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Usability and Human Factors

Usability and Human Factors. Unit 6b Electronic Health Records and Usability. Usability Concepts and Examples. The slides with black backgrounds following are courtesy of Dr. Jeffrey Belden http://www.toomanyclicks.com. Not just spare design Appropriate information density

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Usability and Human Factors

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  1. Usability and Human Factors Unit 6b Electronic Health Records and Usability

  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 1.0/Fall 2010

  3. Not just spare design Appropriate information density Difference between complex and complicated Simplicity Health IT Workforce Curriculum Version 1.0/Fall 2010

  4. Simplicity Health IT Workforce Curriculum Version 1.0/Fall 2010

  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 1.0/Fall 2010

  6. Naturalness Health IT Workforce Curriculum Version 1.0/Fall 2010

  7. Naturalness Health IT Workforce Curriculum Version 1.0/Fall 2010

  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 1.0/Fall 2010

  9. Consistency Health IT Workforce Curriculum Version 1.0/Fall 2010

  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 1.0/Fall 2010

  11. Organize by meaningful relationships Decrease excessive navigation Transparency: Don’t make the user wonder “How do I? Where is…?”, “What does this do..?” Adequate cues for data entry Perception, not computation e.g. visual display Minimize Cognitive Load (cont.) Health IT Workforce Curriculum Version 1.0/Fall 2010

  12. Minimize Cognitive Load Same information presented graphically allows easy detection of patterns & perception, not calculation Health IT Workforce Curriculum Version 1.0/Fall 2010

  13. Minimizing Cognitive Load Health IT Workforce Curriculum Version 1.0/Fall 2010

  14. Minimizing Cognitive Load • Minimizing Cognitive Load Health IT Workforce Curriculum Version 1.0/Fall 2010

  15. Minimizing Cognitive Load Health IT Workforce Curriculum Version 1.0/Fall 2010

  16. Minimizing Cognitive load Health IT Workforce Curriculum Version 1.0/Fall 2010

  17. 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 1.0/Fall 2010

  18. Dashboard Efficiency Health IT Workforce Curriculum Version 1.0/Fall 2010

  19. 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 1.0/Fall 2010

  20. 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 1.0/Fall 2010

  21. Indicate clearly further information e.g. ellipsis… JCAHO has list of forbidden abbreviations (can cause errors) Presentation of structured terminology is complex, area of research Structured terms used for many functions: DS, eliminating redundancy, admin/reporting, identify clinical relationships, etc. Effective Use of Language (cont.) Health IT Workforce Curriculum Version 1.0/Fall 2010

  22. Doctor and Patient Health IT Workforce Curriculum Version 1.0/Fall 2010

  23. 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 1.0/Fall 2010

  24. Effective Info Presentation Health IT Workforce Curriculum Version 1.0/Fall 2010

  25. 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 1.0/Fall 2010

  26. Red: Stop, Hot, Danger, Error, Extreme Warning, Severe Alert, Emergency, Alarm Yellow: Caution, Potential or Mild Warning, Requires Attention, Slow, Moderate Alert Green: Go, Safe, Normal, Good, Proceed Blue: Cold, Advisory Color Meanings (US) Health IT Workforce Curriculum Version 1.0/Fall 2010

  27. 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 1.0/Fall 2010

  28. 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 1.0/Fall 2010

  29. Preservation of Context Health IT Workforce Curriculum Version 1.0/Fall 2010

  30. Medication, Weight, and BP Health IT Workforce Curriculum Version 1.0/Fall 2010

  31. Don't listen to the executives Listen to the users Don't listen to what the say Listen to what they do Don't give them what they ask for Give them what they need Basic methods Health IT Workforce Curriculum Version 1.0/Fall 2010

  32. Meaningful Has personal significance Pleasurable Memorable experience worth sharing Convenient Super easy to use, works like I think Usable Can be used without difficulty Reliable Is available and accurate Functional (Useful) Works as programmed Continuum of Usability Health IT Workforce Curriculum Version 1.0/Fall 2010

  33. The First Cars Health IT Workforce Curriculum Version 1.0/Fall 2010

  34. Cars From the Fifties Health IT Workforce Curriculum Version 1.0/Fall 2010

  35. Modern Cars Health IT Workforce Curriculum Version 1.0/Fall 2010

  36. Rotary Phone Health IT Workforce Curriculum Version 1.0/Fall 2010

  37. First Cellular Phone Health IT Workforce Curriculum Version 1.0/Fall 2010

  38. Phones Today Health IT Workforce Curriculum Version 1.0/Fall 2010

  39. 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 1.0/Fall 2010

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