A User Centered Design Approach for Patient Interfaces to a Diabetes IT Platform

Improving patient self-management can have a greater impact than improving any clinical treatment (WHO). We propose here a systematic and comprehensive user centered design approach for delivering a technological platform for diabetes disease management. The system was developed under the METABO research project framework, involving patients from 3 different clinical centers in Parma, Modena and Madrid.

Application of user-centered design in the development of an atomated/assisted testing system for self-service devices

Automated Teller Machines (ATMs) are sensitive self-service systems that require important investments in security and testing. ATM certifications are testing processes for machines that integrate software components from different vendors and are performed before their deployment for public use. This project was originated from the need of optimization of the certification process in an ATM manufacturing company. The process identifies compatibility problems between software components through testing. It is composed by a huge number of manual user tasks that makes the process very expensive and error-prone. Moreover, it is not possible to fully automate the process as it requires human intervention for manipulating ATM peripherals. This project presented important challenges for the development team. First, this is a critical process, as all the ATM operations rely on the software under test. Second, the context of use of ATMs applications is vastly different from ordinary software. Third, ATMs’ useful lifetime is beyond 15 years and both new and old models need to be supported. Fourth, the know-how for efficient testing depends on each specialist and it is not explicitly documented. Fifth, the huge number of tests and their importance implies the need for user efficiency and accuracy. All these factors led us conclude that besides the technical challenges, the usability of the intended software solution was critical for the project success. This business context is the motivation of this Master Thesis project. Our proposal focused in the development process applied. By combining user-centered design (UCD) with agile development we ensured both the high priority of usability and the early mitigation of software development risks caused by all the technology constraints. We performed 23 development iterations and finally we were able to provide a working solution on time according to users’ expectations. The evaluation of the project was carried out through usability tests, where 4 real users participated in different tests in the real context of use. The results were positive, according to different metrics: error rate, efficiency, effectiveness, and user satisfaction. We discuss the problems found, the benefits and the lessons learned in the process. Finally, we measured the expected project benefits by comparing the effort required by the current and the new process (once the new software tool is adopted). The savings corresponded to 40% less effort (man-hours) per certification. Future work includes additional evaluation of product usability in a real scenario (with customers) and the measuring of benefits in terms of quality improvement.

User experience design

Inmersos en un mundo digital en el que participan cada vez más personas con diferentes niveles de experiencia en tecnología, ha aparecido la necesidad de diseñar las aplicaciones pensando en el usuario. El principal problema que un desarrollador se encuentra hoy en día es la falta de tiempo o agilidad para conceder al usuario una experiencia a medida. Muchas empresas han conseguido destacar en un mundo donde la competencia es muy grande gracias al aporte de valor añadido de una buena experiencia de usuario. Empezando por el análisis psicológico y las reacciones que tenemos cuando estamos interactuando con un sistema digital se intenta conseguir un método para diseñar la experiencia de usuario de un modo satisfactorio para ambas partes. Con el objetivo de probar el método diseñado, en el cual se incorporan muchas técnicas de otros métodos, se diseña parte de la experiencia de usuario de “ESEM 2014”, una de las conferencias informáticas más importantes del norte de Italia. Los resultados obtenidos en este trabajo son muy favorables, ya que mejoran substancialmente el resultado final y permiten al desarrollador seguir mejorando la aplicación hasta el momento y objetivo deseado. Resumen Español---ABSTRACT---In a world where more people with different level of expertise is engaging with technology, designing for the user has become one of the main concerns for the developers. Lack of time or agility are the main problems from the developers’ point of view in order to provide a good user experience. One of most important differentiators for companies is the provided experience as the technology and knowledge is highly available for everyone. The main goal of this project is to compose a method to include experience design in current agile development where short iterations is the main characteristic. In order to test the designed method, were many parts of other techniques have been included, part of the “ESEM 2014” conference has been designed. The results achieved with this guidelines has been very positive from both sides of the development, users and developers. Having short iterations allows improvement until the desired experience is achieved.

Adapting a speech into sign language translation system to a new domain

This paper presents a methodology for adapting an advanced communication system for deaf people in a new domain. This methodology is a user-centered design approach consisting of four main steps: requirement analysis, parallel corpus generation, technology adaptation to the new domain, and finally, system evaluation. In this paper, the new considered domain has been the dialogues in a hotel reception. With this methodology, it was possible to develop the system in a few months, obtaining very good performance: good speech recognition and translation rates (around 90%) with small processing times.

Validación de un marco abierto accesible de tercera generación para la integración nativa de productos de apoyo en tecnologías de la información y la comunicación

Las personas con discapacidad a menudo se encuentran con problemas de acceso a las Tecnologías de la Información y la Comunicación (TIC), debido a diseños y desarrollos que no tienen en cuenta sus diferencias funcionales, y en consecuencia se encuentran en riesgo de exclusión social. Cada vez es más común encontrar productos de apoyo que permitan utilizar diferentes tecnologías (ordenadores, Internet, dispositivos móviles), pero muchos de ellos no se encuentran integrados debido a que funcionan esencialmente modificando la plataforma donde están instalados, siendo soluciones de acceso de segunda generación. Más allá del desarrollo de los productos de apoyo, que sin duda ha evolucionado positivamente en los últimos años, cabe resaltar que existe una falta de herramientas y de aproximación holística que ayuden a los desarrolladores y diseñadores hacer las TIC accesibles. Esta tesis doctoral pretende validar la hipótesis de que una metodología holística de desarrollo de aplicaciones y productos de apoyo TIC, llamada Marco Abierto Accesible, facilita el desarrollo y la integración de modo nativo de la accesibilidad en las aplicaciones y productos apoyo, independientemente de la tecnología utilizada, dando lugar a soluciones de acceso de tercera generación que permitan mejorar la utilización de dichas aplicaciones por parte de personas con discapacidad. Este trabajo se ha desarrollado en el marco del proyecto AEGIS (del inglés, open Accessibility Everywhere: Groundwork, Infrastructure, Standards), que fue parcialmente financiado por la Comisión Europea (CE) bajo el VII Programa Marco y tuvo una duración de cuatro años. La metodología para el diseño, desarrollo y validación seguida en esta tesis es una adaptación de dos metodologías de diseño existentes (el Diseño Centrado en el Usuario y el Diseño Orientado a Metas), la implementación del Marco Abierto Accesible y el uso de diferentes técnicas de validación. Además se ha desarrollado un marco metodológico de entrenamiento para minimizar el efecto que tiene la curva de aprendizaje cuando los usuarios prueban por primera vez las soluciones desarrolladas. En esta tesis se presenta el Marco Abierto Accesible aplicado a las TIC en las tres áreas en las que se desarrolla este trabajo: ordenadores, Internet y dispositivos móviles, partiendo de las necesidades y problemas que tienen los usuarios con discapacidad en el uso de las TIC. Diferentes instanciaciones del Marco Abierto Accesible se definen en las tres áreas TIC mencionadas anteriormente y se describen varios ejemplos de sus implementaciones particulares. Los resultados de las evaluaciones de las implementaciones particulares con usuarios finales y expertos, una vez discutidos y contrastados con las hipótesis, sirven para probar la validez del Marco Abierto Accesible para la integración nativa de productos de apoyo en Tecnologías de la Información y la Comunicación. Finalmente, se presentan las líneas de investigación y trabajo futuro en el área de la accesibilidad en las TIC. ABSTRACT People with disabilities often encounter problems of access to Information and Communications Technology (ICT), due to design and developments that do not take into account their functional differences and therefore put them at risk of social exclusion. It is increasingly common to find assistive products that allow to use different technologies (computers, Internet, mobile devices), but many of them are not well integrated because they work essentially modifying the platform where they are installed, beeing the second-generation access solutions. Beyond the assistive product development, which has certainly evolved positively in recent years, it is notable that there is a lack of tools and holistic approach to help developers and designers make accessible ICT. This doctoral thesis aims to validate the hypothesis that a holistic approach to application development and assistive ICT products, called Open Accessibility Framework, facilitates the development and integration of native accessible applications and assistive products, regardless of the technology used, resulting in third-generation access solutions that improve the use of such applications by people with disabilities. This work was developed under the AEGIS project (open Accessibility Everywhere: Groundwork, Infrastructure, Standards), which was partially funded by the European Commission (EC) under the Seventh Framework Programme and lasted four years. The methodology for the design, development and validation followed in this thesis is an adaptation of two existing design methodologies (User Centered Design and Goal Oriented Design), the implementation of the Open Accessibility Framework and the usage of different validation techniques. A training methodological framework ha also been developed to minimize the effect of the learning curve when users first try the solutions developed. This thesis presents the Open Accessibility Framework applied to ICT in three areas in which this work is developed: computers, Internet and mobile devices, based on the needs and problems of the disabled users in the use of ICT. Different instantiations of the Open Accessibility Framework are defined in the three aforementioned ICT areas and various examples of its particular implementations are described. The results of the evaluations of the particular implementations which have been carried with end users and experts, once discussed and contrasted with the hypotheses, have been used to test the validity of the Open Accessibility Framework for the native integration of assistive products in Information and Communications Technology. Finally, the future research lines and future work in the area of ICT accessibility are presented.

Usability Planner: A Tool to Support the Process of Selecting Usability Methods

There is increasing pressure on developers to produce usable systems, which requires the use of appropriate methods to support user centred design during development. There is currently no consistent advice on which methods are appropriate in which circumstances, so the selection of methods relies on individual experience and expertise. Considerable effort is required to collate information from various sources and to understand the applicability of each method in a particular situation. Usability Planner is a tool aimed to support the selection of the most appropriate methods depending on project and organizational constraints. Many of the rules employed are derived from ISO standards, complemented with rules from the authors’ experience.

An overview of the ciao system

Ciao is a logic-based, multi-paradigm programming system. One of its most distinguishing features is that it supports a large number of semantic and syntactic language features which can be selectively activated or deactivated for each program module. As a result, a module can be written in, for example, ISO-Prolog plus constraints and higher order, while another can be a puré logic module with a different control rule such as iterative deepening and/or tabling, and perhaps using constructive negation. A powerful and modular extensión mechanism allows user-level design and implementation of such features and sub-languages. Another distinguishing feature of Ciao is its powerful assertion language, which allows expressing many kinds of program properties (ranging from, e.g., moded types to resource consumption), as well as tests and documentation. The compiler is capable of statically ñnding violations of these properties or verifying that programs comply with them, and issuing certiñcates of this compliance. The compiler also performs many types of optimizations, including automatic parallelization. It offers very competitive performance, while retaining the flexibility and interactive development of a dynamic language. We will present a hands-on overview of the system, through small examples which emphasize the novel aspects and the motivations which lie behind Ciao's design and implementation.

ClimApp: A Novel Approach of an Intelligent HVAC Control System

This paper describes a novel deployment of an intelligent user-centered HVAC (Heating, Ventilating and Air Conditioner) control system. The main objective of this system is to optimize user comfort and to reduce energy consumption in office buildings. Existing commercial HVAC control systems work in a fixed and predetermined way. The novelty of the proposed system is that it adapts dynamically to the user and to the building environment. For this purpose the system architecture has been designed under the paradigm of Ambient Intelligence. A prototype of the system proposed has been tested in a real-world environment.

Methodology for developing a Speech into Sign Language Translation System in a New Semantic Domain

This paper proposes a methodology for developing a speech into sign language translation system considering a user-centered strategy. This method-ology consists of four main steps: analysis of technical and user requirements, data collection, technology adaptation to the new domain, and finally, evalua-tion of the system. The two most demanding tasks are the sign generation and the translation rules generation. Many other aspects can be updated automatical-ly from a parallel corpus that includes sentences (in Spanish and LSE: Lengua de Signos Española) related to the application domain. In this paper, we explain how to apply this methodology in order to develop two translation systems in two specific domains: bus transport information and hotel reception.

Usability Planner: Herramienta para la planificación de técnicas de usabilidad en el ciclo de vida del software

A pesar del creciente interés de las organizaciones por la aplicación de métodos y técnicas de usabilidad en el proceso de desarrollo de software, seleccionar y poner en práctica aquellas técnicas que más se adecuan a las características de un determinado proyecto es una tarea compleja y con un soporte bajo. La diversidad de métodos de usabilidad, su desconocimiento en el mundo profesional y la falta de unas pautas claras para su aplicación en un determinado proyecto están causando que la introducción del Diseño Centrado en el Usuario (UCD, del inglés User Centred Design o DCU en español) en las compañías sea una tarea costosa y compleja. No obstante, las empresas que apuestan por la usabilidad de sus productos se están posicionando por encima del resto al crear sistemas que los usuarios valoran notablemente y por ver incrementadas sus ventas. Jefes de proyecto y consultores, que ven atractivo el desarrollo de sistemas usables, se hallan en un escenario en el que no encuentran un mecanismo sencillo e inmediato para seleccionar y aplicar las técnicas de usabilidad en sus proyectos de forma ágil y estructurada. El criterio para la selección de técnicas y métodos que manejan se basa únicamente en su experiencia profesional y en la bibliografía de numerosos autores. Usability Planner es una aplicación web dirigida a profesionales, estudiantes e investigadores involucrados en el desarrollo de software para ayudar a cambiar este escenario. Su objetivo es dar soporte a la selección de técnicas y métodos de usabilidad en el proceso de desarrollo de software minimizando riesgos y maximizando beneficios.

Integration of multisensor hybrid reasoners to support personal autonomy in the smart home.

The deployment of the Ambient Intelligence (AmI) paradigm requires designing and integrating user-centered smart environments to assist people in their daily life activities. This research paper details an integration and validation of multiple heterogeneous sensors with hybrid reasoners that support decision making in order to monitor personal and environmental data at a smart home in a private way. The results innovate on knowledge-based platforms, distributed sensors, connected objects, accessibility and authentication methods to promote independent living for elderly people. TALISMAN+, the AmI framework deployed, integrates four subsystems in the smart home: (i) a mobile biomedical telemonitoring platform to provide elderly patients with continuous disease management; (ii) an integration middleware that allows context capture from heterogeneous sensors to program environment¿s reaction; (iii) a vision system for intelligent monitoring of daily activities in the home; and (iv) an ontologies-based integrated reasoning platform to trigger local actions and manage private information in the smart home. The framework was integrated in two real running environments, the UPM Accessible Digital Home and MetalTIC house, and successfully validated by five experts in home care, elderly people and personal autonomy.

Context-awareness in task automation services by distributed event processing

Everybody has to coordinate several tasks everyday, usually in a manual manner. Recently, the concept of Task Automation Services has been introduced to automate and personalize the task coordination problem. Several user centered platforms and applications have arisen in the last years, that let their users configure their very own automations based on third party services. In this paper, we propose a new system architecture for Task Automation Services in a heterogeneous mobile, smart devices, and cloud services environment. Our architecture is based on the novel idea to employ distributed Complex Event Processing to implement innovative mixed execution profiles. The major advantage of the approach is its ability to incorporate context-awareness and real-time coordination in Task Automation Services.

Methodology for developing an advanced communications system for the Deaf in a new domain

A methodology for developing an advanced communications system for the Deaf in a new domain is presented in this paper. This methodology is a user-centred design approach consisting of four main steps: requirement analysis, parallel corpus generation, technology adaptation to the new domain, and finally, system evaluation. During the requirement analysis, both the user and technical requirements are evaluated and defined. For generating the parallel corpus, it is necessary to collect Spanish sentences in the new domain and translate them into LSE (Lengua de Signos Española: Spanish Sign Language). LSE is represented by glosses and using video recordings. This corpus is used for training the two main modules of the advanced communications system to the new domain: the spoken Spanish into the LSE translation module and the Spanish generation from the LSE module. The main aspects to be generated are the vocabularies for both languages (Spanish words and signs), and the knowledge for translating in both directions. Finally, the field evaluation is carried out with deaf people using the advanced communications system to interact with hearing people in several scenarios. In this evaluation, the paper proposes several objective and subjective measurements for evaluating the performance. In this paper, the new considered domain is about dialogues in a hotel reception. Using this methodology, the system was developed in several months, obtaining very good performance: good translation rates (10% Sign Error Rate) with small processing times, allowing face-to-face dialogues.

An ICT-based closed-loop model to improve care for heart failure patients

Durante las últimas décadas se ha producido un fenómeno global de envejecimiento en la población. Esta tendencia se puede observar prácticamente en todos los países del mundo y se debe principalmente a los avances en la medicina, y a los descensos en las tasas de fertilidad y mortalidad. El envejecimiento de la población tiene un gran impacto en la salud de los ciudadanos, y a menudo es la causa de aparición de enfermedades crónicas. Este tipo de enfermedades supone una amenaza y una carga importantes para la sociedad, especialmente en aspectos como la mortalidad o los gastos en los sistemas sanitarios. Entre las enfermedades cardiovasculares, la insuficiencia cardíaca es probablemente la condición con mayor prevalencia y afecta a 23-26 millones de personas en todo el mundo. Normalmente, la insuficiencia cardíaca presenta un mal pronóstico y una tasa de supervivencia bajas, en algunos casos peores que algún tipo de cáncer. Además, suele ser la causa de hospitalizaciones frecuentes y es una de las enfermedades más costosas para los sistemas sanitarios. La tendencia al envejecimiento de la población y la creciente incidencia de las enfermedades crónicas están llevando a una situación en la que los sistemas de salud no son capaces de hacer frente a la demanda de la sociedad. Los servicios de salud existentes tendrán que adaptarse para ser efectivos y sostenibles en el futuro. Es necesario identificar nuevos paradigmas de cuidado de pacientes, así como mecanismos para la provisión de servicios que ayuden a transformar estos sistemas sanitarios. En este contexto, esta tesis se plantea la búsqueda de soluciones, basadas en las Tecnologías de la Información y la Comunicación (TIC), que contribuyan a realizar la transformación en los sistemas sanitarios. En concreto, la tesis se centra en abordar los problemas de una de las enfermedades con mayor impacto en estos sistemas: la insuficiencia cardíaca. Las siguientes hipótesis constituyen la base para la realización de este trabajo de investigación: 1. Es posible definir un modelo basado en el paradigma de lazo cerrado y herramientas TIC que formalice el diseño de mejores servicios para pacientes con insuficiencia cardíaca. 2. El modelo de lazo cerrado definido se puede utilizar para definir un servicio real que ayude a gestionar la insuficiencia cardíaca crónica. 3. La introducción, la adopción y el uso de un servicio basado en el modelo definido se traducirá en mejoras en el estado de salud de los pacientes que sufren insuficiencia cardíaca. a. La utilización de un sistema basado en el modelo de lazo cerrado definido mejorará la experiencia del usuario de los pacientes. La definición del modelo planteado se ha basado en el estándar ISO / EN 13940- Sistema de conceptos para dar soporte a la continuidad de la asistencia. Comprende un conjunto de conceptos, procesos, flujos de trabajo, y servicios como componentes principales, y representa una formalización de los servicios para los pacientes con insuficiencia cardíaca. Para evaluar el modelo definido se ha definido un servicio real basado en el mismo, además de la implementación de un sistema de apoyo a dicho servicio. El diseño e implementación de dicho sistema se realizó siguiendo la metodología de Diseño Orientado a Objetivos. El objetivo de la evaluación consistía en investigar el efecto que tiene un servicio basado en el modelo de lazo cerrado sobre el estado de salud de los pacientes con insuficiencia cardíaca. La evaluación se realizó en el marco de un estudio clínico observacional. El análisis de los resultados ha comprendido métodos de análisis cuantitativos y cualitativos. El análisis cuantitativo se ha centrado en determinar el estado de salud de los pacientes en base a datos objetivos (obtenidos en pruebas de laboratorio o exámenes médicos). Para realizar este análisis se definieron dos índices específicos: el índice de estabilidad y el índice de la evolución del estado de salud. El análisis cualitativo ha evaluado la autopercepción del estado de salud de los pacientes en términos de calidad de vida, auto-cuidado, el conocimiento, la ansiedad y la depresión, así como niveles de conocimiento. Se ha basado en los datos recogidos mediante varios cuestionarios o instrumentos estándar (i.e. EQ-5D, la Escala de Ansiedad y Depresión (HADS), el Cuestionario de Cardiomiopatía de Kansas City (KCCQ), la Escala Holandesa de Conocimiento de Insuficiencia Cardíaca (DHFKS), y la Escala Europea de Autocuidado en Insuficiencia Cardíaca (EHFScBS), así como cuestionarios dedicados no estandarizados de experiencia de usuario. Los resultados obtenidos en ambos análisis, cuantitativo y cualitativo, se compararon con el fin de evaluar la correlación entre el estado de salud objetivo y subjetivo de los pacientes. Los resultados de la validación demostraron que el modelo propuesto tiene efectos positivos en el cuidado de los pacientes con insuficiencia cardíaca y contribuye a mejorar su estado de salud. Asimismo, ratificaron al modelo como instrumento válido para la definición de servicios mejorados para la gestión de esta enfermedad. ABSTRACT During the last decades we have witnessed a global aging phenomenon in the population. This can be observed in practically every country in the world, and it is mainly caused by the advances in medicine, and the decrease of mortality and fertility rates. Population aging has an important impact on citizens’ health and it is often the cause for chronic diseases, which constitute global burden and threat to the society in terms of mortality and healthcare expenditure. Among chronic diseases, Chronic Heart Failure (CHF) or Heart Failure (HF) is probably the one with highest prevalence, affecting between 23 and 26 million people worldwide. Heart failure is a chronic, long-term and serious condition with very poor prognosis and worse survival rates than some type of cancers. Additionally, it is often the cause of frequent hospitalizations and one of the most expensive conditions for the healthcare systems. The aging trends in the population and the increasing incidence of chronic diseases are leading to a situation where healthcare systems are not able to cope with the society demand. Current healthcare services will have to be adapted and redefined in order to be effective and sustainable in the future. There is a need to find new paradigms for patients’ care, and to identify new mechanisms for services’ provision that help to transform the healthcare systems. In this context, this thesis aims to explore new solutions, based on ICT, that contribute to achieve the needed transformation within the healthcare systems. In particular, it focuses on addressing the problems of one of the diseases with higher impact within these systems: Heart Failure. The following hypotheses represent the basis to the elaboration of this research: 1. It is possible to define a model based on a closed-loop paradigm and ICT tools that formalises the design of enhanced healthcare services for chronic heart failure patients. 2. The described closed-loop model can be exemplified in a real service that supports the management of chronic heart failure disease. 3. The introduction, adoption and use of a service based on the outlined model will result in improvements in the health status of patients suffering heart failure. 4. The user experience of patients when utilizing a system based on the defined closed-loop model will be enhanced. The definition of the closed-loop model for health care support of heart failure patients have been based on the standard ISO/EN 13940 System of concepts to support continuity of care. It includes a set of concept, processes and workflows, and services as main components, and it represent a formalization of services for heart failure patients. In order to be validated, the proposed closed-loop model has been instantiated into a real service and a supporting IT system. The design and implementation of the system followed the user centred design methodology Goal Oriented Design. The validation, that included an observational clinical study, aimed to investigate the effect that a service based on the closed-loop model had on heart failure patients’ health status. The analysis of results comprised quantitative and qualitative analysis methods. The quantitative analysis was focused on determining the health status of patients based on objective data (obtained in lab tests or physical examinations). Two specific indexes where defined and considered in this analysis: the stability index and the health status evolution index. The qualitative analysis assessed the self-perception of patients’ health status in terms of quality of life, self-care, knowledge, anxiety and depression, as well as knowledge levels. It was based on the data gathered through several standard instruments (i.e. EQ-5D, the Hospital Anxiety and Depression Scale, the Kansas City Cardiomyopathy Questionnaire, the Dutch Heart Failure Knowledge Scale, and the European Heart Failure Self-care Behaviour Scale) as well as dedicated non-standardized user experience questionnaires. The results obtained in both analyses, quantitative and qualitative, were compared in order to assess the correlation between the objective and subjective health status of patients. The results of the validation showed that the proposed model contributed to improve the health status of the patients and had a positive effect on the patients’ care. It also proved that the model is a valid instrument for designing enhanced healthcare services for heart failure patients.

Using the Journalistic Metaphor to Design User Interfaces That Explain Sensor Data

Facilitating general access to data from sensor networks (including traffic, hydrology and other domains) increases their utility. In this paper we argue that the journalistic metaphor can be effectively used to automatically generate multimedia presentations that help non-expert users analyze and understand sensor data. The journalistic layout and style are familiar to most users. Furthermore, the journalistic approach of ordering information from most general to most specific helps users obtain a high-level understanding while providing them the freedom to choose the depth of analysis to which they want to go. We describe the general characteristics and architectural requirements for an interactive intelligent user interface for exploring sensor data that uses the journalistic metaphor. We also describe our experience in developing this interface in real-world domains (e.g., hydrology).