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Comp 15 - Usability and Human Factors

Learn about key usability concepts for Electronic Health Records (EHRs) to improve efficiency and reduce cognitive load. Explore examples and guidelines for user-friendly EHR design. Boost productivity and user satisfaction in healthcare settings.

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Comp 15 - Usability and Human Factors

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  1. Comp 15 - Usability and Human Factors Unit 6b - Electronic Health Records and Usability This material was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000003.

  2. Usability Concepts and Examples • The slides with black backgrounds following are courtesy of Dr. Jeffrey Belden • http://www.toomanyclicks.com Health IT Workforce Curriculum Version 2.0/Spring 2011

  3. Not just spare design Appropriate information density Difference between complex and complicated Simplicity Health IT Workforce Curriculum Version 2.0/Spring 2011

  4. Simplicity Health IT Workforce Curriculum Version 2.0/Spring 2011

  5. How automatically ‘familiar’ and easy to use it feels to the user Different for different contexts EHRs: little time for training Naturalness Health IT Workforce Curriculum Version 2.0/Spring 2011

  6. Naturalness Health IT Workforce Curriculum Version 2.0/Spring 2011

  7. Naturalness Health IT Workforce Curriculum Version 2.0/Spring 2011

  8. External How similar to other applications the user knows (lower learning curve, errors) Internal Same across different situations Consistency Health IT Workforce Curriculum Version 2.0/Spring 2011

  9. Consistency Health IT Workforce Curriculum Version 2.0/Spring 2011

  10. Perception, attention, memory are limited Less attention to system means more available for medical tasks Present all information needed for task on same screen Decrease memory use Recognition, not recall Minimize Cognitive Load Health IT Workforce Curriculum Version 2.0/Spring 2011

  11. Minimize Cognitive Load (cont.) Health IT Workforce Curriculum Version 2.0/Spring 2011

  12. Minimize Cognitive Load (cont.) Same information presented graphically allows easy detection of patterns & perception, not calculation Health IT Workforce Curriculum Version 2.0/Spring 2011

  13. Minimizing Cognitive Load Health IT Workforce Curriculum Version 2.0/Spring 2011

  14. Minimizing Cognitive Load • Minimizing Cognitive Load Health IT Workforce Curriculum Version 2.0/Spring 2011

  15. Minimizing Cognitive load Health IT Workforce Curriculum Version 2.0/Spring 2011

  16. Efficient Interactions • Minimize steps required • Shortcuts for experienced users • Auto tabbing, good defaults, appropriately changeable, limit scrolling (e.g large text/list boxes), prevent switch between keyboard and mouse • Minimize visual search • Minimize distance cursor travels (Fitt’s law) • Both lead to user fatigue & frustration Health IT Workforce Curriculum Version 2.0/Spring 2011

  17. Dashboard Efficiency Health IT Workforce Curriculum Version 2.0/Spring 2011

  18. Clear messages, clear ability to see system status e.g. action had desired result Reverse actions without penalty Facilitate learning Interrupt handling, don’t lose information, work Forgiveness and Feedback Health IT Workforce Curriculum Version 2.0/Spring 2011

  19. Concise, unambiguous, familiar to users Not computer terminology Not upper case except in rare contexts Only commonly understood abbreviations and acronyms Effective Use of Language Health IT Workforce Curriculum Version 2.0/Spring 2011

  20. Effective Use of Language (cont.) Health IT Workforce Curriculum Version 2.0/Spring 2011

  21. Doctor and Patient Health IT Workforce Curriculum Version 2.0/Spring 2011

  22. Appropriate density: Myth: less dense is better Staggers 1997: nursing interface had more efficiency/lower errors with more density Key is less visual search, organization, drill-down/summarization as appropriate Juxtaposition of related items e.g. INR/coumadin, systolic and diastolic together Effective Information Presentation Health IT Workforce Curriculum Version 2.0/Spring 2011

  23. Effective Info Presentation Health IT Workforce Curriculum Version 2.0/Spring 2011

  24. Information Presentation • Color: use to convey meaning, not decoration • Consistency of color meaning • Use number of colors user can remember • Don’t contradict conventions • e.g. red=danger, stop; green=ok, go • Section 508: 8% of male users are colorblind • Convey color meaning with a secondary method • e.g. underlining Health IT Workforce Curriculum Version 2.0/Spring 2011

  25. Color Meanings (US) Health IT Workforce Curriculum Version 2.0/Spring 2011

  26. Readability • Must be able to scan quickly with high comprehension • 12 point or greater, always >9point • Allow users to change font size • Visual impairments in much of the population • i.e. respect system settings for color, size, font • Sans serif most readable on computer screens • Black on white most readable Health IT Workforce Curriculum Version 2.0/Spring 2011

  27. Preservation of Context • Interruptions abound • Minimize visual interruptions • Direct responsiveness • i.e. user should be able to tell immediately what is happening • Avoid ‘modes’ • e.g. data entry mode v. viewing • Data entry should be directly available if allowed Health IT Workforce Curriculum Version 2.0/Spring 2011

  28. Preservation of Context Health IT Workforce Curriculum Version 2.0/Spring 2011

  29. Medication, Weight, and BP Health IT Workforce Curriculum Version 2.0/Spring 2011

  30. New Developments in Usability • HIMSS released a report February 8th, 2011 • Promoting usability in health organizations • Initial steps and progress toward a healthcare usability maturity model • Comprehensive background and plan for promoting usability in organizations, including 3 case examples • 5-stage model: • Unrecognized • Preliminary • Implemented • Integrated • Strategic Health IT Workforce Curriculum Version 2.0/Spring 2011

  31. Stages of Usability with Respect to Organizational Processes Health IT Workforce Curriculum Version 2.0/Spring 2011

  32. Common Methods for Launching Usability in Organizations • “Wake-up Calls” • Critical incidents that start a change • Individual infiltration methods • Slow talking to various teams, user groups, managers • Finding internal champions • Can be at any level, but usability must be presented as an advantage for the organization’s mission • e.g. efficiency, patient safety, effectiveness • Using external experts as a catalyst • Can be useful, and faster than developing internal expertise Health IT Workforce Curriculum Version 2.0/Spring 2011

  33. Common Methods of Expanding Usability within Organizations Health IT Workforce Curriculum Version 2.0/Spring 2011

  34. Usability Overview Health IT Workforce Curriculum Version 2.0/Spring 2011

  35. Basic methods Health IT Workforce Curriculum Version 2.0/Spring 2011

  36. Continuum of Usability Health IT Workforce Curriculum Version 2.0/Spring 2011

  37. The First Cars Health IT Workforce Curriculum Version 2.0/Spring 2011

  38. Cars From the Fifties Health IT Workforce Curriculum Version 2.0/Spring 2011

  39. Modern Cars Health IT Workforce Curriculum Version 2.0/Spring 2011

  40. Rotary Phone Health IT Workforce Curriculum Version 2.0/Spring 2011

  41. First Cellular Phone Health IT Workforce Curriculum Version 2.0/Spring 2011

  42. Phones Today Health IT Workforce Curriculum Version 2.0/Spring 2011

  43. Resources • Research‐Based Web Design & Usability Guidelines • http://www.usability.gov/pdfs/guidelines.html • Ui-patterns.com • http://www.ui-patterns.com • Mscui.net • Open source standards for medical information display created by National Health Service (Britain) through a rigorous process • http://mscui.net • Joint Commission: official ‘Do Not Use’ abbreviations list: • www.jointcommission.org/NR/rdonlyres/2329F8F5-6Ec5-4E21-B932-54B2B7D53F00/0/dnu_list.pdf • Too Many Clicks • http://www.toomanyclicks.com • Discusses EMR usability, author is Dr. Jeffrey Belden Health IT Workforce Curriculum Version 2.0/Spring 2011

  44. Resources (cont.) • Great YouTube video with summary of color theory and application to screen design! • http://www.youtube.com/xperpetualmotion • http://www.the-hospitalist.org/details/article/972753/Health_IT_Hurdles.html • Physician understanding, hospital compatibility among many concerns: • http://www.kevinmd.com/blog/2010/09/health-usability-matters-patients.html#comments • Usability Resources Toolkit: • http://www.stcsig.org/usability/resources/toolkit/toolkit.html Health IT Workforce Curriculum Version 2.0/Spring 2011

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