Chapter 5 by Judith A. Effken Improving the Human Technology Interface

Objectives Describe human-technology interface. Explore human-technology interface problems. Reflect on the future of the human-technology interface.

Key Terms Defined Cognitive Task Analysis Cognitive Walkthrough Cognitive Work Analysis Ergonomics Field Study Cognitive Task Analysis (CTA) -Examination of the nature of a task by breaking it down into its component parts and identifying the performers’ thought processes. Cognitive Walkthrough -A technique used to evaluate a computer interface or a software program by breaking down and explaining the steps that a user will take to accomplish a task. Cognitive Work Analysis (CWA) - A multi-faceted analytic procedure developed specifically for the analysis of complex, high technology work domains. Ergonomics - In the United States, this term is used to describe the physical characteristics of equipment, for example, the optimal fit of a scissors to a human hand.  In Europe, the term is synonymous with Human Factors. It is the interaction of humans with physical attributes of equipment or the interaction of humans and the arrangement of equipment in the work environment . Field study - In a field study, end users evaluate a prototype in the actual work setting prior to its general release (also called field test, alpha test, or beta test).

Key Terms Defined Gulf of Evaluation Gulf of Execution Heuristic Evaluation Human-Computer Interaction Human-Computer Interface Gulf of Evaluation - The gap between knowing your intention (goal) and knowing the effects of your actions. Gulf of Execution - The gap between knowing what you want to have happen (the goal) and knowing what to do to bring it about (the means to achieve the goal). Heuristic Evaluation - An evaluation in which a small number of evaluators (often experts in relevant fields such as human factors or cognitive engineering) evaluate the degree to which the interface design complies with recognized usability principles (the “heuristics”). Human-Computer Interaction (HCI) - The processes, dialogues and actions that a user employs to interact with a computer; also the study of interaction between people (users) and computers (Wikipedia, 8/1/07); deals with people, software applications, computer technology and the ways they influence each other. Human-Computer Interface - The hardware and software through which the user interacts with the computer.

Key Terms Defined Human Factors Human-Technology Interaction Human-Technology Interface Situational awareness Task analysis Human Factors - Often used to describe the relationship of humans to machines, more specifically, it involves the scientific study of the interaction between people, machines and their work environments (Staggers, 2002).  As a scientific discipline, Human Factors conducts relevant research into human psychological, social, physical and biological characteristics and how those characteristics can be applied to the design, operation or use of products or systems to optimize human performance, health, safety and or habitability (http://www.usabilityfirst.com/glossary/main.cgi). Human-Technology Interaction (HTI) - How users interact with technology; also the study of that interaction. Human-Technology Interface - The hardware and software through which the user interacts with any technology (e.g., computers, patient monitors, telephone, etc.). Situational awareness - The ability to detect, integrate and understand critical information that leads to an overall understanding of a problem or situation. Task analysis - Analytic technique that focuses on how a task must be accomplished, including detailed descriptions of task-related activities, task characteristics and complexity, and the environmental conditions required for a person to perform a given task.

Key Terms Defined Usability Workaround Usability - The ease with which people can use an interface to achieve a particular goal; issues of human performance during computer interactions for specific tasks within a particular context. Workaround - Devising ways to "beat the system" since it does not function appropriately or is not suited to the task it was developed to assist with such as removing the armband from the patient and attaching it to the bed because the bar code reader failed to interpret barcodes when the bracelet curved tightly around a small arm.

Human Technology Interface The help of hardware/software Human-technology interfaces in healthcare Examples of human-technology interfaces Human interfaces differ Any time a human uses technology, there is some type of hardware and/or software that enables and supports the interaction. In today’s healthcare settings, we encounter a wide variety of human-technology interfaces. Examples of human-technology interfaces we might encounter include a defibrillator, a patient-controlled analgesia (PCA) pump, any number of physiologic monitoring systems, electronic thermometers and, of course, telephones and pagers. The human interfaces for each of these technologies are different—and can even differ among different brands or versions of the same device.

Human Technology Interface How information is presented What telehealth allows What human-technology interfaces present The use of large databases Our healthcare technologies may present information to us via computer screen, printer, or a personal data assistant (PDA). Sometimes telehealth interfaces allow patients to interact with a virtual clinician. Human-technology interfaces may present information using text, numbers, pictures, icons, or sound. The growing use of large databases for research has led to the design of novel human-technology interfaces that help researchers visualize and understand patterns in the data that generate new knowledge or lead to new questions.

Human Technology Interface Problem Up to 87% of all patient monitoring incidents are a result of? When does human error occur? Human-technology interface problems are the major cause of up to 87% of all patient monitoring incidents (Walsh & Beatty, 2002). The technology may perform flawlessly, but the interface design may lead the human user to make errors (Vicente, 2004).

Improving Human Technology Interface What we can learn from other fields The focus of users What does a good design consist of? When should formal evaluation take place? We can learn a lot from the related fields of Cognitive Engineering, Human Factors, and Ergonomics about how to make our interfaces more compatible with their human users and the context of care. Users must be an early and continuous focus during interface design. The design process should be iterative, allowing for evaluation and correction of identified problems. Formal evaluation should take place using rigorous experimental and/or qualitative methods.

Improving Human Technology Interface Task Analysis Cognitive Task Analysis Cognitive Work Analysis Five types of analysis Task Analysis examines how a task must be accomplished. Cognitive Task Analysis (CTA) usually starts by identifying, through interviews or questionnaires, the particular task and its typicality and frequency. Cognitive Work Analysis (CWA) was developed specifically for the analysis of complex, high technology work domains. A complete CWA includes five types of analysis: work domain, control tasks, strategies, social-organizational, and worker competencies.

Improving Human Technology Interface Principles and techniques of developing human-technology interface Presenting clinical data A “transparent” interface How does an interface become “transparent”? Today there are available both principles and techniques for developing human-technology interfaces that people will be able to use with minimal stress and maximal efficiency. There is a growing body of research exploring new ways to present clinical data that might facilitate clinicians’ problem identification and accurate treatment. Perhaps one of the highest accolades that any interface can achieve is that it is “transparent.” An interface becomes transparent when it is so easy to use that users no longer think about it, but only about the task at hand.

Improving Human Technology Interface How to have an easy interaction? Usability Evaluation of new human-technology interfaces Typical usability indicators The more transparent the interface, the easier the interaction should be. Usability is a term that denotes the ease with which people can use an interface to achieve a particular goal. Usability of a new human-technology interface needs to be evaluated early and often throughout its development. Typical usability indicators include: ease of use, ease of learning, satisfaction with using, efficiency of use, error tolerance, and fit of the system to the task (Staggers, 2003).

Future of Human Technology Interface Improving human-technology interface Advances in anesthesia machines Anesthesiologists working to improve computer interface Increased attention to improving the human-technology interface through human factors approaches has already led to significant improvement in one area of healthcare—anesthesiology. Anesthesia machines that used to have hoses that would fit into any delivery port now have hoses that can only be plugged into the proper port, thus reducing the chances of error. Anesthesiologists have also been actively working with engineers to improve the computer interface through which they monitor their patients’ status and are among the leaders in investigating the use of audio techniques as an alternative way to help anesthesiologists stay “situationally aware.”

Future of Human Technology Interface What was the cause for a drop in anesthesia related deaths? Is informatics there yet? As a result, anesthesia-related deaths dropped from 1 in 10-20,000 to 1 in 200,000 in under 10 years (Vicente, 2004). The increased amount of informatics research in this area is encouraging, but there is a long way to go.

Thought Provoking Questions You are a member of a team that has been asked to evaluate a prototype PDA-based application for calculating drug dosages. Based on what you know about usability testing, what kind of test (or tests) might you do and why?

Thought Provoking Questions Is there a human-technology interface that you have encountered and you think needs improving? If you were to design a replacement, what of the analysis techniques you read about would you choose? Why?