Helen Monkman

Big Data in Healthcare - Defining the Digital Persona through User Contexts from the Micro to the Macro. Contribution of the IMIA Organizational and Social Issues WG.

OBJECTIVES While big data offers enormous potential for improving healthcare delivery, many of the existing claims concerning big data in healthcare are based on anecdotal reports and theoretical vision papers, rather than scientific evidence based on empirical research. Historically, the implementation of health information technology has resulted in unintended consequences at the individual, organizational and social levels, but these unintended consequences of collecting data have remained unaddressed in the literature on big data. The objective of this paper is to provide insights into big data from the perspective of people, social and organizational considerations. METHOD We draw upon the concept of persona to define the digital persona as the intersection of data, tasks and context for different user groups. We then describe how the digital persona can serve as a framework to understanding sociotechnical considerations of big data implementation. We then discuss the digital persona in the context of micro, meso and macro user groups across the 3 Vs of big data. RESULTS We provide insights into the potential benefits and challenges of applying big data approaches to healthcare as well as how to position these approaches to achieve health system objectives such as patient safety or patient-engaged care delivery. We also provide a framework for defining the digital persona at a micro, meso and macro level to help understand the user contexts of big data solutions. CONCLUSION While big data provides great potential for improving healthcare delivery, it is essential that we consider the individual, social and organizational contexts of data use when implementing big data solutions.

How to Present Evidence-Based Usability Design Principles Dedicated to Medication-Related Alerting Systems to Designers and Evaluators? Results from a Workshop.

Medication alerting system use errors and lack of adoption are often attributed to usability issues. Previous work has used evidence from the literature to reveal usability principles specific to medication alerting systems and identify potential consequences of violating these principles. The current study sought to explore how best to convey these principles to designers and evaluators of these systems to facilitate their work. To this aim, a workshop with 19 participants was used to generate ideas and opinions on how to deliver these topic-specific design principles in a way that would be most helpful for them. Participants generated ideas for how (e.g., a collaborative, continuously updated forum) and what (e.g., illustrations, checklists, evidence sources and strength, consequences of violations) information is most useful to disseminate usability principles for medication alerting systems. Participants, especially designers, expressed desire to use these principles in practice and avoid previously documented mistakes and therefore make design and evaluation of these systems more effective and efficient. Those insights are discussed in terms of feasibility and logistical challenges to developing the proposed documentation). To move this work forward, a more collaborative approach of Human Factors specialists in medical informatics is necessary.

User-Centered Design and Evaluation of Clinical Information Systems: A Usability Engineering Perspective

The usability of health information systems has been a continuing issue in health informatics. Numerous health information systems that have been deployed worldwide have been deemed unusable, not fitting clinical workflow, and in some cases end users have rejected poorly designed systems. Along these lines, there is also growing evidence that poorly designed user interfaces may actually lead health professionals to commit medical errors. In this chapter, we describe work in applying user-centered design principles in conjunction with advances in usability engineering to improve the usability of clinical information systems. Several approaches are described from the application of laboratory style usability testing to the use of clinical simulations conducted in-situ in real-world clinical settings. We also discuss how low-cost rapid usability engineering methods can be applied throughout the design and implementation cycle of clinical information systems. In addition to this, emerging approaches to testing systems in clinical settings will be described, along with future directions.

A Comparison of Danish and Canadian Consumer Medication Information

Many people around the world use prescription medications. Consumers often require information about their medications to support taking them safely and effectively. One source of such information is Consumer Medication Information (CMI). Canadians typically receive printed CMI when a new prescription is filled whereas Danes have the online resource min.medicin.dk. This study compared the content and design of Danish and Canadian CMI. Danish CMI satisfied seven of the 11 content utility criteria (developed in previous work) identified as supporting the safe and effective medication use. However, Danish CMI provided a more information about how frequently possible side effects occur and multimedia (e.g., images, videos) directions for some medications. This study examined some of the similarities and differences between how Canadians and Danes are informed about medications. However, further research is required to determine what content and methods of delivery are most beneficial in supporting safe and effective medication use.