The EU-project United4Health: User-centred design of an information system for a Norwegian telemedicine service

Abstract

Introduction

Organizational changes of health care services in Norway brought to light a need for new clinical pathways. This study presents the design and evaluation of an information system for a new telemedicine service for chronic obstructive pulmonary disease patients after hospital discharge.

Methods

A user-centred design approach was employed composed of a workshop with end-users, two user tests and a field trial. For data collection, qualitative methods such as observations, semi-structured interviews and a questionnaire were used.

Results

User workshop’s outcome informed the implementation of the system initial prototype, evaluated by end-users in a usability laboratory. Several usability and functionality issues were identified and solved, such as the interface between the initial colour scheme and the triage colours. Iterative refinements were made and a second user evaluation showed that the main issues were solved. The responses to a questionnaire presented a high score of user satisfaction. In the final phase, a field trial showed satisfactory use of the system.

Discussion

This study showed how the target end-users groups were actively involved in identifying the needs, suggestions and preferences. These aspects were addressed in the development of an information system through a user-centred design process. The process efficiently enabled users to give feedback about design and functionality. Continuous refinement of the system was the key to full development and suitability for the telemedicine service. This research was a result of the international cooperation between partners within the project United4Health, a part of the Seventh Framework Programme for Research of the European Union.

Keywords

Health information systems human-computer interaction usability telemedicine user-centred design

Get full access to this article

View all access options for this article.

References

Norwegian Ministry of Health and Care Services. The Coordination Reform – Proper treatment – at the right place and right time. Report No. 47 to the Storting (2008–2009), 19 June 2009. Oslo, Norway: Norwegian Government Security and Service Organisation.

United4Health. Transforming the patient experience with telehealth in Europe. European Commission – ICT Policy Support Programme and Competitiveness and Innovation Framework Programme, http://www.united4health.eu/ (2015, accessed 8 September 2015).

Smaradottir B, Gerdes M, Fensli R, et al. User interface development of a COPD remote monitoring application–a user-centred design process. Proceedings: The Eighth International Conference on Advances in Computer-Human Interactions (ACHI 2015, IARIA), Lisbon, Portugal, 22–27 February 2015, pp.57–62. http://www.thinkmind.org/index.php?view=article&articleid=achi_2015_3_40_20235 (accessed 21 October 2015). ISSN: 2308-4138, ISBN: 978-1-61208-382-7.

Norwegian Health Network. Nork helsenett, https://www.nhn.no/english/Pages/default.aspx (2015, accessed 8 September 2015).

Gerdes M and Fensli R. End-to-end security and privacy protection for co-operative access to health and care data in a telehealth trial system for remote supervision of COPD-Patients. Linköping Electronic Conference Proceedings: 13th Scandinavian Conference on Health Informatics, (SHI2015), 15–17 June, Tromsø, Norway, pp. 25–32. Available at: http://www.ep.liu.se/ecp_article/index.en.aspx?issue=115;article=005 (accessed 21 October 2015). ISBN: 978-91-7685-985-8, ISSN (print): 1650-3686, ISSN (online): 1650-3740.

De Vito Dabbs

Myers

Mc Curry

. User-centered design and interactive health technologies for patients. Comput Inform Nurs 2009; 27: 175–183.

Das

Svanæs

. Human-centred methods in the design of an e-health solution for patients undergoing weight loss treatment. Int J Med Inform 2013; 82: 1075–1091.

Årsand

Tufano

Ralston

. Designing mobile dietary management support technologies for people with diabetes. J Telemed Telecare 2008; 14: 329–332.

Lazar

Feng

Hochheiser

. Research methods in human-computer interaction, Chichester, UK: John Wiley and Sons Ltd, 2010. ISBN 978-0-470-72337-1.

10.

Smaradottir B, Holen-Rabbersvik E, Thygesen E, et al. User-centred design of the user interface of a collaborative information system for inter-municipal dementia team. Proceedings of the 8th International Conference on Health Informatics (HealthInf2015, BIOSTEC), Lisbon, Portugal, 12–15 Jan 2015, pp. 446–453, Scitepress Digital Library. http://www.scitepress.org/Portal/PublicationsDetail.aspx?ID=lGxIYunzMvY=&t=1 (accessed 21 October 2015). DOI: 10.5220/0005222704460453. ISBN 978-989-758-068-0.

11.

Bastien

. Usability testing: A review of some methodological and technical aspects of the method. Int J Med Inform 2010; 79: e18–e23.

12.

Kushniruk

Patel

. Cognitive and usability engineering methods for the evaluation of clinical information systems. J Biomed Inform 2004; 37: 56–76.

13.

Jaspers

. A comparison of usability methods for testing interactive health technologies: Methodological aspects and empirical evidence. Int J Med Inform 2009; 78: 340–353.

14.

Horsky

McColgan

Pang

. Complementary methods of system usability evaluation: Surveys and observations during software design and development cycles. J Biomed Inform 2010; 43: 782–790.

15.

Ericsson

Simon

. Verbal reports as data. Psychol Rev 1980; 87: 215–251.

16.

Gerdes M, Smaradottir B and Fensli R. End-to-end infrastructure for usability evaluation of ehealth applications and services. Linköping Electronic Conference Proceedings: 12th Scandinavian Conference on Health Informatics (SHI2014), Grimstad, Norway, 21–22 August 2014, pp. 53–59. Available at: http://www.ep.liu.se/ecp_article/index.en.aspx?issue=102;article=008 (accessed 21 October 2015). ISBN: 978-91-7519-241-3, ISSN(print): 1650-3686, ISSN(online): 1650-3740.

17.

Svanæs

Alsos

Dahl

. Usability testing of mobile ICT for clinical settings: Methodological and practical challenges. Int J Med Inform 2010; 79: e24–e34.

18.

Brooke

. SUS: A quick and dirty usability scale. Usability evaluation in industry, London: Taylor and Francis, 1996, pp. 189–194.

19.

Smaradottir

Gerdes

Martinez

. Usability evaluation of a COPD remote monitoring application. Stud Health Technol Inform 2015; 210: 845–849.

20.

Anthonisen

Manfreda

Warren

. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 1987; 106: 196–204.

21.

Bangor

Kortum

Miller

. Determining what individual SUS scores mean: Adding an adjective rating scale. J Usability Studies 2009; 4: 114–123.

22.

MacLellan

Muddimer

Peres

. The effect of experience on system usability scale ratings. J Usability Studies 2012; 7: 56–67.

23.

Teixeira

Ferreira

Santos

. User-centered requirements engineering in health information systems: A study in the hemophilia field. Comput Methods Programs Biomed 2012; 106: 160–174.

24.

Thoirs

Giles

Barber

. Use of simulated learning environments in radiation science curricula, Adelaide: University of South Australia, 2010.

25.

Beaubien

Baker

. The use of simulation for training teamwork skills in health care: How low can you go? Qual Saf Health Care 2004; 13: i51–i56.

26.

Venot

Burgun

Quantin

. Medical Informatics, e-Health: Fundamentals and Applications, Paris, France: Springer Science and Business Media, 2013. ISBN 979-2-8178-0477-4. DOI 10.1007/978-2-8178-0478-1.

27.

Gray

. Simulated task environments: The role of high-fidelity simulations, scaled worlds, synthetic environments, and laboratory tasks in basic and applied cognitive research. Cogn Sci Q 2002; 2: 205–227.

28.

Shaikh

. The impact of SOA on a system design for a telemedicine healthcare system. Netw Model Anal Health Inform and Bioinforma 2015; 4: 1–16.

29.

Craft

. Toward technical interoperability in telemedicine. Telemed J E Health 2005; 11: 384–404.