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Usability andPatient-centered Design Technology

Bennett Lauber, Chief Experience Officer

July 31, 2018

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Agenda

• Usability

• (Bad) Usability in the news

• Alfred Hitchcock, The Beatles and Pink Floyd?

• A few Health IT Examples

• The Myth of “Too many clicks”

• Health IT is growing exponentially

• What’s the solution?

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The official ISO 9241-11 definition of usability is:

“the extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context of use.”

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Usability is the new black!

• Robert Fabricant (Jan 7, 2013) calls User Experience

“The new Black” borrowing the term from the fashion industry.

Fabricant says

“The recognition

of UX’s

importance

seems to be

slowly sinking

into corporate

culture.”

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How Bad UX Killed Jenny

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Joint Commission Sentinel Alert 54

• https://www.jointcommission.org/sea_issue_54/

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(Bad) HealthIT Usability is in the news…

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Published research about bad UX

“The variability in time, clicks, and error rates highlights the need for improved implementation optimization. EHR implementation, in addition to vendor design and development, is critical to usable and safe products”

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UX in Healthcare IT is too far behind!

The user experiences associated with Healthcare IT are

about 5-10 years behind Enterprise technology, and

Enterprise technology is about 5-10 years behind consumer

technology

What can be done?

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Alfred Hitchcock

• Hitchcock fully understood the technology used to present his films in theaters.

• He made specific directed modifications to the overall production to better match the technology of the final presentation to his audience in the theaters.

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The Early Beatles

By Source, Fair use, https://en.wikipedia.org/w/index.php?curid=1163220

I'm a big fan, but although the writing,

music and lyrics of these songs are

excellent, the early Beatles didn’t fully

understand the power of stereo recording.

They presented the final mix of the song

with the drums on one side, guitar on the

the other, bass on both, etc.

Sure the stereo recording technology was

limited, but the engineers at the time didn’t

understand how to fully take advantage of

the recording equipment.

“She loves you, Yeah, Yeah Yeah!”

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Pink Floyd

By Hipgnosis - https://fi.wikipedia.org/w/index.php?curid=60234

Compare the early Beatles to

Pink Floyd’s “Dark side of the

moon,” where in 1972 the

engineers completely

understood and exploited the

recording technology to produce

a rock masterpiece that is still at

the top of the Billboard charts.

“Any Colour you like”

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Modern “Music”

• My 12 year old daughters are into “K-Pop”

• The ‘band’ members do not play any instruments!

“붐바야'(BOOMBAYAH)”

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Health IT?

• Health IT is like the early Beatles. There are some really great applications out there, and in theory they should help to improve the lives of those that use them.

• In practice, there are a number of fundamental flaws that stem from not fully understanding the power of the technology that is used to present solutions to doctors and patients.

• We need to be more like Alfred Hitchcock, Pink Floyd and The (later) Beatles. (and not like K-pop)

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Some EHR Examples:

Two very different ways to

Enter blood pressure:

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The Myth of Too Many Clicks?

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It isn’t a click, it is a decision

The above are some screen-shots from a system we tested in August, 2014

that received a 29/100 on the System Usability Scale (SUS).

This is a screenshot from a major CMS vendor. What exactly

does clicking on “OK” do?

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Exponential growth of Health IT

We are currently at

the “elbow”

of an exponential

growth curve

of mobile, connected

applications. For $199.00, the AliveCor Heart Monitor

turns your iPhone into an ECG

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Samples from the Exhibit Hall

Location Awareness

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Samples from the Exhibit Hall

Portable and TeleHealth Solutions

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Samples from the Exhibit Hall

Connected Sensors

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The Internet of Medical Things!

A report by Allied Market

Research predicts that the

IoT healthcare market will

reach $136.8 billion

worldwide by 2021.TomTom Spark Cardio + Music, GPS

Fitness Watch + Heart Rate Monitor + 3GB

Music Storage

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IoMT Development Kit!

There is even a development

platform for medical devices and

eHealth applications.

You can use it to develop eHealth

web applications or even to add

your own sensors and build new

medical devices.

The Kit includes 17 sensors which can be used to monitor more than 20

biometric parameters. All the data is encrypted and sent to the user's

private account through WiFi or Bluetooth. The data can be then visualized

in a tablet or smart phone with Android or iPhone Apps.

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Lots of tech, what’s the solution?

For a mobile HealthIT application to be successfully in this new world,

it needs to fully embrace the connected mobile technology.

Powered by a ubiquitous high speed network, that connects to a light

weight, vibrating, touch screen, a GPS, an accelerometer, camera, with a

speakerphone and microphone.

It is a Bluetooth enabled device that can connect to a plethora of sensors,

has serious amounts of computing power and data storage.

It has full access to Cloud-based Artificial Intelligence, Business Process

Modeling and Enterprise Social Networks.

BUT... How do we solve the Usability problem?

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The “Human Factor”

Despite the rise in the

capacity and number of

technological devices,

The capacity of the human

brain to process information

has remained the same.

The field of psychology, especially cognitive psychology

has, among other things, focused on understanding the

processes by which we store information, make

decisions, and communicate with others.

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Jean Piaget

Piaget used the terms Assimilation and

Accommodation to describe how we process

and adapt schema to new situations.

Assimilation occurs when you can take an

existing mental structure and incorporate it into

a new event.

Accommodation occurs when you must

change your mental structure in order to

understand and incorporate a new event.

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The Future of Healthcare is easy to use!

• There is a lot of great technology that we can exploit to

make the doctor and patient experience better and

safer.

Make sure that you don’t use technology for

technology’s sake. We do not want to be like the early

websites that had a fancy flash introduction—of which

most of us just clicked on “SKIP.”

We can’t forget about the “Human Factor” and must

design to match the mental model and workflow of

real users!

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More information:

http://www.HealthcareUsability.com

http://www.usability.gov/

@UsabilityPeople

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