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Designing a useful and usable mobile EMR application through a participatory design methodology: a case study

Robin De Croon, profile picture
Robin De Croon

The document discusses the design of a mobile electronic medical record (EMR) application aimed at aiding general practitioners during house visits using a participatory design methodology. The research emphasizes the importance of identifying functional requirements, user needs, and rapid prototyping to create a usable and effective application. Key challenges addressed include optimizing the application for mobile use and improving the efficiency of data entry and patient information management.

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DESIGNING  A  USEFUL  AND  USABLE   MOBILE  EMR  APPLICATION     THROUGH  A  PARTICIPATORY     DESIGN  METHODOLOGY:    A  CASE  STUDY     ir.  Robin  De  Croon,  dr.  Joris  Klerkx,  prof.  dr.  ir.  Erik  Duval                  http://about.me/robindecroon  &            robin.decroon@cs.kuleuven.be      IEEE  International  Conference  on  Healthcare  Informatics  2014  (ICHI  2014)  
Who  Am  I?   •   Robin  De  Croon   •   Scientific  Researcher   •   Computer  Science  background     •   KU  Leuven  (Belgium)   •   Human  Computer  Interaction   •   Prof.  dr.  ir.  Erik  Duval   •   Dr.  Joris  Klerkx   •   datavislab     •  http://datavislab.org   Saturday  21  February  15   2  
Secure  &  Usable  medical     applications  in  the  cloud  (MAPC)   •   IWT  R&D  company  project    è  “How  can  a  mobile  device  help  general   practioners,  using  context  and  mobile   affordances,  to  maintain  an  electronic  patient   file  on  a  house  visit?   Saturday  21  February  15   3  
Secure  &  Usable  medical     applications  in  the  cloud  (MAPC)   •   IWT  R&D  company  project  à  case  study    è  “How  can  a  mobile  device  help  general   practioners,  using  context  and  mobile   affordances,  to  maintain  an  electronic  patient   file  on  a  house  visit?   Saturday  21  February  15   4  
target  user   Target  Audience   Saturday  21  February  15   5   • General  Practitioners  in  Flanders  (Belgium)   Independent  of:   •   Experience  &  age   •   Individual  or  group  practice   •   ICT-­‐knowledge   •   Current  medical  software   http://marketingyoucanuse.com/wp-­‐content/uploads/2010/12/HittingTarget.jpg  
Methodology:  Participatory  Design   1.  Initial  research   •   existing  research  papers   •   existing  electronic  patient  files  and  applications   2.  Discovery  process   •   initial  questionnaire   •   initial  talks   3.  Rapid  prototyping   •   functional  requirements   •   prototypes  (paper  &  digital)   •   usability  evaluation   Saturday  21  February  15   6   http://farm8.staticflickr.com/7221/7351141086_85640e3c06.jpg   Where  should  I   register   medication?   Spinuzzi,  C.  (2005).  The  methodology  of  participatory  design.  Technical  Communication,  52(August  2004),  163–174.    
Methodology:  Participatory  Design   1.  Initial  research   •   existing  research  papers   •   existing  electronic  patient  files  and  applications   2.  Discovery  process   •   initial  questionnaire   •   initial  talks   3.  Rapid  prototyping   •   functional  requirements   •   prototypes  (paper  &  digital)   •   usability  evaluation   Saturday  21  February  15   7   http://farm8.staticflickr.com/7221/7351141086_85640e3c06.jpg   Where  should  I   register   medication?   Spinuzzi,  C.  (2005).  The  methodology  of  participatory  design.  Technical  Communication,  52(August  2004),  163–174.    
Related  work  (i)   •   Which  information  does  a  general  practitioner   need?   •  Abd  Ghani,  M.  K.  (2011).  The  design  of  flexible  Pervasive  Electronic  Health  Record  (PEHR).  In  2011  IEEE  Colloquium  on  Humanities,   Science  and  Engineering  (pp.  249–254).  IEEE.  doi:10.1109/CHUSER.2011.6163727   •  Plancke,  L.  (2013).  Het  thuisdossier  voor  de  wachtarts  :  stand  van  zaken.  Universiteit  Gent.  Retrieved  from  http://lib.ugent.be/fulltxt/ RUG01/002/002/163/RUG01-­‐002002163_2013_0001_AC.pdf   •   Mobile  applications  in  the  medical  world   •  Fischer,  S.   (2002).   Handheld  Computing   in   Medicine.  Journal   of   the  American   Medical   Informatics  Association,   10(2),   139–149.   doi: 10.1197/jamia.M1180   •  Ebell,   M.   H.,  Gaspar,   D.   L.,   &   Khurana,   S.   (1997).   Family   physicians’   preferences   for   computerized   decision-­‐support   hardware   and   software.  The  Journal  of  Family  Practice,  45(2),  137–141.   •  Page,  T.  (2013).  Usability  of  text  input  interfaces  in  smartphones.  J.  of  Design  Research,  11(1),  39.  doi:10.1504/JDR.2013.054065   •  Kelly,  J.  (2000).  Going  wireless.  Hospitals  &  Health  Networks  /  AHA,  74(11),  65–66,  68.  doi:10.1038/sj.bdj.2011.41   •  Nyssen,  M.,  Thomeer,  K.,  &  Buyl,  R.  (2010).  Generating  and  transmitting  ambulatory  electronic  medical  prescriptions.  In  P.  Bamidis  &  N.   Pallikarakis  (Eds.),  XII  Mediterranean  Conference  on  Medical  and  Biological  Engineering  and  Computing  2010  (pp.  890–892).  Springer   Berlin  Heidelberg.  doi:10.1007/978-­‐3-­‐642-­‐13039-­‐7_225   •  Chen,  Y.,  &  Atwood,  M.  E.  (2010).  Challenges  of  Mobile  Clinical  System  Design:  What  do  Nurses  Think?  In  2010  43rd  Hawaii  International   Conference  on  System  Sciences  (pp.  1–9).  IEEE.  doi:10.1109/HICSS.2010.99   •  Grossman,  J.   M.,  Gerland,  A.,   Reed,   M.  C.,   &   Fahlman,  C.   (2007).   Physicians’   experiences   using   commercial   e-­‐prescribing   systems.   Health  Affairs  (Project  Hope),  26(3),  w393–404.  doi:10.1377/hlthaff.26.3.w393   Saturday  21  February  15   8  
Related  work  (ii)   •   Usability  problems  with  medical  software   •  Grossman,  J.  M.,  Gerland,  A.,  Reed,  M.  C.,  &  Fahlman,  C.  (2007).  Physicians’  experiences  using  commercial  e-­‐ prescribing  systems.  Health  Affairs  (Project  Hope),  26(3),  w393–404.  doi:10.1377/hlthaff.26.3.w393   •  Schumacher,  R.  M.,  Berkowitz,  L.,  Abramson,  P.,  &  Liebovitz,  D.  (2010).  Electronic  Health  Records:  Physician’s   Perspective  on  Usability.  Proceedings  of  the  Human  Factors  and  Ergonomics  Society  Annual  Meeting,  54(12),   816–820.  doi:10.1177/154193121005401202   •  Van  der  Sijs,  H.,  Aarts,  J.,  Vulto,  A.,  &  Berg,  M.  (2006).  Overriding  of  drug  safety  alerts  in  computerized  physician   order   entry.   Journal   of   the   American   Medical   Informatics   Association   :   JAMIA,   13(2),   138–47.   doi:10.1197/ jamia.M1809   •  Williams,  W.  G.,  &  Morgan,  J.  M.  (1995).  The  clinician-­‐information  interface.  Medinfo.  MEDINFO,  8  Pt  1,  801–5.   Retrieved  from  http://www.ncbi.nlm.nih.gov/pubmed/8591334   •  Devine,  E.  B.,  Hollingworth,  W.,  Hansen,  R.  N.,  Lawless,  N.  M.,  Wilson-­‐Norton,  J.  L.,  Martin,  D.  P.,  …  Sullivan,  S.  D.   (2010).   Electronic   prescribing   at   the   point   of   care:   a   time-­‐motion   study   in   the   primary   care   setting.   Health   Services  Research,  45(1),  152–71.  doi:10.1111/j.1475-­‐6773.2009.01063.x   •  Han,   S.,   Harkke,   V.,   Mustonen,   P.,   Seppanen,   M.,   &   Kallio,   M.   (2004).   Mobilizing   Medical   Information   and   Knowledge:  Some  Insights  from  a  Survey.  Retrieved  from  http://aisel.aisnet.org/ecis2004/69/   Saturday  21  February  15   9  
Related  work  (iii)   •   Participatory  design  in  the  medical  domain   •  Tang,  K.,  Hirano,  S.,  Cheng,  K.,  &  Hayes,  G.  (2012).  Balancing  Caregiver  and  Clinician  Needs  in  a  Mobile   Health   Informatics  Tool   for   Preterm   Infants.   In   Proceedings   of   the   6th   International   Conference   on   Pervasive   Computing   Technologies   for   Healthcare   (pp.   1–8).   IEEE.   doi:10.4108/icst.pervasivehealth. 2012.248716   •  Hwang,  A.,  Truong,   K.,   &   Mihailidis,  A.   (2012).  Using   participatory   design   to   determine   the   needs   of   informal  caregivers  for  smart  home  user  interfaces.  In  Proceedings  of  the  6th  International  Conference   on   Pervasive   Computing   Technologies   for   Healthcare   (pp.   41–48).   IEEE.   doi:10.4108/ icst.pervasivehealth.2012.248671   •  Miller,  A.,  Pater,  J.,  &  Mynatt,  E.  (2013).  Design  Strategies  for  Youth-­‐Focused  Pervasive  Social  Health   Games.  In  Proceedings  of  the  ICTs  for  improving  Patients  Rehabilitation  Research  Techniques.  IEEE.  doi: 10.4108/pervasivehealth.2013.252081   •   Using  context   •  Stocky,  T.,  Faaborg,  A.,  &  Lieberman,  H.  (2004).  A  commonsense  approach  to  predictive  text  entry.  In   Extended   abstracts   of   the   2004   conference   on   Human   factors   and   computing   systems   -­‐  CHI   ’04   (p.   1163).  New  York,  New  York,  USA:  ACM  Press.  doi:10.1145/985921.986014   •  Abowd,  G.  D.,  Dey,  A.  K.,  Brown,  P.  J.,  Davies,  N.,  Smith,  M.,  &  Steggles,  P.  (1999).  Towards  a  Better   Understanding   of   Context   and   Context-­‐Awareness.   Ubiquitous   Computing/Handheld   and   Ubiquitous   Computing  (pp.  304–307).  doi:10.1007/3-­‐540-­‐48157-­‐5_29   Saturday  21  February  15   10  
Methodology:  Participatory  Design   1.  Initial  research   •   existing  research  papers   •   existing  electronic  patient  files  and  applications   2.  Discovery  process   •   initial  questionnaire   •   initial  talks   3.  Rapid  prototyping   •   functional  requirements   •   prototypes  (paper  &  digital)   •   usability  evaluation   Saturday  21  February  15   11   http://farm8.staticflickr.com/7221/7351141086_85640e3c06.jpg   Where  should  I   register   medication?   Spinuzzi,  C.  (2005).  The  methodology  of  participatory  design.  Technical  Communication,  52(August  2004),  163–174.    
Saturday  21  February  15   12   https://www.ehealth.fgov.be/nl/registratie-­‐van-­‐de-­‐medische-­‐softwarepakketten    
Saturday  21  February  15   13  
Where  should  I   register   medication?   Methodology:  Participatory  Design   1.  Initial  research   •   existing  research  papers   •   existing  electronic  patient  files  and  applications   2.  Discovery  process   •   initial  questionnaire   •   initial  talks   3.  Rapid  prototyping   •   functional  requirements   •   prototypes  (paper  &  digital)   •   usability  evaluation   Saturday  21  February  15   14   http://farm8.staticflickr.com/7221/7351141086_85640e3c06.jpg   Spinuzzi,  C.  (2005).  The  methodology  of  participatory  design.  Technical  Communication,  52(August  2004),  163–174.    
Initial  Questionnaire  &  Talks   •   What  kind  of  information  or  material  do  you  carry  with   you  during  house  visits?     •   Do  you  already  use  an  EMR  application  or,  if  not,  what   kinds  of  patient  information  do  you  take  with  you?     •   Which  data  is  entered  in  the  EMR  application  (after  the   house  visits)?     •   How  do  you  prescribe  medicine?     •   Do  you  take  pictures  of  wounds  or  rash?     •   What  kind  of  patients  do  you  normally  treat  during  a   house  visit?     •   …   Saturday  21  February  15   15   https://picasaweb.google.com/100923738088214702616/Omini3d#5456698262314545906   http://goo.gl/Wxh3Gi  (questionnaire,  Dutch)  
Battery   Saturday  21  February  15   16  
Weight   Saturday  21  February  15   17   http://www.elmospa.com/userfiles/image/Varie/forza.png      
No  internet  connection   Saturday  21  February  15   18  
Time  expensive   Saturday  21  February  15   19  
Information  overload   Saturday  21  February  15   20   http://m.c.lnkd.licdn.com/mpr/mpr/p/5/005/061/1de/3cc6bc7.jpg    
Usability   Saturday  21  February  15   21  
Result   •   Patient  data  gets  rarely  registered  on  a  house  visit   •   Patient  data  registered  afterwards  is  error  prone      è  Solution  is  needed!   Saturday  21  February  15   22   http://static.squarespace.com/static/52e99ee6e4b074062a408c89/t/52eb6098e4b008799dcd8d23/1391157403129/3D%20Person%20-­‐%20Magnifing%20Glass-­‐Edited.png    
Methodology:  Participatory  Design   1.  Initial  research   •   existing  research  papers   •   existing  electronic  patient  files  and  applications   2.  Discovery  process   •   initial  questionnaire   •   initial  talks   3.  Rapid  prototyping   •   functional  requirements   •   prototypes  (paper  &  digital)   •   usability  evaluation   Saturday  21  February  15   23   http://farm8.staticflickr.com/7221/7351141086_85640e3c06.jpg   Where  should  I   register   medication?   Spinuzzi,  C.  (2005).  The  methodology  of  participatory  design.  Technical  Communication,  52(August  2004),  163–174.    
Funtional  Requirement   Research  Question   •   “How  can  a  mobile  device  help  general  practioners,  using  context  and   mobile  affordances,  to  maintain  an  electronic  patient  file  on  a  house   visit?   •   What  information  does  a  GP  instantly  needs  on  a  house  visit?   •   How  should  mobile  affordances  be  applied  when  designing  a   mobile  health  record?      è  Not  just  a  port  of  existing  applications!   Saturday  21  February  15   24  
Timeline  prototypes   Saturday  21  February  15   25   Paper   prototype  5   Sketches   Paper   prototype  1   Paper   prototype  4   Paper   prototype  3   Paper   prototype  2   Digital   prototype   Design  V1   5  GPs   3  GPs   3  GPs   3  GPs   5  GPs   6  HCI  colleagues   53  students  
Some  Sketches   Saturday  21  February  15   26  
Problems  è  Requirements   ①   Not  optimized  for  mobile  è      Use  mobile  affordances   ②   Too  slow  è      Show  timely  &  relevant  information   ③   Necessary  patient  information  è      Quick  overview  important  information   ④   Registering  data  è      Efficient  and  effective  data  input   ⑤   Prescribing  medicine  è      Raise  motivation  to  register   Saturday  21  February  15   27  
Methodology:  Participatory  Design   1.  Initial  research   •   existing  research  papers   •   existing  electronic  patient  files  and  applications   2.  Discovery  process   •   initial  questionnaire   •   initial  talks   3.  Rapid  prototyping   •   functional  requirements   •   prototypes  (paper  &  digital)   •   usability  evaluation   Saturday  21  February  15   28   http://farm8.staticflickr.com/7221/7351141086_85640e3c06.jpg   Where  should  I   register   medication?   Spinuzzi,  C.  (2005).  The  methodology  of  participatory  design.  Technical  Communication,  52(August  2004),  163–174.    
Saturday  21  February  15   29   Demonstration  
Dashboard   Saturday  21  February  15   30   Sá,  M.  de,  &  Carriço,  L.  (2006).  Low-­‐Fi  Prototyping  for  Mobile  Devices.  In  CHI  ’06  Extended  Abstracts:  Human   Factors  in  Computing  Systems  (pp.  694–699).  ACM.  doi:10.1145/1125451.1125592  
Subjective  Input   Saturday  21  February  15   31   Stocky,  T.,  Faaborg,  A.,  &  Lieberman,  H.  (2004).  A  commonsense  approach  to  predictive  text  entry.  In  Extended   abstracts  of  the  2004  conference  on  Human  factors  and  computing  systems  -­‐  CHI  ’04  (p.  1163).  New  York,  New  York,   USA:  ACM  Press.  doi:10.1145/985921.986014  
Objective  Input   Saturday  21  February  15   32   Weibel,  N.,  Emmenegger,  C.,  Lyons,  J.,  Dixit,  R.,  Hill,  L.,  &  Hollan,  J.  (2013).  Interpreter-­‐Mediated  Physician-­‐Patient   Communication:  Opportunities  for  Multimodal  Healthcare  Interfaces.  In  Proceedings  of  the  ICTs  for  improving   Patients  Rehabilitation  Research  Techniques.  IEEE.  doi:10.4108/icst.pervasivehealth.2013.252026  
Messages   Saturday  21  February  15   33  
Problems  è  Requirements   ①   Not  optimized  for  mobile  è      Use  mobile  affordances   ②   Too  slow  è      Show  timely  &  relevant  information   ③   Necessary  patient  information  è      Quick  overview  important  information   ④   Registering  data  è      Efficient  and  effective  data  input   ⑤   Prescribing  medicine  è      Raise  motivation  to  register   Saturday  21  February  15   34  
Saturday  21  February  15   35   Mobile  Affordances  
Saturday  21  February  15   36   Medical  Affordances  
Problems  è  Requirements   ①   Not  optimized  for  mobile  è      Use  mobile  affordances   ②   Too  slow  è      Show  timely  &  relevant  information   ③   Necessary  patient  information  è      Quick  overview  important  information   ④   Registering  data  è      Efficient  and  effective  data  input   ⑤   Prescribing  medicine  è      Raise  motivation  to  register   Saturday  21  February  15   37  
GPS  to  patient  &  open  right  file   Saturday  21  February  15   38  
Workflow   •   Information   •   Messages   •   SOAP   subjective  à  objective  à  assessment  à  planning   • Medication   Saturday  21  February  15   39   Robin  De  Croon  
Patient  records   Saturday  21  February  15   40  
Filter  messages   Saturday  21  February  15   41  
Camera  &  calendar  &  search   Saturday  21  February  15   42  
Problems  è  Requirements   ①   Not  optimized  for  mobile  è      Use  mobile  affordances   ②   Too  slow  è      Show  timely  &  relevant  information   ③   Necessary  patient  information  è      Quick  overview  important  information   ④   Registering  data  è      Efficient  and  effective  data  input   ⑤   Prescribing  medicine  è      Raise  motivation  to  register   Saturday  21  February  15   43  
Saturday  21  February  15   44  
Saturday  21  February  15   45  
Requirement  3   quick  overview  of  the  most  important  data     Saturday  21  February  15   46  
Participatory  design  approach   •   WEL  à  Onderzoek   •   Vergelijkend  onderzoek     Saturday  21  February  15   47  
Final  Dashboard   Saturday  21  February  15   48  
Saturday  21  February  15   49  
Problems  è  Requirements   ①   Not  optimized  for  mobile  è      Use  mobile  affordances   ②   Too  slow  è      Show  timely  &  relevant  information   ③   Necessary  patient  information  è      Quick  overview  important  information   ④   Registering  data  è      Efficient  and  effective  data  input   ⑤   Prescribing  medicine  è      Raise  motivation  to  register   Saturday  21  February  15   50  
Keyboard  uses  much  screen  space   Saturday  21  February  15   51  
Speech-­‐to-­‐Text   Saturday  21  February  15   52  
Saturday  21  February  15   53  
Input  through  colored  sliders   Saturday  21  February  15   54   Weibel,  N.,  Emmenegger,  C.,  Lyons,  J.,  Dixit,  R.,  Hill,  L.,  &  Hollan,  J.  (2013).  Interpreter-­‐Mediated  Physician-­‐Patient   Communication:  Opportunities  for  Multimodal  Healthcare  Interfaces.  In  Proceedings  of  the  ICTs  for  improving   Patients  Rehabilitation  Research  Techniques.  IEEE.  doi:10.4108/icst.pervasivehealth.2013.252026  
Auto  Complete   Saturday  21  February  15   55  
Assessment  à  Tree  Structure     (ICPC,  ICD10,  …)   Saturday  21  February  15   56  
Problems  è  Requirements   ①   Not  optimized  for  mobile  è      Use  mobile  affordances   ②   Too  slow  è      Show  timely  &  relevant  information   ③   Necessary  patient  information  è      Quick  overview  important  information   ④   Registering  data  è      Efficient  and  effective  data  input   ⑤   Prescribing  medicine  è      Raise  motivation  to  register   Saturday  21  February  15   57  
Slow  law  adaptation   Saturday  21  February  15   58  
Tools   Saturday  21  February  15   59  
Pharmocovigilance   Saturday  21  February  15   60   http://www.amazingpregnancy.com/blog/wp-­‐content/uploads/2013/05/drug_or_alimentary_supplement_idea_of_health_and_disease.jpg    
Methodology:  Participatory  Design   1.  Initial  research   •   existing  research  papers   •   existing  electronic  patient  files  and  applications   2.  Discovery  process   •   initial  questionnaire   •   initial  talks   3.  Rapid  prototyping   •   functional  requirements   •   prototypes  (paper  &  digital)   •   usability  evaluation   Saturday  21  February  15   61   http://farm8.staticflickr.com/7221/7351141086_85640e3c06.jpg   Where  should  I   register   medication?   Spinuzzi,  C.  (2005).  The  methodology  of  participatory  design.  Technical  Communication,  52(August  2004),  163–174.    
Saturday  21  February  15   62   Schulenberg,  S.  E.,  &  Melton,  A.  M.  a.  (2008).  The  Computer  Aversion,  Attitudes,  and  Familiarity  Index  (CAAFI):  A  validity  study.  Computers  in   Human  Behavior,  24(6),  2620–2638.  doi:10.1016/j.chb.2008.03.002   Computer  Aversion,  Attitudes  and   Familiarity  Index  (CAAFI)   Questionnaire  
System  Usability  Scale  (SUS)   Questionnaire   Saturday  21  February  15   63   http://iqcontent.com/blog/files/wp/2013/05/sus.png   Bangor,  A.,  Kortum,  P.,  &  Miller,  J.  (2009).  Determining  what  individual  SUS  scores  mean:  Adding  an  adjective  rating  scale.  Journal  of   Usability  Studies,  4(3),  114–123.  Retrieved  from  http://66.39.39.113/upa_publications/jus/2009may/JUS_Bangor_May2009.pdf  
Evaluation  general  practice  students   •   During  general  practice  course  Leuven   •   Last  year  general  practice   •   ≈  120  hours  experience     •   Presentation  ≈  30  minutes   •   Accompanied  with  questionnaire   Saturday  21  February  15   64  
53  last  year     general  practice  students   Gender   Age   Saturday  21  February  15   65   0   5   10   15   20   25   30   53   31   30   29   28   27   26   25   24   17   tablet   smartphone   man   geen  tablet   dumbphone   vrouw   0   10   20   30   40   50  
Computer  Aversion,  Attitudes  and   Familiarity  Index  (CAAFI)    Score  Students   Saturday  21  February  15   66   Factors Average Standard  Deviation Factor  1   (familiarity) 0.76 0.75 Factor  2   (attitudes) 1.91 0.69 Factor  3   (aversion) 0.68 1.1 Schulenberg,  S.  E.,  &  Melton,  A.  M.  a.  (2008).  The  Computer  Aversion,  Attitudes,  and  Familiarity  Index  (CAAFI):  A  validity  study.  Computers  in   Human  Behavior,  24(6),  2620–2638.  doi:10.1016/j.chb.2008.03.002  
System  Usability  Scale  (SUS)   Score  students   Saturday  21  February  15   67   Bangor,  A.,  Kortum,  P.,  &  Miller,  J.  (2009).  Determining  what  individual  SUS  scores  mean:  Adding  an  adjective  rating  scale.  Journal  of   Usability  Studies,  4(3),  114–123.  Retrieved  from  http://66.39.39.113/upa_publications/jus/2009may/JUS_Bangor_May2009.pdf   Average  score:  70  
Saturday  21  February  15   68   Likert  Scores  students   0.03   0.02   0.06   0.12   0.32   0.04   0.12   0.2   0.04   0.02   0.42   0.22   0.3   0.28   0.14   0.12   0.04   0.19   0.6   0.44   0.36   0.68   0.5   0.7   0.03   0.08   0.08   0.04   0.14   0.36   0.26   0   0.1   0.2   0.3   0.4   0.5   0.6   0.7   0.8   0.9   1   SOAP  -­‐  Planning   SOAP  -­‐  evaluation   SOAP  -­‐  objective   SOAP  -­‐  subjective   Documents   Patient  informartion   Dashboard   Very  poor   Poor   Neutral   Good   Very  good  
Difference  between  generations   •   SOAP  note  system  <-­‐>  Medical  History   De  Croon,  R.,  Klerkx,  J.,  Duval,  E.  (2014).  The  involvement  of   students  in  the  user-­‐centered  design  process  of  a  mobile  health   record:  a  case  study.  Workshop  on  Designing  the  Future  of  Mobile   Healthcare  Support.  Toronto,  Canada,  23  September  2014,  accepted.     Saturday  21  February  15   69  
Conclusion   •   Smaller  subset  on  dashboard   •   Five  core  considerations   •   Difference  between  generations   •   Interface  under  active  development   Saturday  21  February  15   70   http://cdn.makeuseof.com/wp-­‐content/uploads/2012/12/3D-­‐Man-­‐Presenting-­‐Intro-­‐Image.jpg?a53b57    
Future  work   •   Generation  difference  /  two  paradigms  (SOAP  <-­‐>  EBM)   •   Expand  research  (not  only  Belgian  markets)   •   Can  a  GP  inform  a  patient  with  an  EMD  more  efficiently?   Saturday  21  February  15   71  
You  think  our  work  interesting?     • We’re  expanding  our  team!      à  erik.duval@cs.kuleuven.be   Saturday  21  February  15   72  
Thank  you!   Saturday  21  February  15   73   http://2.bp.blogspot.com/-­‐gZjNR3XVULs/T_ZOVgE-­‐5lI/AAAAAAAAAg8/6YVmd5Q064o/s1600/questions11.jpg     robin.decroon@cs.kuleuven.be  

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Designing a useful and usable mobile EMR application through a participatory design methodology: a case study

  • 1. DESIGNING  A  USEFUL  AND  USABLE   MOBILE  EMR  APPLICATION     THROUGH  A  PARTICIPATORY     DESIGN  METHODOLOGY:    A  CASE  STUDY     ir.  Robin  De  Croon,  dr.  Joris  Klerkx,  prof.  dr.  ir.  Erik  Duval                  http://about.me/robindecroon  &            robin.decroon@cs.kuleuven.be      IEEE  International  Conference  on  Healthcare  Informatics  2014  (ICHI  2014)  
  • 2. Who  Am  I?   •   Robin  De  Croon   •   Scientific  Researcher   •   Computer  Science  background     •   KU  Leuven  (Belgium)   •   Human  Computer  Interaction   •   Prof.  dr.  ir.  Erik  Duval   •   Dr.  Joris  Klerkx   •   datavislab     •  http://datavislab.org   Saturday  21  February  15   2  
  • 3. Secure  &  Usable  medical     applications  in  the  cloud  (MAPC)   •   IWT  R&D  company  project    è  “How  can  a  mobile  device  help  general   practioners,  using  context  and  mobile   affordances,  to  maintain  an  electronic  patient   file  on  a  house  visit?   Saturday  21  February  15   3  
  • 4. Secure  &  Usable  medical     applications  in  the  cloud  (MAPC)   •   IWT  R&D  company  project  à  case  study    è  “How  can  a  mobile  device  help  general   practioners,  using  context  and  mobile   affordances,  to  maintain  an  electronic  patient   file  on  a  house  visit?   Saturday  21  February  15   4  
  • 5. target  user   Target  Audience   Saturday  21  February  15   5   • General  Practitioners  in  Flanders  (Belgium)   Independent  of:   •   Experience  &  age   •   Individual  or  group  practice   •   ICT-­‐knowledge   •   Current  medical  software   http://marketingyoucanuse.com/wp-­‐content/uploads/2010/12/HittingTarget.jpg  
  • 6. Methodology:  Participatory  Design   1.  Initial  research   •   existing  research  papers   •   existing  electronic  patient  files  and  applications   2.  Discovery  process   •   initial  questionnaire   •   initial  talks   3.  Rapid  prototyping   •   functional  requirements   •   prototypes  (paper  &  digital)   •   usability  evaluation   Saturday  21  February  15   6   http://farm8.staticflickr.com/7221/7351141086_85640e3c06.jpg   Where  should  I   register   medication?   Spinuzzi,  C.  (2005).  The  methodology  of  participatory  design.  Technical  Communication,  52(August  2004),  163–174.    
  • 7. Methodology:  Participatory  Design   1.  Initial  research   •   existing  research  papers   •   existing  electronic  patient  files  and  applications   2.  Discovery  process   •   initial  questionnaire   •   initial  talks   3.  Rapid  prototyping   •   functional  requirements   •   prototypes  (paper  &  digital)   •   usability  evaluation   Saturday  21  February  15   7   http://farm8.staticflickr.com/7221/7351141086_85640e3c06.jpg   Where  should  I   register   medication?   Spinuzzi,  C.  (2005).  The  methodology  of  participatory  design.  Technical  Communication,  52(August  2004),  163–174.    
  • 8. Related  work  (i)   •   Which  information  does  a  general  practitioner   need?   •  Abd  Ghani,  M.  K.  (2011).  The  design  of  flexible  Pervasive  Electronic  Health  Record  (PEHR).  In  2011  IEEE  Colloquium  on  Humanities,   Science  and  Engineering  (pp.  249–254).  IEEE.  doi:10.1109/CHUSER.2011.6163727   •  Plancke,  L.  (2013).  Het  thuisdossier  voor  de  wachtarts  :  stand  van  zaken.  Universiteit  Gent.  Retrieved  from  http://lib.ugent.be/fulltxt/ RUG01/002/002/163/RUG01-­‐002002163_2013_0001_AC.pdf   •   Mobile  applications  in  the  medical  world   •  Fischer,  S.   (2002).   Handheld  Computing   in   Medicine.  Journal   of   the  American   Medical   Informatics  Association,   10(2),   139–149.   doi: 10.1197/jamia.M1180   •  Ebell,   M.   H.,  Gaspar,   D.   L.,   &   Khurana,   S.   (1997).   Family   physicians’   preferences   for   computerized   decision-­‐support   hardware   and   software.  The  Journal  of  Family  Practice,  45(2),  137–141.   •  Page,  T.  (2013).  Usability  of  text  input  interfaces  in  smartphones.  J.  of  Design  Research,  11(1),  39.  doi:10.1504/JDR.2013.054065   •  Kelly,  J.  (2000).  Going  wireless.  Hospitals  &  Health  Networks  /  AHA,  74(11),  65–66,  68.  doi:10.1038/sj.bdj.2011.41   •  Nyssen,  M.,  Thomeer,  K.,  &  Buyl,  R.  (2010).  Generating  and  transmitting  ambulatory  electronic  medical  prescriptions.  In  P.  Bamidis  &  N.   Pallikarakis  (Eds.),  XII  Mediterranean  Conference  on  Medical  and  Biological  Engineering  and  Computing  2010  (pp.  890–892).  Springer   Berlin  Heidelberg.  doi:10.1007/978-­‐3-­‐642-­‐13039-­‐7_225   •  Chen,  Y.,  &  Atwood,  M.  E.  (2010).  Challenges  of  Mobile  Clinical  System  Design:  What  do  Nurses  Think?  In  2010  43rd  Hawaii  International   Conference  on  System  Sciences  (pp.  1–9).  IEEE.  doi:10.1109/HICSS.2010.99   •  Grossman,  J.   M.,  Gerland,  A.,   Reed,   M.  C.,   &   Fahlman,  C.   (2007).   Physicians’   experiences   using   commercial   e-­‐prescribing   systems.   Health  Affairs  (Project  Hope),  26(3),  w393–404.  doi:10.1377/hlthaff.26.3.w393   Saturday  21  February  15   8  
  • 9. Related  work  (ii)   •   Usability  problems  with  medical  software   •  Grossman,  J.  M.,  Gerland,  A.,  Reed,  M.  C.,  &  Fahlman,  C.  (2007).  Physicians’  experiences  using  commercial  e-­‐ prescribing  systems.  Health  Affairs  (Project  Hope),  26(3),  w393–404.  doi:10.1377/hlthaff.26.3.w393   •  Schumacher,  R.  M.,  Berkowitz,  L.,  Abramson,  P.,  &  Liebovitz,  D.  (2010).  Electronic  Health  Records:  Physician’s   Perspective  on  Usability.  Proceedings  of  the  Human  Factors  and  Ergonomics  Society  Annual  Meeting,  54(12),   816–820.  doi:10.1177/154193121005401202   •  Van  der  Sijs,  H.,  Aarts,  J.,  Vulto,  A.,  &  Berg,  M.  (2006).  Overriding  of  drug  safety  alerts  in  computerized  physician   order   entry.   Journal   of   the   American   Medical   Informatics   Association   :   JAMIA,   13(2),   138–47.   doi:10.1197/ jamia.M1809   •  Williams,  W.  G.,  &  Morgan,  J.  M.  (1995).  The  clinician-­‐information  interface.  Medinfo.  MEDINFO,  8  Pt  1,  801–5.   Retrieved  from  http://www.ncbi.nlm.nih.gov/pubmed/8591334   •  Devine,  E.  B.,  Hollingworth,  W.,  Hansen,  R.  N.,  Lawless,  N.  M.,  Wilson-­‐Norton,  J.  L.,  Martin,  D.  P.,  …  Sullivan,  S.  D.   (2010).   Electronic   prescribing   at   the   point   of   care:   a   time-­‐motion   study   in   the   primary   care   setting.   Health   Services  Research,  45(1),  152–71.  doi:10.1111/j.1475-­‐6773.2009.01063.x   •  Han,   S.,   Harkke,   V.,   Mustonen,   P.,   Seppanen,   M.,   &   Kallio,   M.   (2004).   Mobilizing   Medical   Information   and   Knowledge:  Some  Insights  from  a  Survey.  Retrieved  from  http://aisel.aisnet.org/ecis2004/69/   Saturday  21  February  15   9  
  • 10. Related  work  (iii)   •   Participatory  design  in  the  medical  domain   •  Tang,  K.,  Hirano,  S.,  Cheng,  K.,  &  Hayes,  G.  (2012).  Balancing  Caregiver  and  Clinician  Needs  in  a  Mobile   Health   Informatics  Tool   for   Preterm   Infants.   In   Proceedings   of   the   6th   International   Conference   on   Pervasive   Computing   Technologies   for   Healthcare   (pp.   1–8).   IEEE.   doi:10.4108/icst.pervasivehealth. 2012.248716   •  Hwang,  A.,  Truong,   K.,   &   Mihailidis,  A.   (2012).  Using   participatory   design   to   determine   the   needs   of   informal  caregivers  for  smart  home  user  interfaces.  In  Proceedings  of  the  6th  International  Conference   on   Pervasive   Computing   Technologies   for   Healthcare   (pp.   41–48).   IEEE.   doi:10.4108/ icst.pervasivehealth.2012.248671   •  Miller,  A.,  Pater,  J.,  &  Mynatt,  E.  (2013).  Design  Strategies  for  Youth-­‐Focused  Pervasive  Social  Health   Games.  In  Proceedings  of  the  ICTs  for  improving  Patients  Rehabilitation  Research  Techniques.  IEEE.  doi: 10.4108/pervasivehealth.2013.252081   •   Using  context   •  Stocky,  T.,  Faaborg,  A.,  &  Lieberman,  H.  (2004).  A  commonsense  approach  to  predictive  text  entry.  In   Extended   abstracts   of   the   2004   conference   on   Human   factors   and   computing   systems   -­‐  CHI   ’04   (p.   1163).  New  York,  New  York,  USA:  ACM  Press.  doi:10.1145/985921.986014   •  Abowd,  G.  D.,  Dey,  A.  K.,  Brown,  P.  J.,  Davies,  N.,  Smith,  M.,  &  Steggles,  P.  (1999).  Towards  a  Better   Understanding   of   Context   and   Context-­‐Awareness.   Ubiquitous   Computing/Handheld   and   Ubiquitous   Computing  (pp.  304–307).  doi:10.1007/3-­‐540-­‐48157-­‐5_29   Saturday  21  February  15   10  
  • 11. Methodology:  Participatory  Design   1.  Initial  research   •   existing  research  papers   •   existing  electronic  patient  files  and  applications   2.  Discovery  process   •   initial  questionnaire   •   initial  talks   3.  Rapid  prototyping   •   functional  requirements   •   prototypes  (paper  &  digital)   •   usability  evaluation   Saturday  21  February  15   11   http://farm8.staticflickr.com/7221/7351141086_85640e3c06.jpg   Where  should  I   register   medication?   Spinuzzi,  C.  (2005).  The  methodology  of  participatory  design.  Technical  Communication,  52(August  2004),  163–174.    
  • 12. Saturday  21  February  15   12   https://www.ehealth.fgov.be/nl/registratie-­‐van-­‐de-­‐medische-­‐softwarepakketten    
  • 13. Saturday  21  February  15   13  
  • 14. Where  should  I   register   medication?   Methodology:  Participatory  Design   1.  Initial  research   •   existing  research  papers   •   existing  electronic  patient  files  and  applications   2.  Discovery  process   •   initial  questionnaire   •   initial  talks   3.  Rapid  prototyping   •   functional  requirements   •   prototypes  (paper  &  digital)   •   usability  evaluation   Saturday  21  February  15   14   http://farm8.staticflickr.com/7221/7351141086_85640e3c06.jpg   Spinuzzi,  C.  (2005).  The  methodology  of  participatory  design.  Technical  Communication,  52(August  2004),  163–174.    
  • 15. Initial  Questionnaire  &  Talks   •   What  kind  of  information  or  material  do  you  carry  with   you  during  house  visits?     •   Do  you  already  use  an  EMR  application  or,  if  not,  what   kinds  of  patient  information  do  you  take  with  you?     •   Which  data  is  entered  in  the  EMR  application  (after  the   house  visits)?     •   How  do  you  prescribe  medicine?     •   Do  you  take  pictures  of  wounds  or  rash?     •   What  kind  of  patients  do  you  normally  treat  during  a   house  visit?     •   …   Saturday  21  February  15   15   https://picasaweb.google.com/100923738088214702616/Omini3d#5456698262314545906   http://goo.gl/Wxh3Gi  (questionnaire,  Dutch)  
  • 16. Battery   Saturday  21  February  15   16  
  • 17. Weight   Saturday  21  February  15   17   http://www.elmospa.com/userfiles/image/Varie/forza.png      
  • 18. No  internet  connection   Saturday  21  February  15   18  
  • 19. Time  expensive   Saturday  21  February  15   19  
  • 20. Information  overload   Saturday  21  February  15   20   http://m.c.lnkd.licdn.com/mpr/mpr/p/5/005/061/1de/3cc6bc7.jpg    
  • 21. Usability   Saturday  21  February  15   21  
  • 22. Result   •   Patient  data  gets  rarely  registered  on  a  house  visit   •   Patient  data  registered  afterwards  is  error  prone      è  Solution  is  needed!   Saturday  21  February  15   22   http://static.squarespace.com/static/52e99ee6e4b074062a408c89/t/52eb6098e4b008799dcd8d23/1391157403129/3D%20Person%20-­‐%20Magnifing%20Glass-­‐Edited.png    
  • 23. Methodology:  Participatory  Design   1.  Initial  research   •   existing  research  papers   •   existing  electronic  patient  files  and  applications   2.  Discovery  process   •   initial  questionnaire   •   initial  talks   3.  Rapid  prototyping   •   functional  requirements   •   prototypes  (paper  &  digital)   •   usability  evaluation   Saturday  21  February  15   23   http://farm8.staticflickr.com/7221/7351141086_85640e3c06.jpg   Where  should  I   register   medication?   Spinuzzi,  C.  (2005).  The  methodology  of  participatory  design.  Technical  Communication,  52(August  2004),  163–174.    
  • 24. Funtional  Requirement   Research  Question   •   “How  can  a  mobile  device  help  general  practioners,  using  context  and   mobile  affordances,  to  maintain  an  electronic  patient  file  on  a  house   visit?   •   What  information  does  a  GP  instantly  needs  on  a  house  visit?   •   How  should  mobile  affordances  be  applied  when  designing  a   mobile  health  record?      è  Not  just  a  port  of  existing  applications!   Saturday  21  February  15   24  
  • 25. Timeline  prototypes   Saturday  21  February  15   25   Paper   prototype  5   Sketches   Paper   prototype  1   Paper   prototype  4   Paper   prototype  3   Paper   prototype  2   Digital   prototype   Design  V1   5  GPs   3  GPs   3  GPs   3  GPs   5  GPs   6  HCI  colleagues   53  students  
  • 26. Some  Sketches   Saturday  21  February  15   26  
  • 27. Problems  è  Requirements   ①   Not  optimized  for  mobile  è      Use  mobile  affordances   ②   Too  slow  è      Show  timely  &  relevant  information   ③   Necessary  patient  information  è      Quick  overview  important  information   ④   Registering  data  è      Efficient  and  effective  data  input   ⑤   Prescribing  medicine  è      Raise  motivation  to  register   Saturday  21  February  15   27  
  • 28. Methodology:  Participatory  Design   1.  Initial  research   •   existing  research  papers   •   existing  electronic  patient  files  and  applications   2.  Discovery  process   •   initial  questionnaire   •   initial  talks   3.  Rapid  prototyping   •   functional  requirements   •   prototypes  (paper  &  digital)   •   usability  evaluation   Saturday  21  February  15   28   http://farm8.staticflickr.com/7221/7351141086_85640e3c06.jpg   Where  should  I   register   medication?   Spinuzzi,  C.  (2005).  The  methodology  of  participatory  design.  Technical  Communication,  52(August  2004),  163–174.    
  • 29. Saturday  21  February  15   29   Demonstration  
  • 30. Dashboard   Saturday  21  February  15   30   Sá,  M.  de,  &  Carriço,  L.  (2006).  Low-­‐Fi  Prototyping  for  Mobile  Devices.  In  CHI  ’06  Extended  Abstracts:  Human   Factors  in  Computing  Systems  (pp.  694–699).  ACM.  doi:10.1145/1125451.1125592  
  • 31. Subjective  Input   Saturday  21  February  15   31   Stocky,  T.,  Faaborg,  A.,  &  Lieberman,  H.  (2004).  A  commonsense  approach  to  predictive  text  entry.  In  Extended   abstracts  of  the  2004  conference  on  Human  factors  and  computing  systems  -­‐  CHI  ’04  (p.  1163).  New  York,  New  York,   USA:  ACM  Press.  doi:10.1145/985921.986014  
  • 32. Objective  Input   Saturday  21  February  15   32   Weibel,  N.,  Emmenegger,  C.,  Lyons,  J.,  Dixit,  R.,  Hill,  L.,  &  Hollan,  J.  (2013).  Interpreter-­‐Mediated  Physician-­‐Patient   Communication:  Opportunities  for  Multimodal  Healthcare  Interfaces.  In  Proceedings  of  the  ICTs  for  improving   Patients  Rehabilitation  Research  Techniques.  IEEE.  doi:10.4108/icst.pervasivehealth.2013.252026  
  • 33. Messages   Saturday  21  February  15   33  
  • 34. Problems  è  Requirements   ①   Not  optimized  for  mobile  è      Use  mobile  affordances   ②   Too  slow  è      Show  timely  &  relevant  information   ③   Necessary  patient  information  è      Quick  overview  important  information   ④   Registering  data  è      Efficient  and  effective  data  input   ⑤   Prescribing  medicine  è      Raise  motivation  to  register   Saturday  21  February  15   34  
  • 35. Saturday  21  February  15   35   Mobile  Affordances  
  • 36. Saturday  21  February  15   36   Medical  Affordances  
  • 37. Problems  è  Requirements   ①   Not  optimized  for  mobile  è      Use  mobile  affordances   ②   Too  slow  è      Show  timely  &  relevant  information   ③   Necessary  patient  information  è      Quick  overview  important  information   ④   Registering  data  è      Efficient  and  effective  data  input   ⑤   Prescribing  medicine  è      Raise  motivation  to  register   Saturday  21  February  15   37  
  • 38. GPS  to  patient  &  open  right  file   Saturday  21  February  15   38  
  • 39. Workflow   •   Information   •   Messages   •   SOAP   subjective  à  objective  à  assessment  à  planning   • Medication   Saturday  21  February  15   39   Robin  De  Croon  
  • 40. Patient  records   Saturday  21  February  15   40  
  • 41. Filter  messages   Saturday  21  February  15   41  
  • 42. Camera  &  calendar  &  search   Saturday  21  February  15   42  
  • 43. Problems  è  Requirements   ①   Not  optimized  for  mobile  è      Use  mobile  affordances   ②   Too  slow  è      Show  timely  &  relevant  information   ③   Necessary  patient  information  è      Quick  overview  important  information   ④   Registering  data  è      Efficient  and  effective  data  input   ⑤   Prescribing  medicine  è      Raise  motivation  to  register   Saturday  21  February  15   43  
  • 44. Saturday  21  February  15   44  
  • 45. Saturday  21  February  15   45  
  • 46. Requirement  3   quick  overview  of  the  most  important  data     Saturday  21  February  15   46  
  • 47. Participatory  design  approach   •   WEL  à  Onderzoek   •   Vergelijkend  onderzoek     Saturday  21  February  15   47  
  • 48. Final  Dashboard   Saturday  21  February  15   48  
  • 49. Saturday  21  February  15   49  
  • 50. Problems  è  Requirements   ①   Not  optimized  for  mobile  è      Use  mobile  affordances   ②   Too  slow  è      Show  timely  &  relevant  information   ③   Necessary  patient  information  è      Quick  overview  important  information   ④   Registering  data  è      Efficient  and  effective  data  input   ⑤   Prescribing  medicine  è      Raise  motivation  to  register   Saturday  21  February  15   50  
  • 51. Keyboard  uses  much  screen  space   Saturday  21  February  15   51  
  • 52. Speech-­‐to-­‐Text   Saturday  21  February  15   52  
  • 53. Saturday  21  February  15   53  
  • 54. Input  through  colored  sliders   Saturday  21  February  15   54   Weibel,  N.,  Emmenegger,  C.,  Lyons,  J.,  Dixit,  R.,  Hill,  L.,  &  Hollan,  J.  (2013).  Interpreter-­‐Mediated  Physician-­‐Patient   Communication:  Opportunities  for  Multimodal  Healthcare  Interfaces.  In  Proceedings  of  the  ICTs  for  improving   Patients  Rehabilitation  Research  Techniques.  IEEE.  doi:10.4108/icst.pervasivehealth.2013.252026  
  • 55. Auto  Complete   Saturday  21  February  15   55  
  • 56. Assessment  à  Tree  Structure     (ICPC,  ICD10,  …)   Saturday  21  February  15   56  
  • 57. Problems  è  Requirements   ①   Not  optimized  for  mobile  è      Use  mobile  affordances   ②   Too  slow  è      Show  timely  &  relevant  information   ③   Necessary  patient  information  è      Quick  overview  important  information   ④   Registering  data  è      Efficient  and  effective  data  input   ⑤   Prescribing  medicine  è      Raise  motivation  to  register   Saturday  21  February  15   57  
  • 58. Slow  law  adaptation   Saturday  21  February  15   58  
  • 59. Tools   Saturday  21  February  15   59  
  • 60. Pharmocovigilance   Saturday  21  February  15   60   http://www.amazingpregnancy.com/blog/wp-­‐content/uploads/2013/05/drug_or_alimentary_supplement_idea_of_health_and_disease.jpg    
  • 61. Methodology:  Participatory  Design   1.  Initial  research   •   existing  research  papers   •   existing  electronic  patient  files  and  applications   2.  Discovery  process   •   initial  questionnaire   •   initial  talks   3.  Rapid  prototyping   •   functional  requirements   •   prototypes  (paper  &  digital)   •   usability  evaluation   Saturday  21  February  15   61   http://farm8.staticflickr.com/7221/7351141086_85640e3c06.jpg   Where  should  I   register   medication?   Spinuzzi,  C.  (2005).  The  methodology  of  participatory  design.  Technical  Communication,  52(August  2004),  163–174.    
  • 62. Saturday  21  February  15   62   Schulenberg,  S.  E.,  &  Melton,  A.  M.  a.  (2008).  The  Computer  Aversion,  Attitudes,  and  Familiarity  Index  (CAAFI):  A  validity  study.  Computers  in   Human  Behavior,  24(6),  2620–2638.  doi:10.1016/j.chb.2008.03.002   Computer  Aversion,  Attitudes  and   Familiarity  Index  (CAAFI)   Questionnaire  
  • 63. System  Usability  Scale  (SUS)   Questionnaire   Saturday  21  February  15   63   http://iqcontent.com/blog/files/wp/2013/05/sus.png   Bangor,  A.,  Kortum,  P.,  &  Miller,  J.  (2009).  Determining  what  individual  SUS  scores  mean:  Adding  an  adjective  rating  scale.  Journal  of   Usability  Studies,  4(3),  114–123.  Retrieved  from  http://66.39.39.113/upa_publications/jus/2009may/JUS_Bangor_May2009.pdf  
  • 64. Evaluation  general  practice  students   •   During  general  practice  course  Leuven   •   Last  year  general  practice   •   ≈  120  hours  experience     •   Presentation  ≈  30  minutes   •   Accompanied  with  questionnaire   Saturday  21  February  15   64  
  • 65. 53  last  year     general  practice  students   Gender   Age   Saturday  21  February  15   65   0   5   10   15   20   25   30   53   31   30   29   28   27   26   25   24   17   tablet   smartphone   man   geen  tablet   dumbphone   vrouw   0   10   20   30   40   50  
  • 66. Computer  Aversion,  Attitudes  and   Familiarity  Index  (CAAFI)    Score  Students   Saturday  21  February  15   66   Factors Average Standard  Deviation Factor  1   (familiarity) 0.76 0.75 Factor  2   (attitudes) 1.91 0.69 Factor  3   (aversion) 0.68 1.1 Schulenberg,  S.  E.,  &  Melton,  A.  M.  a.  (2008).  The  Computer  Aversion,  Attitudes,  and  Familiarity  Index  (CAAFI):  A  validity  study.  Computers  in   Human  Behavior,  24(6),  2620–2638.  doi:10.1016/j.chb.2008.03.002  
  • 67. System  Usability  Scale  (SUS)   Score  students   Saturday  21  February  15   67   Bangor,  A.,  Kortum,  P.,  &  Miller,  J.  (2009).  Determining  what  individual  SUS  scores  mean:  Adding  an  adjective  rating  scale.  Journal  of   Usability  Studies,  4(3),  114–123.  Retrieved  from  http://66.39.39.113/upa_publications/jus/2009may/JUS_Bangor_May2009.pdf   Average  score:  70  
  • 68. Saturday  21  February  15   68   Likert  Scores  students   0.03   0.02   0.06   0.12   0.32   0.04   0.12   0.2   0.04   0.02   0.42   0.22   0.3   0.28   0.14   0.12   0.04   0.19   0.6   0.44   0.36   0.68   0.5   0.7   0.03   0.08   0.08   0.04   0.14   0.36   0.26   0   0.1   0.2   0.3   0.4   0.5   0.6   0.7   0.8   0.9   1   SOAP  -­‐  Planning   SOAP  -­‐  evaluation   SOAP  -­‐  objective   SOAP  -­‐  subjective   Documents   Patient  informartion   Dashboard   Very  poor   Poor   Neutral   Good   Very  good  
  • 69. Difference  between  generations   •   SOAP  note  system  <-­‐>  Medical  History   De  Croon,  R.,  Klerkx,  J.,  Duval,  E.  (2014).  The  involvement  of   students  in  the  user-­‐centered  design  process  of  a  mobile  health   record:  a  case  study.  Workshop  on  Designing  the  Future  of  Mobile   Healthcare  Support.  Toronto,  Canada,  23  September  2014,  accepted.     Saturday  21  February  15   69  
  • 70. Conclusion   •   Smaller  subset  on  dashboard   •   Five  core  considerations   •   Difference  between  generations   •   Interface  under  active  development   Saturday  21  February  15   70   http://cdn.makeuseof.com/wp-­‐content/uploads/2012/12/3D-­‐Man-­‐Presenting-­‐Intro-­‐Image.jpg?a53b57    
  • 71. Future  work   •   Generation  difference  /  two  paradigms  (SOAP  <-­‐>  EBM)   •   Expand  research  (not  only  Belgian  markets)   •   Can  a  GP  inform  a  patient  with  an  EMD  more  efficiently?   Saturday  21  February  15   71  
  • 72. You  think  our  work  interesting?     • We’re  expanding  our  team!      à  erik.duval@cs.kuleuven.be   Saturday  21  February  15   72  
  • 73. Thank  you!   Saturday  21  February  15   73   http://2.bp.blogspot.com/-­‐gZjNR3XVULs/T_ZOVgE-­‐5lI/AAAAAAAAAg8/6YVmd5Q064o/s1600/questions11.jpg     robin.decroon@cs.kuleuven.be