Human-Centered Design for Health Information Technology

This chapter presents issues that may arise in human-centered research in health care environments. The authors first discuss why human-centered approach is increasingly employed to study and to design health care technology. They then present some practical concerns that may arise when conducting qualitative research in medical settings, from research design, to data collection and data analysis, and to technology design. Many of these concerns were also experienced in their own human-centered field studies conducted in the last few years. The authors conclude the chapter by illustrating some of these issues using their own research case study that investigated nurses’ information flow in a hospital ward.

Using New Model-Based Techniques for the User Interface Design of Medical Devices and Systems

Studies concerning critical incidents with technical equipment in the medical/clinical context have found out, that in most of the cases non-ergonomic and non-reliable user interfaces provoke use deficiencies and therefore hazards for the patient and the attending physician. Based on these studies, the authors assume that adequate and powerful tools for the systematic design of error-tolerant and ergonomic Human-Machine-Interfaces for medical devices are missing. In this context, the Chair of Medical Engineering (mediTEC) has developed the new software-based tool mAIXuse in order to overcome these difficulties and to support designers as well as risk assessors. Based on two classical formal-analytical approaches, mAIXuse provides a high-performance modelling structure with integrated temporal relations in order to visualise and analyse the detailed use process, even with complex user interfaces. The approach can be used from the very early developmental stages up to the final validation process. Results of a comparative study with the new mAIXuse tool and a conventional process-FMEA (Failure Mode and Effect Analysis) show, that the new approach clearly outperforms the FMEA technique.

e-Health Technologies in Home Care Nursing

The innovative impact of advancing e-Health technologies is more frequently being discussed in nursing science. Nurses play an important role in collecting data and giving support to other users, especially in home care. Since issues of acceptance play a major role, the following article, which presents findings based on a focus group consisting of the elderly, caretaking relatives and professional nurses, is discussed from an ethical point of view in the context of international debate. It is interesting to note, that to some extent there is substantial ambivalence in the willingness to integrate such technologies into daily care. A need for technical assistance is clearly recognizable, however, limits as well. The authors’ findings indicate that a fundamental discussion on the relevance of e-Health methods in professional nursing needs to be held. It should address the ethical questions of often conflicting interests and rights (protection of identity, privacy and safety) in situations of high vulnerability.

Evaluating the Usability of Home Healthcare Applications

Home healthcare applications have the potential to reduce healthcare costs and improve the quality of life for elderly people who prefer to stay in their own homes instead of making frequent visits to the hospital. This requires ambient assisted living applications that fulfil relevant needs of the users; yet it also requires applications with a high level of usability in order to achieve user acceptance, especially when the target user group is elderly people. This chapter proposes a method to be used for conducting usability evaluations of smart healthcare applications. It includes a report from a usability evaluation where the method was used to evaluate a simple home healthcare application for collecting personal health data in the home. The usability evaluation demonstrates that the method presented here facilitates identification of key usability problems, while the efforts required to conduct the evaluation are considerably reduced compared to conventional methods.

Medico Ergonomics

The importance of technology for the medical sector is steadily growing. Potentials for rationalization that can help to overcome the problems of an ageing population exist. So far these expectations could not be fulfilled because some devices lack a sufficient usability concept and do not fulfill the user demands. This chapter will illustrate problems that can arise when developing user-centered and task-oriented “health care applications.” The “medico ergonomics approach” is introduced as a possibility to overcome these problems. The applicability of the developed approach is demonstrated with the help of a case study. Content of this case study is a usability context analysis of a web-based patient record. The case study shows the suitability of the medico ergonomic models to illustrate complex interrelations of patient treatment. Based on these results requirements are defined and task-supporting functions are derived. The models support the development of a “common ground of understanding” between the potential user and the developers of the product. This is a crucial condition for developing integrated and utilizable (software) products and therewith for developing ergonomic working systems.

A Cup of Coffee

The area of homecare is not normally associated with the use of Information and Communication Technology (ICT). Today ICT and mobile ICT are being implemented within homecare practice to make the job of caring more effective and attractive. This chapter focuses attention on the human aspects when an automatic planning system and a handheld computer were implemented in a homecare practice. The aim of the chapter is to explore care workers’ experiences of how these technologies supported and facilitated their day-to-day work, but also how they affect daily work in practice. The authors’ findings indicate that some of the wants and needs for ICT of the homecare team regarding their work practice were met. The integration of principles from Participatory Action Research (PAR) in the Participatory Design (PD) process made it possible for staff to participate during the full development process, take part in the design process and make decisions during the whole trial.

An Approach to Adapt the Product Functionality to the Abilities of Seniors

Elderly people are restricted in their efficiency due to the aging process. Technical systems provide a considerable potential to support the elderly in their domestic environment. It is important, to focus not only on aspects of ergonomics and operability, but the functionality of the products themselves should be stronger in these considerations. To be able to support the designers in their complex development tasks at first typical age-related restrictions and medical conditions from an engineer’s point of view will be described in the framework of this presentation, as well as, the influence of the biography on the use of technique will be analyzed. Considering these aspects, an approach for classification and structuring can be derived, in which typical symptoms and their characteristics are related to appropriate product requirements.

Usability Engineering and E-Health

The chapter presents case studies of e-health applications that the author has been involved in such as a paramedic application that presented treatment information to the paramedic. Furthermore, a review of e-health applications to help people with medical issues and in particular people with mental health problems is discussed. In addition, various tools to use in the development of e-health systems such learning models, focus groups and the Technology Acceptance Model (TAM) are presented. Finally a methodology that combines technological consideration as well as human factors issues is proposed.

Personalized Acoustic Interfaces for Human-Computer Interaction

The importance of personalized and adaptable user-interfaces has been extensively discussed (European Ambient Assisted Living Innovation Alliance, 2009; Alexandersson et al., 2009). However, it often remains unclear how to specifically implement such concepts. In the field of acoustic communication, existing models and technologies offer a wide range of possibilities. Based on these technologies, this chapter presents a concrete realization of a model-based interface in the field of acoustic human-computer interaction. The core element of the implementation is a holistic approach towards a hearing perception model, which incorporates information of the acoustic environment, the context and the user himself provides relevant information for control and adjustment of adaptable and personalized acoustic user interfaces. In principle, this way of integrating state-of-the-art technologies and models into user interfaces could be applied to other sensory perceptions as e.g. vision.

User Diversity as a Challenge for the Integration of Medical Technology into Future Smart Home Environments

Facing the growing aging population in many countries of the world, healthcare-related technologies become increasingly important, representing a possible solution to the soaring overstrained health care systems and dwindling number of caregivers. Though a user-centred and sensible integration of medical technology in home environments is highly challenging, especially when focusing on the group of old and frail users. Their specific needs and wants, their (dis)abilities and limitations have to be carefully considered, in order to reach full acceptance and a successful rollout of e-health applications in home environments. As the knowledge about acceptance in the medical sector is still limited, an elaborate research is needed in order to understand and respect aged persons’ specific demands. In an empirical approach, the role of age, technology generation, technical expertise, and gender are determining for the acceptance of medical technologies. As the acceptance of medical technologies might be also biased by social norms and the way aging and age-related consequences are evaluated within a society, individual ageing concepts as well as economic and educational levels were considered for the evaluation of the perceived benefits and drawbacks of medical technologies. Outcomes show the importance of understanding users’ needs and wants in order to develop user-centred medical technology concepts and to allow a successful rollout.