Observations in a maternity ward: Usability considerations for EHRs in an interrupt driven environment

With the increasing demand on healthcare systems it is imperative that all care is provided as efficiently and effectively as possible. Technology within the medical domain offers an exciting opportunity to augment work practices in order to meet these needs. This research project explores the implications of the interrupt-driven nature of work in clinical situations on documentation within an environment that increasingly involves electronic health records (EHRs). Midwives in a busy maternity ward were observed and interviewed about the work practices they employed to document information associated with patient care. The results showed that the interrupt-driven nature of the workplace, a feature common to many healthcare settings, led to a tension between the work and the work to document the work. Further, the IT environment in which the information was collected was not designed to cater for frequent interruption of the data entry process. Several recommendations for improving the IT environment are proposed to support health professionals in documenting patient data whilst attending to the interruptions. The recommendations include timeout screens, push technology, use of handheld PDAs, and cues to augment documentation in an interrupted session. Copyright © 2008 RMIT Publishing

Usability of a mobile, group communication prototype while rendezvousing

Mobile phones are increasingly being used collaboratively by social networks of users in spite of the fact that they are primarily designed to support single users and one-to-one communication. It is not well understood how services such as group SMS, SMS-based discussion lists and mobile instant messaging (IM) will be used by mobile groups in natural settings. Studying specific instances of common styles of in situ, group interaction may provide a way to see behavior patterns and typical interaction problems. We conducted a study of a mobile, group communication probe used during a rendezvousing activity in an urban environment. Usability problems relating to group usage, phone interface design and context were identified. Several major issues included: multitasking during message composition and reading; speed of text entry; excessive demand on visual attention; and ambiguity of intended recipients. We suggest that existing mobile device designs are overly-focused on individual users to the detriment of usability for mobile groups of users. We provide recommendations for the design of future mobile, group interfaces, used in similar situations to those explored here

Pattern-based reuse of successful designs: usability ofsafety-critical systems

Users of safety-critical systems are expected to effectively control or monitor complex systems, with errors potentially leading to catastrophe. For such systems, safety is of paramount importance and must be designed into the human-machine interface. While many case studies show how inadequate design practice led to poor safety and usability, concrete guidance on good design practices is scarce. The paper argues that the pattern language paradigm, widely used in the software design community, is a suitable means of documenting appropriate design strategies. We discuss how typical usability-related properties (e.g., flexibility) need some adjustment to be used for assessing safety-critical systems, and document a pattern language, based on corresponding "safety-usability" principles

Comparison of the Retinomax autorefractor with hand-held retinoscopy in 1-year-old infants

This study aimed to determine the accuracy (and usability) of the Retinomax, a hand-held autorefractor, compared to measurements taken from hand-held retinoscopy (HHR) in a sample of normal 1-year-old children. The study was a method comparison set at four Community Child Health Clinics. Infants (n = 2079) of approximately 1 year of age were identified from birth/immunization records and their caregivers were contacted by mail. A total of 327 infants ranging in age from 46 weeks to 81 weeks (mean 61 weeks) participated in the study. The children underwent a full ophthalmic examination. Under cycloplegia, refraction was measured in each eye by streak retinoscopy (HHR) and then re-measured using the Retinomax autorefractor. Sphere, cylinder, axis of cylinder and spherical equivalent measurements were recorded for HHR and Retinomax instruments, and compared. Across the range of refractive errors measured, there was generally close agreement between the two examination methods, although the Retinomax consistently read around 0.3 D less hyperopic than HHR. Significantly more girls (72 infants, 47.7%), struggled during examination with the Retinomax than boys (52 infants, 29.5%) (P < 0.001). Agreement deteriorated between the two instruments if the patient struggled during the examination (P < 0.001). In general, the Retinomax would appear to be a useful screening instrument in early childhood. However, patient cooperation affects the accuracy of results and is an important con-sideration in determining whether this screening instrument should be adopted for measuring refractive errors in early infancy.

User dyads in software testing: bypassing the need for expert observers

This paper arises out of a research study into the online help facilities provided in popular software applications such as word processors. Its particular focus is on experimental methods of evaluating the effectiveness and usability of those facilities. Focus groups, questionnaires, and online surveys had already been used in other phases of the study, but it was judged that these approaches would be unsuitable for measuring effectiveness and usability because they are susceptible to respondents' subjectivity. Direct observation of people working on set word-processing tasks was ruled out initially because of a lack of trained observers; it would have taken too long for the investigator to observe a large enough sample by himself. Automatic recording of users' actions was also rejected, as it would have demanded equipment and/or software that was not available and seemed too expensive to acquire. The approach and techniques described here were an attempt to overcome these difficulties by using observers drawn from the same population of students that provided the test subjects; as a by-product, this may also have enhanced the acceptability (and hence possibly the validity) of the experiments by reducing the exam pressure perceived by participants.

Stepping Stones Triple P: A pilot study to evaluate acceptability of the program by parents of a child diagnosed with an Autism Spectrum Disorder

The experience of parents of children with Autism Spectrum Disorder (ASD) in standard parenting programs has not been researched, although anecdotal evidence suggests that they do not find them acceptable. Forty-two parents of children with ASD were asked to view a DVD explaining individual parenting strategies from Stepping Stones, a new branch of the Triple P program targeted specifically at parents of children with disabilities. Parents were asked to rate each strategy for acceptability, usability and behavioural intention, i.e., their intention to use the strategy. Additionally, parental attributions and parental perceived control were explored as possible barriers to positive evaluations of Stepping Stones parenting strategies. A focus group of parents was used to gather more detailed parent response to the program. Parent responses to the program were generally positive and attribution of the child's behaviour to uncontrollable factors was found to predict higher ratings of usability. The results were interpreted within the context of Weiner's attributional theory and the theory of reasoned action. The limitations of this study and suggestions for future research are discussed. (c) 2005 Elsevier Ltd. All rights reserved.

Virtual reality exposure therapy: 150-degree screen to desktop PC

Virtual reality exposure therapy (VRET) developed using immersive or semi-immersive virtual environments present a usability problem for practitioners. To meet practitioner requirements for lower cost and portability VRET programs must often be ported onto desktop environments such as the personal computer (PC). However, success of VRET has been shown to be linked to presence, and the environment's ability to evoke the same reactions and emotions as a real experience. It is generally accepted that high-end virtual environments ( VEs) are more immersive than desktop PCs, but level of immersion does not always predict level of presence. This paper reports on the impact on presence of porting a therapeutic VR application for Schizophrenia from the initial research environment of a semi-immersive curved screen to PC. Presence in these two environments is measured both introspectively and across a number of causal factors thought to underlie the experience of presence. Results show that the VR exposure program successfully made users feel they were present in both platforms. While the desktop PC achieved higher scores on presence across causal factors participants reported they felt more present in the curved screen environment. While comparison of the two groups was statistically significant for the PQ but not for the IPQ, subjective reports of experiences in the environments should be considered in future research as the success of VRET relies heavily on the emotional response of patients to the therapeutic program.

A software engineering framework for context-aware pervasive computing

There is growing interest in the use of context-awareness as a technique for developing pervasive computing applications that are flexible, adaptable, and capable of acting autonomously on behalf of users. However, context-awareness introduces various software engineering challenges, as well as privacy and usability concerns. In this paper, we present a conceptual framework and software infrastructure that together address known software engineering challenges, and enable further practical exploration of social and usability issues by facilitating the prototyping and fine-tuning of context-aware applications.

A web recommendation technique based on probabilistic latent semantic analysis

Web transaction data between Web visitors and Web functionalities usually convey user task-oriented behavior pattern. Mining such type of click-stream data will lead to capture usage pattern information. Nowadays Web usage mining technique has become one of most widely used methods for Web recommendation, which customizes Web content to user-preferred style. Traditional techniques of Web usage mining, such as Web user session or Web page clustering, association rule and frequent navigational path mining can only discover usage pattern explicitly. They, however, cannot reveal the underlying navigational activities and identify the latent relationships that are associated with the patterns among Web users as well as Web pages. In this work, we propose a Web recommendation framework incorporating Web usage mining technique based on Probabilistic Latent Semantic Analysis (PLSA) model. The main advantages of this method are, not only to discover usage-based access pattern, but also to reveal the underlying latent factor as well. With the discovered user access pattern, we then present user more interested content via collaborative recommendation. To validate the effectiveness of proposed approach, we conduct experiments on real world datasets and make comparisons with some existing traditional techniques. The preliminary experimental results demonstrate the usability of the proposed approach.