration.– Sending a referral to oral surgery.– …

• Repeated inspection of the signs in all parts

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Sample Findings• Metalinguistic signs

– Busy professionals– Interest in adapting

the system– Extensive instructions

& lack of instructions– …

• Static signs– Irrelevant information– Lack of signifiers– …

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Sample Findings• Dynamic signs

– Assumes users know what to do– No guidance– No indication of order– Lack of feedback– …

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The Communication Message• Users are expected to have advanced digital skills and clinical

knowledge• Assumed order through tabs

– General– Additional info– …– Basic planning

• Some order in toolbars

• Overall inconsistent

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Comparison

HE1 HE2 SIM ECW PUEA0

5

10

15

20

25

30

35

2426

33 33

9

Percentage of unique usability issues

Usability inspection method

Perc

enta

ge o

f ide

ntifi

ed u

sabi

lity

issu

es

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Discussion• Wanted to show problems with flow and wayfinding

• Focus on 3 different types of signs– Helped to reflect on what text, icons etc actually

communicate– Clearly not consistent

• SIM includes manuals etc, interesting aspect• Large system

– Lots of data– Method could give more support

• More about overall quality than other methods but not enough

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Thank you for your attention

Weronika Tancrediw.tancredi@gmail.com

Olof Torgerssonolof.torgersson@ait.gu.se

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