Mixed Methodology for Improving Usability of e-Health Systems


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Yousef Awwad Daraghmi
School of Information Management
Victoria University of Wellington
(P07, 17/10/08, Usability stream, 2.10pm)

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Mixed Methodology for Improving Usability of e-Health Systems

  1. 1. Mixed Methodology for Improving Usability of e-Health Systems Name : Yousef Awwad Daraghmi Co-author: Dr Rowena Cullen Co-author: Tiong Goh School of Information Management Victoria University of Wellington A presentation for HINZ Conference & Exhibition 2008 17- October, 2008
  2. 2. Agenda <ul><li>Introduction </li></ul><ul><li>Methodology Components </li></ul><ul><li>Integration of Components </li></ul><ul><li>Development stages </li></ul><ul><li>Conclusion </li></ul>Yousef Daraghmi
  3. 3. Introduction <ul><ul><li>Adoption of ICT applications such as EHRs in healthcare is low due to several barriers ( Kaplan, 2001) </li></ul></ul><ul><ul><li>Although some barriers have been partially resolved, usability and complexity of health ICT applications have remained as major issues. </li></ul></ul><ul><ul><li>( Kushniruk and Patel, 2004) </li></ul></ul><ul><ul><li>In order to achieve usability, system development and evaluation methods should: </li></ul></ul><ul><ul><ul><li>Focus on healthcare users’ requirements </li></ul></ul></ul><ul><ul><ul><li>Healthcare Work requirements ( Kushniruk and Patel, 2004) </li></ul></ul></ul><ul><ul><li>Users participations in the design helps to achieve the previous goal because users can express what they need, how the work flows, what is required and what is not required ( Kuhn, 1993) </li></ul></ul><ul><ul><li>Emerging requirements should be also considered which can be achieved by rapid development (Martin, 1991) </li></ul></ul>Yousef Daraghmi
  4. 4. Methodology Components <ul><li>The components were selected to meet the previous need </li></ul><ul><li>The components are: </li></ul><ul><ul><li>User-Centred Design (UCD) </li></ul></ul><ul><ul><li>Participatory Design (PD) – Third Generation </li></ul></ul><ul><ul><li>Rapid Application Development (RAD) </li></ul></ul><ul><ul><li>Evaluative usability engineering approach </li></ul></ul>Yousef Daraghmi
  5. 5. Methodology Components <ul><li>1. User-Centred Design (UCD) </li></ul><ul><ul><li>UCD is a philosophy that addresses user requirements </li></ul></ul><ul><ul><li>UCD is a process that focuses on cognitive factors (Norman,1986) </li></ul></ul><ul><ul><li>UCD is based on Human Computer Interaction (HCI) (Katz-Haas,1998) </li></ul></ul><ul><ul><li>UCD advantages: (Katz-Haas,1998) (Norman,1986) </li></ul></ul><ul><ul><ul><li>Enhancing systems usability </li></ul></ul></ul><ul><ul><ul><li>Focusing on the core of the system and minimizing unnecessary functions </li></ul></ul></ul><ul><ul><ul><li>Enabling revision of development stages because of the iterative nature of UCD </li></ul></ul></ul><ul><ul><ul><li>Increasing user satisfaction and productivity </li></ul></ul></ul>Yousef Daraghmi
  6. 6. Methodology Components <ul><li>2. Participatory Design (PD) </li></ul><ul><ul><li>PD provides design guidelines, and techniques (Kuhn,1993) </li></ul></ul><ul><ul><li>PD Adopts UCD principles and achieves same advantages by allowing user participation in the design process (Katz-Haas,1998) </li></ul></ul><ul><ul><li>PD has limitations: (Beynon-Devis,1998) (Pilemalm and Timpka,2008) </li></ul></ul><ul><ul><ul><li>development takes a long time </li></ul></ul></ul><ul><ul><ul><li>technology is not clear during the design process </li></ul></ul></ul><ul><ul><ul><li>difficult to keep user interested in the process during the development stages </li></ul></ul></ul>Yousef Daraghmi
  7. 7. Methodology Components <ul><li>2. The Third Generation Participatory Design (3GPD) </li></ul><ul><ul><li>3GPD was proposed by Pilemalm and Timpka (2008) to overcome the drawbacks of PD and to suit the healthcare field </li></ul></ul><ul><ul><li>3GPD consists of three modules: </li></ul></ul><ul><ul><ul><li>Pre-design : project plan, schedules, contacts with stakeholders </li></ul></ul></ul><ul><ul><ul><li>Design : requirements analyses, designing and prototyping </li></ul></ul></ul><ul><ul><ul><li>Post-design : full implementation </li></ul></ul></ul><ul><ul><li>3GPD has advantages: </li></ul></ul><ul><ul><ul><li>Resource-effective </li></ul></ul></ul><ul><ul><ul><li>Ability to be integrated with rapid development methods </li></ul></ul></ul><ul><ul><ul><li>Full documentation </li></ul></ul></ul><ul><ul><ul><li>Focusing on user needs and work flow </li></ul></ul></ul><ul><ul><li>3GPD language is limited to employer-employee context </li></ul></ul>Yousef Daraghmi
  8. 8. Methodology Components <ul><li>3. Rapid Application Development (RAD) </li></ul><ul><ul><li>RAD was developed to give much faster development and higher quality results (Martin,1991) </li></ul></ul><ul><ul><li>RAD allows iterative development (series of increments) </li></ul></ul><ul><ul><li>(Martin,1991) </li></ul></ul><ul><ul><li>RAD development stages are planning, design, construction and cutover (Martin,1991) </li></ul></ul><ul><ul><li>RAD limitations: (Beynon-Devis,1998) (Sommerville,2004) </li></ul></ul><ul><ul><ul><li>Inability to set up efficient team, plans and user-developer relation </li></ul></ul></ul><ul><ul><ul><li>Insufficient design place </li></ul></ul></ul><ul><ul><ul><li>Demonstrating prototyping rather than cooperative prototyping </li></ul></ul></ul><ul><ul><ul><li>Lack of documentation </li></ul></ul></ul>Yousef Daraghmi
  9. 9. Methodology Components <ul><li>4. Evaluative Usability Engineering Approach </li></ul><ul><ul><li>Evaluation should be performed iteratively, continuously and should consider user needs to achieve better usability. ( kushniruk,2004) </li></ul></ul><ul><ul><li>Five-phase formative evaluation would increase systems usability. </li></ul></ul><ul><ul><li>( kushniruk,2004) </li></ul></ul><ul><ul><li>Five-phase formative evaluation (kushniruk,2004) </li></ul></ul><ul><ul><ul><li>An exploratory test to check preliminary design concepts </li></ul></ul></ul><ul><ul><ul><li>Usability testing to gather user requirements in elicitation stage </li></ul></ul></ul><ul><ul><ul><li>Prototype assessment during design stage to provide feedback </li></ul></ul></ul><ul><ul><ul><li>A validation test to ensure that the system meets the requirements </li></ul></ul></ul><ul><ul><ul><li>A comparison test to check alternatives solutions at any stage. </li></ul></ul></ul>Yousef Daraghmi
  10. 10. Integration of Components <ul><ul><li>The previous components can to be integrated </li></ul></ul><ul><ul><li>RAD and PD have been integrated before and used in healthcare </li></ul></ul><ul><ul><li>(Beynon-Devis,1998) </li></ul></ul><ul><ul><li>UCD and RAD have been integrated and used in mobile learning </li></ul></ul><ul><ul><li>(Lank,2006) </li></ul></ul><ul><ul><li>A mixed methodology integrated all components to achieve the following advantages: </li></ul></ul><ul><ul><ul><li>producing an acceptable and usable new system quickly and allowing early deployment </li></ul></ul></ul><ul><ul><ul><li>meeting the requirements of critical systems by producing a reliable, dependable, usable, safe, secure and easy to use system </li></ul></ul></ul><ul><ul><ul><li>minimizing the post deployment corrective events </li></ul></ul></ul><ul><ul><ul><li>providing full documentation which makes evaluation easier </li></ul></ul></ul>Yousef Daraghmi
  11. 11. Development stages <ul><li>Methodology stages </li></ul>Yousef Daraghmi
  12. 12. Conclusion <ul><ul><li>Implementation and adoption of ICT applications in healthcare have not reached expectations </li></ul></ul><ul><ul><li>There is a need for new system development methods that focus on users, tasks, workflow in healthcare </li></ul></ul><ul><ul><li>A mixed methodology of RAD, 3GPD, UCD and formative evaluation is proposed to develop usable and accepted systems </li></ul></ul><ul><ul><li>The methodology will be validated practically by developing an electronic antenatal care system </li></ul></ul><ul><li>Thank You </li></ul>Yousef Daraghmi