Some Usability Issues in Healthcare Interactive Systems

Slide 1: 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 1 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 2: 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 2 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 3: Presentation outline • Our working definition of usability • Case study #1: Abrumet web portal • Case study #2: Arthur multi-platform system • Conclusion 3 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 4: 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 4 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 5: 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 5 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 6: What is usability? (3/3) • Is this web page usable? 6 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 7: 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 7 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 8: Case study #1: Abrumet web portal • Example: Access the Abrumet Medical Date of a Patient by a Hospital Physician in Emergency (Breaking Glass) 8:Medical record of patient X in A accessed by H A HOSPITAL B HOSPITAL ABRUMET A Hospital Physicians B Hospital Physician H OFFICE Medical record 7: Access the of patient X medical in A Hospital record of patient X in A Administration agent 4: Search patient X in AMPI 10:Notification of 5: Patient X is in AMPI ABRUMET PORTAL breaking glass and has a medical record in A Access AMPI to ABruMeT 3: Physician control 6: Request for accessing ARF X logged in the medical record AAA Identif (breaking glass) Admin SUMEHR 2: Access granted Keys Physician G ATRs 1: Physician logging in 9:Notification of breaking glass by H Generalist Physician G [Abrumet 2006] 8 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 9: Browse AMD screen (1/6) ABruMeT Portal Go Search : EN – FR – NL Enter Text Advanced search Home Register Contact Site map Welcome Dr. Jean Dupont Date: 11/10/07 Approval management By SIS card Select a patient to browse her AMD or search a patient: Renew my approval Bertrand Armand By phonetic search (Soundex): Terminate my approval Alice Chevalier Update my profile Patrick Dupont Enter Text Add an AAP in my group Florence Rigo By search criteria Françoise Rigo Patient management Alain Térieur Firstname: Enter Text Alex Térieur Access an ABruMeT References File (ARF) Jan Vandierendonck Create an ABruMeT References File (ARF) Lastname: Frans Van Piperzeel Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Enter Text City: Renew an ABruMeT Therapeutic Relation (ATR) Browse Cancel Enter No Zip code: Browse ABruMeT Medical Data (AMD) Enter a Breaking glass procedure Transfer patients momentarily Electronic mail Send an e-mail to a hospital Send an e-mail to an AAP Access e-mails Manage e-mail preferences [Abrumet 2006] 9 World Usability Day – Louvain-la-Neuve, 8 November 2007 Help – Privacy policy – Terms and conditions

Slide 10: Browse AMD screen (2/6) ABruMeT Portal Go Search : EN – FR – NL Enter Text Advanced search Home Register Contact Site map Welcome Dr. Jean Dupont Date: 11/10/07 Approval management AMD of Florence Rigo: Update Cancel Renew my approval Terminate my approval Personal information SUMEHR Medical data at Hospital A Medical data at Hospital B Update my profile Add an AAP in my group Enter Text Enter Text Patient management Lastname: Access an ABruMeT References File (ARF) Legal address: Address Create an ABruMeT References File (ARF) Enter Text Enter No Street: No: Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Enter Text Enter No City: Zip code: Renew an ABruMeT Therapeutic Relation (ATR) Browse ABruMeT Medical Data (AMD) Residence address: Address Enter a Breaking glass procedure Enter Text Enter No Street: No: Transfer patients momentarily Enter Text Enter No City: Zip code: Electronic mail Send an e-mail to a hospital Send an e-mail to an AAP Enter Text E-mail: Access e-mails Enter Text Enter Text Phone number: Mobile number: Manage e-mail preferences SIS Card number: Enter Text Enter Text NISS number: SIS Card validity: Enter Text Enter Text Contact person: Mutuality ID: Mutuality Affiliation: Enter Text Enter No Mutuality period: Start date: End date: Enter No Enter No [Abrumet 2006] 10 World Usability Day – Louvain-la-Neuve, 8 November 2007 Help – Privacy policy – Terms and conditions

Slide 11: Browse AMD screen (3/6) ABruMeT Portal Go Search : EN – FR – NL Enter Text Advanced search Home Register Contact Site map Welcome Dr. Jean Dupont Date: 11/10/07 Approval management AMD of Florence Rigo: Update Cancel Renew my approval Terminate my approval Personal information SUMEHR Medical data at Hospital A Medical data at Hospital B Update my profile Add an AAP in my group Adverse drug reaction: Enter Text Patient management Access an ABruMeT References File (ARF) Allergy: Allergie au pollen . Create an ABruMeT References File (ARF) Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Renew an ABruMeT Therapeutic Relation (ATR) Social risk: Enter Text Browse ABruMeT Medical Data (AMD) Other risks: Enter Text Enter a Breaking glass procedure Global medical Transfer patients momentarily data manager: Electronic mail Send an e-mail to a hospital Not to be ressuscitated: Send an e-mail to an AAP Blood transfusion refusal: Access e-mails Vaccinations: Enter Text Manage e-mail preferences Current medications: Enter Text Other medical information: Enter Text Antecedent information: Enter Text History [Abrumet 2006] 11 World Usability Day – Louvain-la-Neuve, 8 November 2007 Help – Privacy policy – Terms and conditions

Slide 12: Browse AMD History screen (4/6) ABruMeT Portal Go Search : EN – FR – NL Enter Text Advanced search Home Register Contact Site map Welcome Dr. Jean Dupont Date: 11/10/07 Approval management AMD of Florence Rigo: Update Cancel Renew my approval Terminate my approval Personal information SUMEHR Medical data at Hospital A Medical data at Hospital B Update my profile Add an AAP in my group Allergies: Patient management Event Date Service Physician Access an ABruMeT References File (ARF) Pollen allergy revealed 02/06/06 Emergency care Hospital A Dr. Stamate Create an ABruMeT References File (ARF) Heavy pollen reaction 03/06/06 Emergency care Hospital A Dr. Stamate Insert an ABruMeT Therapeutic Relation (ATR) Acarian allergy 23/08/06 Radiology service Hospital B Dr. Radio Delete an ABruMeT Therapeutic Relation (ATR) Renew an ABruMeT Therapeutic Relation (ATR) Return Browse ABruMeT Medical Data (AMD) Enter a Breaking glass procedure Transfer patients momentarily Electronic mail Send an e-mail to a hospital Send an e-mail to an AAP Access e-mails Manage e-mail preferences [Abrumet 2006] 12 World Usability Day – Louvain-la-Neuve, 8 November 2007 Help – Privacy policy – Terms and conditions

Slide 13: Browse AMD screen (5/6) ABruMeT Portal Go Search : EN – FR – NL Enter Text Advanced search Home Register Contact Site map Welcome Dr. Jean Dupont Date: 11/10/07 Approval management AMD of Florence Rigo: Renew my approval Terminate my approval Personal information SUMEHR Medical data at Hospital A Medical data at Hospital B Update my profile Add an AAP in my group Event Date Service Physician Select link Hospital admission 02/05/06 Emergency care Dr. Stamate Patient management Emergency care 02/05/06 Emergency care Dr. Stamate Access an ABruMeT References File (ARF) Echography 03/05/06 Radiology service Dr. Radio Create an ABruMeT References File (ARF) Insert an ABruMeT Therapeutic Relation (ATR) Browse Cancel Delete an ABruMeT Therapeutic Relation (ATR) Renew an ABruMeT Therapeutic Relation (ATR) Browse ABruMeT Medical Data (AMD) Enter a Breaking glass procedure Transfer patients momentarily Electronic mail Send an e-mail to a hospital Send an e-mail to an AAP Access e-mails Manage e-mail preferences [Abrumet 2006] 13 World Usability Day – Louvain-la-Neuve, 8 November 2007 Help – Privacy policy – Terms and conditions

Slide 14: Browse AMD screen (6/6) ABruMeT Portal Go Search : EN – FR – NL Enter Text Advanced search Home Register Contact Site map Welcome Dr. Jean Dupont Date: 11/10/07 Approval management AMD of Florence Rigo: Renew my approval Terminate my approval Personal information SUMEHR Medical data at Hospital A Medical data at Hospital B Update my profile Add an AAP in my group Event Date Service Physician Echography 03/05/06 Radiology service Dr. Radio Patient management Access an ABruMeT References File (ARF) The patient has been admitted to the emergency care with heavy stomach pain , probably after Create an ABruMeT References File (ARF) gastro-entiritis . Since the pain persists , an echography revealed the start of an appendicitis . Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Renew an ABruMeT Therapeutic Relation (ATR) Browse ABruMeT Medical Data (AMD) Enter a Breaking glass procedure Transfer patients momentarily Electronic mail Send an e-mail to a hospital Send an e-mail to an AAP Plain radiographic image of the abdomen revealing an appendicolith Attached documents: Access e-mails Transverse ultrasound image of the right lower quadrant of the abdomen Manage e-mail preferences Download Close Return to AMD [Abrumet 2006] 14 World Usability Day – Louvain-la-Neuve, 8 November 2007 Help – Privacy policy – Terms and conditions

Slide 15: Documents attached to AMD ABruMeT Portal Go Search : EN – FR – NL Enter Text Advanced search Home Register Contact Site map Welcome Dr. Jean Dupont Date: 11/10/07 Approval management AMD of Florence Rigo: Renew my approval Terminate my approval Personal information SUMEHR Medical data at Hospital A Medical data at Hospital B Update my profile Add an AAP in my group Event Date Service Physician Echography 03/05/06 Radiology service Dr. Radio Patient management Access an ABruMeT References File (ARF) Attached document: Plain radiographic image of the abdomen revealing an appendicolith (arrow) Create an ABruMeT References File (ARF) Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Renew an ABruMeT Therapeutic Relation (ATR) Browse ABruMeT Medical Data (AMD) Enter a Breaking glass procedure Transfer patients momentarily Electronic mail Send an e-mail to a hospital Send an e-mail to an AAP Access e-mails Manage e-mail preferences Close Return to AMD [Abrumet 2006] 15 World Usability Day – Louvain-la-Neuve, 8 November 2007 Help – Privacy policy – Terms and conditions

Slide 16: Why is it usable? ABruMeT Portal Go Search : EN – FR – NL Enter Text Advanced search Home Register Contact Site map Welcome Dr. Jean Dupont Date: 11/10/07 Approval management AMD of Florence Rigo: Renew my approval Terminate my approval Personal information SUMEHR Medical data at Hospital A Medical data at Hospital B Update my profile Add an AAP in my group Event Date Service Physician Echography 03/05/06 Radiology service Dr. Radio Patient management Access an ABruMeT References File (ARF) Attached document: Plain radiographic image of the abdomen revealing an appendicolith (arrow) Create an ABruMeT References File (ARF) Insert an ABruMeT Therapeutic Relation (ATR) Delete an ABruMeT Therapeutic Relation (ATR) Renew an ABruMeT Therapeutic Relation (ATR) Browse ABruMeT Medical Data (AMD) Enter a Breaking glass procedure Transfer patients momentarily Electronic mail Send an e-mail to a hospital Send an e-mail to an AAP Access e-mails Manage e-mail preferences Close Return to AMD [Abrumet 2006] 16 World Usability Day – Louvain-la-Neuve, 8 November 2007 Help – Privacy policy – Terms and conditions

Slide 17: Usability decomposed by Linguistic level Task Supprimer un paragraphe de ma lettre Supprimer les 6 lignes du texte édité formant Pragmatic le paragraphe Supprimer un certain nombre de lignes Semantic DELETE 6 Syntactic commande [DELETE], chiffre [6] Lexical D, 6 Alphabetic pression de la touche [Ctrl]+ [D] suivie de [6] Physic 17 [Nielsen86] World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 18: Lexical level Alphabetic level Why is it usable? ABruMeT Portal Go Search : EN – FR – NL Enter Text Advanced search Home Register Contact Site map Welcome Dr. Jean Dupont Date: 11/10/07 Semantic level Approval management AMD of Florence Rigo: Renew my approval Terminate my approval Personal information SUMEHR Medical data at Hospital A Medical data at Hospital B Update my profile Add an AAP in my group Event Date Service Physician Echography 03/05/06 Radiology service Dr. Radio Patient management Access an ABruMeT References File (ARF) Attached document: Plain radiographic image of the abdomen revealing an appendicolith (arrow) Create an ABruMeT References File (ARF) Insert an ABruMeT Therapeutic Relation (ATR) Syntactic level Delete an ABruMeT Therapeutic Relation (ATR) Renew an ABruMeT Therapeutic Relation (ATR) Browse ABruMeT Medical Data (AMD) Enter a Breaking glass procedure Transfer patients momentarily Physical level Electronic mail Send an e-mail to a hospital Send an e-mail to an AAP Access e-mails Manage e-mail preferences Pragmatic level Close Return to AMD 18 World Usability Day – Louvain-la-Neuve, 8 November 2007 Help – Privacy policy – Terms and conditions

Slide 19: Case study #2: ARTHUR • What is ARTHUR? – Architecture de Télécommunications des Hôpitaux en Situation d’Urgence – Projet inter-universitaire (FUNDP, UCL,…) 19 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 20: Multi-platform for Emergency 20 [Amouh et al.,2005] World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 21: Multi-platform for Emergency • Three platforms – Pocket PC – Desktop PC – Wall Screens 21 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 22: 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 22 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 23: Graceful degradation 23 World Usability Day – Louvain-la-Neuve, 8 November 2007 [Florins & Vanderdonckt,2004]

Slide 24: Transformation rules 24 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 25: Transformation rules Add all >> >> Add > > < Remove < << Remove all << Item 1 Item 1 > Item 2 Item 2 Item 3 Item 3 Item 4 Item 4 < Item 1 Item 5 Item 5 Item 6 Item 6 Group box Item 7 Item 7 Item 1 Item 5 Item 2 Item 6 Item 3 Item 7 Item 4 Item 8 25 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 26: Transformation rules 26 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 27: 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 27 World Usability Day – Louvain-la-Neuve, 8 November 2007

Slide 28: Thank you very much for your attention http://www.usixml.org User Interface eXtensible Markup Language http://www.similar.cc European network on Multimodal UIs For more information and downloading, http://www.isys.ucl.ac.be/bchi Special thanks to all members of the team! 28 World Usability Day – Louvain-la-Neuve, 8 November 2007