Current and Future Directions in User Interface Design & Why UX is Important! Anne Miller, PhD August 2017 1
Paper-based information systems Visible, interactive, observable, configurable in real-time, data entry & assessment concurrent 2 2
1st wave EHRs – computerizing paper Clinical categories Displays only one category 3 3
Information fragmentation ‘Too many clicks’ • Disrupts cognitive flow • Increases memory load • Increases risk of omission • Increases frustration 4 4
2 nd wave EHRs – computerizing information Where to start? • Most persistent complaints: – Poor integration into clinical work – Poor usability Miller et al. (2015) J Med Info 84:1009 5 5
The most common approach … Business process – Service delivery approach Triggers & criteria for admission Initiating the service Initiating the service But … Patient processes? Providing the service Clinical processes? 6 6
Patients Have: – Health problems or concerns that change over a life-time → ‘womb to tomb’ – Life aspirations, goals, beliefs, values, priorities Most come to hospital Often physiologically unstable, because they are sick . unpredictable, complex 7 7
Patient pathways Goal = Pt ready for ICU discharge 48hrs post-op Post-op chest surgery pathway: Patients off • ( Patho-) physiologically pathway grounded Patients on • Evidence-based pathway • Link cues to actions – feedback loops • Ongoing plan of care Miller et al. (2014) J.Cardiothor. Vasc.Surg. Pathway milestones: 28:441 M1= Pt awake; M2 = Pt extubated M3 = vasoactives off; M4 = Pt out of bed 8 8
Clinical work...Cognitive work Global Situation Awareness Intervention Awareness Situation Awareness Action planning, execution & Information acquisition & monitoring (i.e. therapy) processing (i.e. situation assessment; diagnosis) What should be done? What was done? What is it? Did it work? What does it mean? Where is it going? 9 9
Global Situation Awareness Representing states Dynamic interplay b/w: • Patients • Clinician interpretation & action 10 10
Global Situation Awareness Representing dynamics Dynamic interplay b/w: • Patients • Clinical interpretation & action 11 11
Why UX is important in EHR design Human Centered Design: • Focuses on understanding clinical work from patient-clinician perspective • Supports development of new approaches to information design • Consolidates inter-disciplinarity – clinical, technological, human factors & design 12 12
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