Understanding digital health ecosystem from Australian citizens’ perspective: A scoping review

Background Digital health (DH) and the benefits of related services are fairly well understood. However, it still is critical to map the digital health care landscape including the key elements that define it as an ecosystem. Particularly, knowing the perspectives of citizens on this digital transformation is an important angle to capture. In this review we aim to analyze the relevant studies to identify how DH is understood and experienced by Australian citizens and what they may require from DH platforms. Materials and methods A scoping literature review was conducted across several electronic databases (ACM Digital Library, OVID, PubMed, Scopus, IEEE, Science Direct, SAGE), as well as grey literature. Additionally, citation mining was conducted to identify further relevant studies. Identified studies were subjected to eligibility criteria and the final set of articles was independently reviewed, analyzed, discussed and interpreted by three reviewers. Results Of 3811 articles, 98 articles met the inclusion criteria with research-based articles–as opposed to review articles or white papers– comprising the largest proportion (72%) of the selected literature. The qualitative analysis of the literature revealed five key elements that capture the essence of the digital health ecosystem interventions from the viewpoint of the Australian citizens. The identified elements were “consumer/user”, “health care”, “technology”, “use and usability”, “data and information”. These elements were further found to be associated with 127 subcategories. Conclusions This study is the first of its kind to analyze and synthesize the relevant literature on DH ecosystems from the citizens’ perspective. Through the lens of two research questions, this study defines the key components that were found crucial to understanding citizens’ experiences with DH. This understanding lays a strong foundation for designing and fostering DH ecosystem. The results provide a solid ground for empirical testing.

The Application of a Novel, Context Specific, Remote, Usability Assessment Tool to Conduct a Pre-Redesign and Post-Redesign Usability Comparison of a Telemedicine Website

The usability of telemedicine provider websites is an essential component of increasing the public’s awareness of, understanding of, and safe and effective use of telemedicine. A newly developed usability data collection tool was used to conduct a usability assessment of the Teladoc website pre- and post- a redesign. The results suggest that the Teladoc website had better usability prior to the redesign. The Teladoc Website Usability Survey (TWUS) developed for the Teladoc website usability assessment can be modified and used in future usability studies of telemedicine provider interfaces. Usability research that takes place in specific context of use settings is more valuable to identify usability problems.

Digital Contact Tracing Applications for COVID-19: A Citizen-Centred Evaluation Framework (Preprint)

BACKGROUND The silent transmission of COVID-19 has led to an exponential growth of fatal infections. With over 3 million deaths world-wide, the need to control and stem transmission has never been more critical. New COVID-19 vaccines offer hope. However, administration timelines, long-term protection, and effectiveness against variants are still unknown. In this context, Contact Tracing, and digital Contact Tracing Apps (CTAs) continue to offer a mechanism to help contain transmission, keep people safe, and help kickstart economies. However, CTAs must address a wide range of often conflicting concerns which make their development/evolution complex: for example, the app must preserve citizens’ privacy whilst gleaning their close contacts and as much epidemiological information as possible. OBJECTIVE In this paper, we derive a compare-and-contrast evaluative framework for CTAs that captures best-of-breed development and evolution concerns for CTAs organized into seven pillars. As our goal is to integrate and expand on existing work in this domain, with a particular focus on citizen adoption, we call this framework the Citizen-Focused Compare-and-Contrast Evaluation Framework (C3EF) for CTAs. METHODS The framework has been derived through mixed methods. First, we reviewed the related literature on CTAs and mHealth app evaluations, from which we derived a preliminary set of attributes and organizing pillars. These attributes were validated, augmented, and refined by applying the provisional framework against a selection of CTAs. At this point, questions to probe each attribute of the framework were formulated and iteratively tested on selected CTAs. Each framework pillar was then subjected to internal cross-team scrutiny where domain experts responsible for developing a pillar defended its sufficiency, relevancy, specificity, and non-redundancy. The consolidated framework was further validated on the selected CTAs to create a refined version of C3EF for CTAs. RESULTS The final framework presents seven pillars exploring issues related to CTA’s design, adoption, and use: (General) Characteristics, Usability, Data Protection, Effectiveness, Transparency, Technical Performance, and Citizen Autonomy. The pillars encompass attributes, sub-attributes, and a set of illustrative questions (with associated example answers) to support app design, evaluation, and evolution. An online version of the framework has been made available to developers, health authorities, and others interested in assessing CTAs. CONCLUSIONS Our CTA evaluation-concerns framework provides a holistic compare-and-contrast tool that supports the work of decision-makers in the development and evolution of CTAs for citizens. This framework supports reflection on design decisions to better understand and optimize the design compromises in play when evolving current CTAs for increased public adoption. We intend it to act as a foundation for other researchers to build on and extend, as the technology matures and new CTAs become available.

Usability Issues with E-Commerce Websites in Nigeria

Usability issues are vital components for online-based businesses. With Nigeria integrating electronic payment into its financial system coupled with rising internet penetration in the country, several businesses have created an online presence and are cashing in on the opportunities. This has created a form of online competition among e-commerce businesses. This study employs the user test method to test the usability issues associated with E-commerce websites in Nigeria and how this affects the success of e-commerce businesses. We find several usability issues with all e-commerce websites tested and a general need for user-focused improvement on all the websites. We also find the issues of security and trust as salient to expand the e-commerce business in Nigerians. Based on the result and analysis, recommendations on usability, data policy, security, registration and other vital issues are offered.

Usability and User Experience of Cognitive Intervention Technologies for Elderly People With MCI or Dementia: A Systematic Review

IntroductionIncorporating technology in cognitive interventions represents an innovation, making them more accessible, flexible, and cost-effective. This will not be feasible without adequate user-technology fit. Bearing in mind the importance of developing cognitive interventions whose technology is appropriate for elderly people with cognitive impairment, the objective of this systematic review was to find evidence about usability and user experience (UX) measurements and features of stimulation, training, and cognitive rehabilitation technologies for older adults with mild cognitive impairment (MCI) or dementia.MethodThe Medline, PubMed, Scopus, ScienceDirect, and PsycINFO databases were searched for literature published in the last 10 years (2009–2019), and three researchers independently reviewed potentially eligible studies, following specific inclusion criteria. A systematic review of the studies was conducted, presenting a qualitative synthesis of usability and UX measures with their outcomes, study characteristics and features of the cognitive intervention technologies.ResultsTen studies were selected: five were cognitive stimulation and five were cognitive training. Most of them (60%) were computer-based programs with a serious game format. Efficiency and effectiveness were the most frequent measurements used for collecting objective usability data, showing that elderly people with cognitive impairment require more time (45%) and help (40%) but can complete tasks (60%). Regarding UX or subjective usability data, questionnaires and scales were the most used methods, reporting positive experience despite certain difficulties with the interface in five studies.ConclusionMeasuring usability and UX in cognitive intervention technologies for older adults with MCI or dementia provides an integrated view that can contribute to their development according to the needs and characteristics of the target population. More research is required to include this population group in usability and UX studies, as well as standardized tools and consensus on the relationship of these terms to guarantee the future effectiveness of cognitive intervention technologies.Review registrationThis review was registered in the PROSPERO (CRD42020158147) International Register of Systematic Review Protocols.

Assessing the Psychometric Properties of Students’ MOOC-Efficacy Measurement Model

Massive Open Online Courses (MOOCs) have been identified as a potential innovation for improving teaching and learning. This research aims to develop and evaluate a measurement model of students’ MOOC-efficacy. The study conceptualized students’ MOOC-efficacy in four dimensions of information searching, making queries, MOOC learning, and MOOC usability. Data were collected with a 23 items questionnaire whose reliability indexes ranged from 0.822 to 0.890, identified from university students who have had some experience with MOOCs and who willingly volunteered to participate in the research (N=1,524). A sample of 623 respondents was drawn through simple random sampling. The Confirmatory Factor Analysis (CFA) was adopted for data analysis. The findings designate that four-dimensional students’ MOOC-efficacy measurement model achieved an acceptable level of fit (RMSEA = 0.061, CFI = 0.935 and a normed chi-square, χ2/df = 3.322). All statistics provide empirical evidence that the students’ MOOC-efficacy measurement model is psychometrically sound in terms of validity and reliability. The measurement model of students’ MOOC-efficacy provides further insights into what works in an open online environment which may be used to fulfill learners’ needs and preferences.

Pengembangan Aplikasi Pengenalan Tokoh Pahlawan dan Kebudayaan Melalui Patung di Pantai Losari Makassar Menggunakan Teknologi Machine Learning Kit Berbasis Android

Penelitian ini merupakan penelitian pengembangan perangkat lunak yang bertujuan untuk menghasilkan aplikasi pengenalan tokoh pahlawan dan kebudayaan melalui patung di pantai Losari Makassar berbasis android dengan memanfaatkan teknologi machine learning kit serta untuk mengetahui hasil uji kelayakan terhadap aplikasi. Model pengembangan yang digunakan adalah prototipe dan menggunakan pengujian standar kualita ISO / IEC 25010 dengan menguji 4 aspek yaitu functionality, suitability, portability, efficiency, dan usability. Data penelitian diperoleh menggunakan wawancara, observasi dan angket. Data penelitian dianalisis dengan menggunakan teknik analisis statistik deskriptif. Hasil dari penelitian ini adalah 1) Aplikasi pengenalanTokoh pahlawan dan kebudayaan melalui patung di pantai Losari menggunakan android dengan penyajian informasi melalui scan replika patung hingga informasi ditampilkan dari objek yang terdeteksi serta informasi detail dapat dilihat langsung melalui menu galery. 2) Hasil pengujian aplikasi menggunakan ISO / IEC 25010 pada aspek functionality, suitability, portability, efficiency, dan usability aplikasi berkualitas baik

The Cognitive Walkthough for Implementation Strategies (CWIS): A Pragmatic Method for Assessing Implementation Strategy Usability

Background. Implementation strategies have flourished over the last decade in an effort to increase integration of research evidence into clinical practice. Most strategies are complex, socially-mediated processes. Many are complicated, expensive, and ultimately impractical to deliver in real-world settings. The field lacks methods to assess the extent to which implementation strategies are usable and aligned with the needs and constraints of the individuals and contexts who will deliver or receive them. Drawn from the field of human-centered design, cognitive walkthroughs are an efficient assessment method with potential to surface aspects of strategies that may inhibit their usability and, ultimately, their effectiveness. This article presents a novel cognitive walkthrough methodology for evaluating strategy usability as well as an example application to a post-training consultation strategy to support mental health clinicians in the education sector to adopt measurement-based care.Method. The Cognitive Walkthrough for Implementation Strategies (CWIS) is a pragmatic, mixed-methods approach for evaluating complex, socially-mediated implementation strategies in health. CWIS includes six steps: (1) determine preconditions; (2) hierarchical task analysis; (3) task prioritization; (4) convert tasks to scenarios; (5) pragmatic group testing; and (6) usability issue identification, classification, and prioritization. A facilitator conducted two group testing sessions with clinician users (N = 10), guiding participants through 6 scenarios and 11 associated subtasks. Clinicians reported their anticipated likelihood of completing each subtask and provided qualitative justifications during group discussion. Following the walkthrough sessions, users completed a quantitative assessment of strategy usability.Results. Average subtask success ratings indicated substantial variability across participants and subtasks. Usability ratings (scale: 0-100) of the consultation protocol averaged 71.3 (SD = 10.6). Twenty-one usability problems were identified via qualitative coding and classified by severity and problem type to explain the ratings. High-severity problems included potential misalignment between consultation and clinical service timelines as well as digressions during consultation processes.Conclusions. Ratings indicated that usability of the consultation protocol was at the low end of the “acceptable” range. Collectively, the 21 usability issues explained the ISUS quantitative usability data and provided specific direction for usability enhancements. The current study provides preliminary evidence for the utility of CWIS to assess strategy usability and generate a blueprint for redesign.

Functionalities and issues in the implementation of personal health record: a systematic review (Preprint)

BACKGROUND Functionalities of PHR are evolving, and continued discussions about PHR functionalities need to be carried out to keep it up-to-date. Technological issues as non-functional requirements are also required to be discussed in the implementation of PHR. OBJECTIVE This study systematically reviews the main functionalities and issues in the implementation of the Personal Health Record (PHR). METHODS This systematic review conducted using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The search is performed using online databases such as Scopus, ScienceDirect, IEEE, MEDLINE, CINAHL, and PubMed for English journal articles and conference proceedings published between 2015 and 2020. RESULTS A total of 67 articles were selected in the review. Seven function categories are identified in this review, which is grouped into basic and advanced functions. Health records and administrative records were grouped into basic functions. Medication management, communication, appointment management, education, and self-health monitoring were grouped into advanced functions. The issues found in this study include interoperability, security and privacy, usability, data quality, and personalization. CONCLUSIONS In addition to PHR’s basic and advanced functions, other supporting functionalities may also need to be developed based on the issues identified in this study. This paper provides an integrated PHR architectural model that describes the functional requirements and data sources of PHR.

Assessment of patient safety challenges and electronic occurrence variance reporting (e-OVR) barriers facing physicians and nurses in the emergency department: a cross sectional study

Background The purpose of patient safety is to prevent harm occurring in the healthcare system. Patient safety is improved by the use of a reporting system in which healthcare workers can document and learn from incidents, and thus prevent potential medical errors. The present study aimed to determine patient safety challenges facing clinicians (physicians and nurses) in emergency medicine and to assess barriers to using e-OVR (electronic occurrence variance reporting). Methods This cross-sectional study involved physicians and nurses in the emergency department (ED) at King Khalid University Hospital (KKUH) in Riyadh, Saudi Arabia. Using convenience sampling, a self-administered questionnaire was distributed to 294 clinicians working in the ED. The questionnaire consisted of items pertaining to patient safety and e-OVR usability. Data were analyzed using frequencies, means, and percentages, and the chi-square test was used for comparison. Results A total of 197 participants completed the questionnaire (67% response rate) of which 48 were physicians (24%) and 149 nurses (76%). Only 39% of participants thought that there was enough staff to handle work in the ED. Roughly half (48%) of participants spoke up when something negatively affected patient safety, and 61% admitted that they sometimes missed important patient care information during shift changes. Two-thirds (66%) of the participants reported experiencing violence. Regarding e-OVR, 31% of participants found reporting to be time consuming. Most (85%) participants agreed that e-OVR training regarding knowledge and skills was sufficient. Physicians reported lower knowledge levels regarding how to access (46%) and how to use (44%) e-OVR compared to nurses (98 and 95%, respectively; p < 0.01). Less than a quarter of the staff did not receive timely feedback after reporting. Regarding overall satisfaction with e-OVR, only 25% of physicians were generally satisfied compared to nearly half (52%) of nurses. Conclusion Although patient safety is well emphasized in clinical practice, especially in the ED, many factors hinder patient safety. More awareness is needed to eliminate violence and to emphasize the needs of additional staff in the ED. Electronic reporting and documentation of incidents should be well supported by continuous staff training, help, and feedback.