Some Usability Issues in Healthcare Interactive Systems Jean Vanderdonckt Université catholique de Louvain (UCL) Louvain School of Management (LSM) Information Systems Unit (ISYS) Belgian Laboratory of Computer-Human Interaction (BCHI) http://www.isys.ucl.ac.be/bchi

BCHI: Belgian Lab. of Computer-Human Interaction Couvrir le cycle de vie de développement de l’interface homme-machine d’un système Multi-device, multi-modal, multi-user Projets régionaux Arthur, Destine, ReQuest, Salamandre (Région Wallonne) DefiMedia, TEC Namur-Luxembourg Projets nationaux Dexia, Namahn (Fortis), Office du Tourisme, Smals-MvB Projets européens FP4 (Syrecos), FP5 (Cameleon), FP 6 (Similar), FP 7 (Human) Projets internationaux Harmonia (USA), RedWhale Soft Corp. (USA), OASIS

Couvrir le cycle de vie de développement de l’interface homme-machine d’un système

Multi-device, multi-modal, multi-user

Projets régionaux

Arthur, Destine, ReQuest, Salamandre (Région Wallonne)

DefiMedia, TEC Namur-Luxembourg

Projets nationaux

Dexia, Namahn (Fortis), Office du Tourisme, Smals-MvB

Projets européens

FP4 (Syrecos), FP5 (Cameleon), FP 6 (Similar), FP 7 (Human)

Projets internationaux

Harmonia (USA), RedWhale Soft Corp. (USA), OASIS

Presentation outline Our working definition of usability Case study #1: Abrumet web portal Case study #2: Arthur multi-platform system Conclusion

Our working definition of usability

Case study #1: Abrumet web portal

Case study #2: Arthur multi-platform system

Conclusion

What is usability? (1/3) Ergonomics in general Goal: to design any system so that it can be used effectively and efficiently by a given population of users Means: to rely on efficient work procedures respecting health and well-being of end users Software ergonomics = Usability Our working definition Utility Adequacy of user interface with respect to functional requirements of the system Is independent of the end user Usability Adequacy of user interface with respect to operational needs of the end user Is dependent of the end user

Ergonomics in general

Goal: to design any system so that it can be used effectively and efficiently by a given population of users

Means: to rely on efficient work procedures respecting health and well-being of end users

Software ergonomics = Usability

Our working definition

Utility

Adequacy of user interface with respect to functional requirements of the system

Is independent of the end user

Usability

Adequacy of user interface with respect to operational needs of the end user

Is dependent of the end user

What is usability? (2/3) Utilité assure un grand nombre de fonctions utiles pour l'utilisateur, pour un traitement de texte : créer une table des matières avoir un correcteur orthographique déplacer des blocs d'un endroit à un autre Utilisabilité : facilité d'usage accepte les erreurs de l'utilisateur offre la possibilité de les corriger ne bloque pas en cas d'erreur facilité d'accès aux fonctions commandes, messages, icônes compréhensibles Certains logiciels sont riches en fonctions (utilité), mais difficiles à exploiter (utilisabilité) Utilité : les utilisateurs intensifs préfèrent parfois utiliser un outil riche, mais difficile à utiliser plutôt qu'un outil facile à utiliser, mais pauvre Utilisabilité : pour les utilisateurs novices ou épisodiques, la facilité d'emploi est un critère prioritaire l'attitude de l'utilisateur vis-à-vis de l'outil dépend de son interface

Utilité

assure un grand nombre de fonctions utiles pour l'utilisateur, pour un traitement de texte :

créer une table des matières

avoir un correcteur orthographique

déplacer des blocs d'un endroit à un autre

Utilisabilité :

facilité d'usage

accepte les erreurs de l'utilisateur

offre la possibilité de les corriger

ne bloque pas en cas d'erreur

facilité d'accès aux fonctions

commandes, messages, icônes compréhensibles

Certains logiciels sont riches en fonctions (utilité), mais difficiles à exploiter (utilisabilité)

Utilité :

les utilisateurs intensifs préfèrent parfois utiliser un outil riche, mais difficile à utiliser plutôt qu'un outil facile à utiliser, mais pauvre

Utilisabilité :

pour les utilisateurs novices ou épisodiques, la facilité d'emploi est un critère prioritaire

l'attitude de l'utilisateur vis-à-vis de l'outil dépend de son interface

What is usability? (3/3) Is this web page usable?

Is this web page usable?

Case study #1: Abrumet web portal What is ABRUMET? ASBL located in Brussels Main project: To introduce a regional network between hospitals in Brussels To facilitate exchange of medical patient data across hospitals Members CHIREC, Clinique de l’Europe, Hopital Erasme, C. de Paepe, Sanatia, Saint Jean, UCL Saint Luc, UZ Brussel IRIS

What is ABRUMET?

ASBL located in Brussels

Main project:

To introduce a regional network between hospitals in Brussels

To facilitate exchange of medical patient data across hospitals

Members

CHIREC, Clinique de l’Europe, Hopital Erasme, C. de Paepe, Sanatia, Saint Jean, UCL Saint Luc, UZ Brussel

IRIS

Case study #1: Abrumet web portal Example: Access the Abrumet Medical Date of a Patient by a Hospital Physician in Emergency (Breaking Glass) AMPI Access control AAA Physician G B HOSPITAL A HOSPITAL Medical record of patient X in A Hospital A Hospital Physicians B Hospital Physician H Generalist Physician G Administration agent [Abrumet 2006] ABRUMET PORTAL ARF X Identif Admin SUMEHR ATRs Keys 2: Access granted ABRUMET OFFICE 1: Physician logging in 3: Physician logged in 4: Search patient X in AMPI 5: Patient X is in AMPI and has a medical record in A 7: Access the medical record of patient X in A 6: Request for accessing the medical record (breaking glass) 8:Medical record of patient X in A accessed by H 10:Notification of breaking glass to ABruMeT 9:Notification of breaking glass by H

Example: Access the Abrumet Medical Date of a Patient by a Hospital Physician in Emergency (Breaking Glass)

Browse AMD screen (1/6) Browse ABruMeT Medical Data (AMD) Home Search : EN – Help FR – NL Advanced search Register Contact Site map Privacy policy – Terms and conditions – Date: 05/28/09 Welcome Dr. Jean Dupont Select a patient to browse her AMD or search a patient: Firstname: Lastname: City: Zip code: Create an ABruMeT References File (ARF) Update my profile Approval management Renew my approval Terminate my approval Patient management Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Enter a Breaking glass procedure Electronic mail Send an e-mail to a hospital Access e-mails Manage e-mail preferences Access an ABruMeT References File (ARF) Transfer patients momentarily Send an e-mail to an AAP Add an AAP in my group Renew an ABruMeT Therapeutic Relation (ATR) [Abrumet 2006] ABruMeT Portal

Browse AMD screen (2/6) Browse ABruMeT Medical Data (AMD) Home Search : EN – Help FR – NL Advanced search Register Contact Site map Privacy policy – Terms and conditions – Date: 05/28/09 Welcome Dr. Jean Dupont AMD of Florence Rigo: Lastname: Legal address: Street: No: City: Zip code: Phone number: Mobile number: E-mail: Residence address: Street: No: City: Zip code: NISS number: SIS Card number: SIS Card validity: Contact person: Mutuality Affiliation: Mutuality ID: Mutuality period: Start date: End date: Create an ABruMeT References File (ARF) Update my profile Approval management Renew my approval Terminate my approval Patient management Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Enter a Breaking glass procedure Electronic mail Send an e-mail to a hospital Access e-mails Manage e-mail preferences Access an ABruMeT References File (ARF) Transfer patients momentarily Send an e-mail to an AAP Add an AAP in my group Renew an ABruMeT Therapeutic Relation (ATR) [Abrumet 2006] ABruMeT Portal

Browse AMD screen (3/6) Browse ABruMeT Medical Data (AMD) Home Search : EN – Help FR – NL Advanced search Register Contact Site map Privacy policy – Terms and conditions – Date: 05/28/09 Welcome Dr. Jean Dupont AMD of Florence Rigo: Adverse drug reaction: Allergy: Social risk: Other risks: Global medical data manager: Not to be ressuscitated: Blood transfusion refusal: Vaccinations: Current medications: Other medical information: Antecedent information: Create an ABruMeT References File (ARF) Update my profile Approval management Renew my approval Terminate my approval Patient management Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Enter a Breaking glass procedure Electronic mail Send an e-mail to a hospital Access e-mails Manage e-mail preferences Access an ABruMeT References File (ARF) Transfer patients momentarily Send an e-mail to an AAP Add an AAP in my group Renew an ABruMeT Therapeutic Relation (ATR) [Abrumet 2006] ABruMeT Portal

Browse AMD History screen (4/6) Browse ABruMeT Medical Data (AMD) Home Search : EN – Help FR – NL Advanced search Register Contact Site map Privacy policy – Terms and conditions – Date: 05/28/09 Welcome Dr. Jean Dupont AMD of Florence Rigo: Allergies: Create an ABruMeT References File (ARF) Update my profile Approval management Renew my approval Terminate my approval Patient management Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Enter a Breaking glass procedure Electronic mail Send an e-mail to a hospital Access e-mails Manage e-mail preferences Access an ABruMeT References File (ARF) Transfer patients momentarily Send an e-mail to an AAP Add an AAP in my group Renew an ABruMeT Therapeutic Relation (ATR) Event Pollen allergy revealed Heavy pollen reaction Acarian allergy Date 02/06/06 03/06/06 23/08/06 Service Emergency care Hospital A Emergency care Hospital A Radiology service Hospital B Physician Dr. Stamate Dr. Stamate Dr. Radio [Abrumet 2006] ABruMeT Portal

Browse AMD screen (5/6) Browse ABruMeT Medical Data (AMD) Home Search : EN – Help FR – NL Advanced search Register Contact Site map Privacy policy – Terms and conditions – Date: 05/28/09 Welcome Dr. Jean Dupont AMD of Florence Rigo: Event Hospital admission Emergency care Echography Date 02/05/06 02/05/06 03/05/06 Service Emergency care Emergency care Radiology service Physician Dr. Stamate Dr. Stamate Dr. Radio Select link Create an ABruMeT References File (ARF) Update my profile Approval management Renew my approval Terminate my approval Patient management Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Enter a Breaking glass procedure Electronic mail Send an e-mail to a hospital Access e-mails Manage e-mail preferences Access an ABruMeT References File (ARF) Transfer patients momentarily Send an e-mail to an AAP Add an AAP in my group Renew an ABruMeT Therapeutic Relation (ATR) [Abrumet 2006] ABruMeT Portal

Browse AMD screen (6/6) Browse ABruMeT Medical Data (AMD) Home Search : EN – Help FR – NL Advanced search Register Contact Site map Privacy policy – Terms and conditions – Date: 05/28/09 Welcome Dr. Jean Dupont AMD of Florence Rigo: Event Echography Date 03/05/06 Service Radiology service Physician Dr. Radio Attached documents: Create an ABruMeT References File (ARF) Update my profile Approval management Renew my approval Terminate my approval Patient management Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Enter a Breaking glass procedure Electronic mail Send an e-mail to a hospital Access e-mails Manage e-mail preferences Access an ABruMeT References File (ARF) Transfer patients momentarily Send an e-mail to an AAP Add an AAP in my group Renew an ABruMeT Therapeutic Relation (ATR) [Abrumet 2006] ABruMeT Portal

Documents attached to AMD Browse ABruMeT Medical Data (AMD) Home Search : EN – Help FR – NL Advanced search Register Contact Site map Privacy policy – Terms and conditions – Date: 05/28/09 Welcome Dr. Jean Dupont AMD of Florence Rigo: Event Echography Date 03/05/06 Service Radiology service Physician Dr. Radio Attached document: Plain radiographic image of the abdomen revealing an appendicolith (arrow) Create an ABruMeT References File (ARF) Update my profile Approval management Renew my approval Terminate my approval Patient management Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Enter a Breaking glass procedure Electronic mail Send an e-mail to a hospital Access e-mails Manage e-mail preferences Access an ABruMeT References File (ARF) Transfer patients momentarily Send an e-mail to an AAP Add an AAP in my group Renew an ABruMeT Therapeutic Relation (ATR) [Abrumet 2006] ABruMeT Portal

Why is it usable? Browse ABruMeT Medical Data (AMD) Home Search : EN – Help FR – NL Advanced search Register Contact Site map Privacy policy – Terms and conditions – Date: 05/28/09 Welcome Dr. Jean Dupont AMD of Florence Rigo: Event Echography Date 03/05/06 Service Radiology service Physician Dr. Radio Attached document: Plain radiographic image of the abdomen revealing an appendicolith (arrow) Create an ABruMeT References File (ARF) Update my profile Approval management Renew my approval Terminate my approval Patient management Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Enter a Breaking glass procedure Electronic mail Send an e-mail to a hospital Access e-mails Manage e-mail preferences Access an ABruMeT References File (ARF) Transfer patients momentarily Send an e-mail to an AAP Add an AAP in my group Renew an ABruMeT Therapeutic Relation (ATR) [Abrumet 2006] ABruMeT Portal

Usability decomposed by Linguistic level Task [Nielsen86] Supprimer un paragraphe de ma lettre Physic pression de la touche [Ctrl]+ [D] suivie de [6] Alphabetic D, 6 Lexical commande [DELETE], chiffre [6] Syntactic DELETE 6 Semantic Supprimer un certain nombre de lignes Pragmatic Supprimer les 6 lignes du texte édité formant le paragraphe

Why is it usable? Browse ABruMeT Medical Data (AMD) Home Search : EN – Help FR – NL Advanced search Register Contact Site map Privacy policy – Terms and conditions – Date: 05/28/09 Welcome Dr. Jean Dupont AMD of Florence Rigo: Event Echography Date 03/05/06 Service Radiology service Physician Dr. Radio Attached document: Plain radiographic image of the abdomen revealing an appendicolith (arrow) Create an ABruMeT References File (ARF) Update my profile Approval management Renew my approval Terminate my approval Patient management Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Enter a Breaking glass procedure Electronic mail Send an e-mail to a hospital Access e-mails Manage e-mail preferences Access an ABruMeT References File (ARF) Transfer patients momentarily Send an e-mail to an AAP Add an AAP in my group Renew an ABruMeT Therapeutic Relation (ATR) Physical level Alphabetic level Lexical level Semantic level Pragmatic level ABruMeT Portal Syntactic level

Case study #2: ARTHUR What is ARTHUR? Architecture de Télécommunications des Hôpitaux en Situation d’Urgence Projet inter-universitaire (FUNDP, UCL,…)

What is ARTHUR?

Architecture de Télécommunications des Hôpitaux en Situation d’Urgence

Projet inter-universitaire (FUNDP, UCL,…)

Multi-platform for Emergency [Amouh et al.,2005]

Multi-platform for Emergency Three platforms Pocket PC Desktop PC Wall Screens

Three platforms

Pocket PC

Desktop PC

Wall Screens

Multi-platform for Emergency Model and method Design the reference screen first Refine the others screens later By applying graceful degradation By applying transformation techniques

Model and method

Design the reference screen first

Refine the others screens later

By applying graceful degradation

By applying transformation techniques

Graceful degradation [Florins & Vanderdonckt,2004]

Transformation rules

Transformation rules Add all >> Add > << Remove all < Remove >> > << < > < Group box Item 1 Item 2 Item 3 Item 4 Item 5 Item 6 Item 7 Item 8 Item 1 Item 2 Item 3 Item 4 Item 5 Item 6 Item 7 Item 1 Item 1 Item 2 Item 3 Item 4 Item 5 Item 6 Item 7

Transformation rules

Conclusion Usability applyies everywhere Most known form: web sites Towards Accessibility of web sites Towards Healthcare systems Source: J. Jacko et al., Framework for Usability: healthcare professionals and the Internet

Usability applyies everywhere

Most known form: web sites

Towards Accessibility of web sites

Towards Healthcare systems

Thank you very much for your attention For more information and downloading, http://www.isys.ucl.ac.be/bchi http://www.usixml.org User Interface eXtensible Markup Language http://www.similar.cc European network on Multimodal UIs Special thanks to all members of the team!