An Example of an Application of the Semiotic Inspection Method in the Domain of Computerized Patient Record System Weronika Tancredi, Olof Torgersson Department of Applied IT Chalmers University of Technology and University of Gothenburg ESSIQ AB, Gothenburg, Sweden Oral presentation at MedInfo2013, August 22 Copenhagen, Denmark MedInfo2013 Olof Torgersson 1

The System MedInfo2013 Olof Torgersson 2

A Closer Look What? MedInfo2013 Olof Torgersson 3

Study Context Computerized Patient Record System for dental care – Widely used by public dental care in Sweden Major upgrade caused a lot of confusion Evaluation – Work place studies – University of Skövde – Expert evaluation – Chalmers Heuristic evaluation x 2 Enhanced cognitive walkthrough Predictive use error analysis Semiotic inspection method MedInfo2013 Olof Torgersson 4

Semiotic Engineering Clarisse Sieckenius de Souza, 2005 Focus on signs and their meaning Interface message from designer to user – Designers communicate through the interface to users Communicability “Here is my understanding of who you are, what I’ve learned you want or need to do, in which preferred ways, and why. This is the system that I have therefore designed for you, and this is the way you can or should use it in order to fulfil a range of purposes that fall within this vision.” MedInfo2013 Olof Torgersson 5

Semiotic Engineering When users do not understand the message a communication breakdown takes place You do not care about icons, so therefore I use only one MedInfo2013 Olof Torgersson 6

Semiotic Inspection Method Analyze 3 types of signs – (1) Metalinguistic signs – (2) Static signs – (3) Dynamic signs Contrastive comparison of results from 1-3 – Identify problems & lack of consistency Summarize – describe the message – Conclusive appreciation of the quality of the designer-to-user communication MedInfo2013 Olof Torgersson 7

Procedure Observation Scenario – Anna is a fifty years old dentist who works in a bigger dental clinic…. Anna has many patients booked for each day and she needs to work quickly to be able to examine and treat the patient as well as to insert the data about the current and future treatment into the CPR system… Describe tasks to evaluate (10) – Opening the medical record of a specific patient. – Making a new health declaration. – Sending a referral to oral surgery. – … Repeated inspection of the signs in all parts MedInfo2013 Olof Torgersson 8

Sample Findings Metalinguistic signs – Busy professionals – Interest in adapting the system – Extensive instructions & lack of instructions – … Static signs – Irrelevant information – Lack of signifiers – … MedInfo2013 Olof Torgersson 9

Sample Findings Dynamic signs – Assumes users know what to do – No guidance – No indication of order – Lack of feedback – … MedInfo2013 Olof Torgersson 10

The Communication Message Users are expected to have advanced digital skills and clinical knowledge Assumed order through tabs – General – Additional info – … – Basic planning Some order in toolbars Overall inconsistent MedInfo2013 Olof Torgersson 11

Comparison MedInfo2013 Olof Torgersson 12

Discussion Wanted to show problems with flow and wayfinding Focus on 3 different types of signs – Helped to reflect on what text, icons etc actually communicate – Clearly not consistent SIM includes manuals etc, interesting aspect Large system – Lots of data – Method could give more support More about overall quality than other methods but not enough MedInfo2013 Olof Torgersson 13

Thank you for your attention Weronika Tancredi Olof Torgersson MedInfo2013 Olof Torgersson 14