Talya Porat

It's a Pleasure Buying Here: The Effects of Web-Store Design on Consumers' Emotions and Attitudes

We draw on research in human–computer interaction, information systems, environmental psychology, and marketing to develop and to test a model, which suggests that salient design characteristics of the web store (aesthetics and usability) influence the emotions of visitors to the stores site, which in turn affect their attitudes toward the store. A study examined the proposed model in two e-commerce domains—bookstores and apparel stores. The results, based on data collected from 327 participants, suggest that the effect of the design aspects on attitudes toward the store was partially mediated by affect. In addition, certain design aspects also affected attitudes directly. Specifically, effects of perceived aesthetic aspects of the online store were mainly mediated by affect. The influence of perceived usability was mainly direct and less mediated by affect. Both pleasure and arousal were associated with attitudes toward the store, with pleasure being the main mediator between store design and attitudes toward the store.

Diagnostic accuracy of GPs when using an early-intervention decision support system: a high-fidelity simulation

Background Observational and experimental studies of the diagnostic task have demonstrated the importance of the first hypotheses that come to mind for accurate diagnosis. A prototype decision support system (DSS) designed to support GPs’ first impressions has been integrated with a commercial electronic health record (EHR) system. Aim To evaluate the prototype DSS in a high-fidelity simulation. Design and setting Within-participant design: 34 GPs consulted with six standardised patients (actors) using their usual EHR. On a different day, GPs used the EHR with the integrated DSS to consult with six other patients, matched for difficulty and counterbalanced. Method Entering the reason for encounter triggered the DSS, which provided a patient-specific list of potential diagnoses, and supported coding of symptoms during the consultation. At each consultation, GPs recorded their diagnosis and management. At the end, they completed a usability questionnaire. The actors completed a satisfaction questionnaire after each consultation. Results There was an 8–9% absolute improvement in diagnostic accuracy when the DSS was used. This improvement was significant (odds ratio [OR] 1.41, 95% confidence interval [CI] = 1.13 to 1.77, P<0.01). There was no associated increase of investigations ordered or consultation length. GPs coded significantly more data when using the DSS (mean 12.35 with the DSS versus 1.64 without), and were generally satisfied with its usability. Patient satisfaction ratings were the same for consultations with and without the DSS. Conclusion The DSS prototype was successfully employed in simulated consultations of high fidelity, with no measurable influences on patient satisfaction. The substantially increased data coding can operate as motivation for future DSS adoption.

Eliciting User Decision Requirements for Designing Computerized Diagnostic Support for Family Physicians

Despite its 40-year history, computerized diagnostic support is not used in routine clinical practice. As part of a European project to develop computerized diagnostic support for family physicians, we identified user decision requirements and made design recommendations. To this end, we employed multiple data types and sources. All data were elicited from U.K. family physicians and pertained to consultations with patients, either real or simulated. To elicit user requirements, we conducted in situ observations and interviews with eight physicians and performed a hierarchical task analysis of the diagnostic task. We also analyzed 34 think-aloud transcripts of 17 family physicians diagnosing detailed patient scenarios on a computer and 24 interview transcripts of 18 family physicians describing past cases of intuitive diagnoses from their experience. All transcripts were coded using the situation assessment record (SAR) method. We report our methods and results using the decision-centered design framework. Studies employing multiple human factors techniques and data types in order to elicit user requirements are rare. Our approach enabled us to propose interface design recommendations that go beyond existing “differential diagnosis generators,” with the aim to improve physicians’ performance and acceptance of the resulting tool.

Task-dependent processing of tables and graphs

In two experiments participants had to detect changes in periodic sinusoidal functions, displayed in either graphic or tabular displays. Graphs had a major advantage over tables when the task required considering configurations of data. Both displays led to similar results when task performance could rely on inspecting individual data points. With graphs almost all participants reported using the optimal method for detecting changes in the function, i.e., they used the method requiring the least effort to perform the task. With tables only about half used the optimal detection method, and these participants showed transfer of learning of detection methods between tasks. Experience in using a detection method led to improved performance if the new task relied on the same method of detection. These findings demonstrate the need to consider task performance methods when determining the relative value of different displays. The set of tasks for which a display is used is likely to affect performance and needs to be analysed as a whole, since methods employed for one task can affect task performance in other tasks.

Tactful calling: investigating asymmetric social dilemmas in mobile communications

Recipients of phone calls face a constant dilemma between ignoring calls at the possible expense of offending the caller, missing business opportunities or neglecting family members on one hand; and answering them at the expense of interrupting their train of thought or appearing rude and impolite towards others with whom they share a social activity on the other hand. We studied peoples attitudes regarding these dilemmas, with emphasis on their social aspects. In a cross-cultural study, conducted in Israel and in Germany, we surveyed both caller and recipient attitudes towards answering mobile phone calls in various circumstances. The study also assessed the aspects of providing contextual information about a call prior to it being answered, including types of information deemed most valuable. The results emphasise the importance of social norms in affecting respondents’ attitudes towards making or accepting phone calls regardless of role (caller or recipient), gender or culture. We also found that the norms in the physical context (e.g. being in a meeting) prevailed over norms in the virtual context (e.g. the phone call). Cultural and gender differences did not affect the degree to which people were frustrated by insufficient information regarding the other partys context. However, these factors did affect the suggested design solutions to this problem. The research provides insight into the social aspects of the problem of interruptive mobile phone calls and towards designing applications that help users maintain politeness while handling the caller–recipient dilemma.

The impact of a diagnostic decision support system on the consultation: perceptions of GPs and patients

BackgroundClinical decision support systems (DSS) aimed at supporting diagnosis are not widely used. This is mainly due to usability issues and lack of integration into clinical work and the electronic health record (EHR). In this study we examined the usability and acceptability of a diagnostic DSS prototype integrated with the EHR and in comparison with the EHR alone.MethodsThirty-four General Practitioners (GPs) consulted with 6 standardised patients (SPs) using only their EHR system (baseline session); on another day, they consulted with 6 different but matched for difficulty SPs, using the EHR with the integrated DSS prototype (DSS session). GPs were interviewed twice (at the end of each session), and completed the Post-Study System Usability Questionnaire at the end of the DSS session. The SPs completed the Consultation Satisfaction Questionnaire after each consultation.ResultsThe majority of GPs (74%) found the DSS useful: it helped them consider more diagnoses and ask more targeted questions. They considered three user interface features to be the most useful: (1) integration with the EHR; (2) suggested diagnoses to consider at the start of the consultation and; (3) the checklist of symptoms and signs in relation to each suggested diagnosis. There were also criticisms: half of the GPs felt that the DSS changed their consultation style, by requiring them to code symptoms and signs while interacting with the patient. SPs sometimes commented that GPs were looking at their computer more than at them; this comment was made more often in the DSS session (15%) than in the baseline session (3%). Nevertheless, SP ratings on the satisfaction questionnaire did not differ between the two sessions.ConclusionsTo use the DSS effectively, GPs would need to adapt their consultation style, so that they code more information during rather than at the end of the consultation. This presents a potential barrier to adoption. Training GPs to use the system in a patient-centred way, as well as improvement of the DSS interface itself, could facilitate coding. To enhance patient acceptability, patients should be informed about the potential of the DSS to improve diagnostic accuracy.

Tools and Techniques for MOMU (Multiple Operator Multiple UAV) Environments; an Operational Perspective

Multiple operators controlling multiple unmanned aerial vehicles (MOMU) can be an efficient operational setup for reconnaissance and surveillance missions. However, it dictates switching and coordination among operators. Efficient switching is time-critical and cognitively demanding, thus vitally affecting mission accomplishment. As such, tools and techniques (T&Ts) to facilitate switching and coordination among operators are required. Furthermore, development of metrics and test-scenarios becomes essential to evaluate, refine, and adjust T&Ts to the specifics of the operational environment. To illustrate, tools that were designed and developed for MOMU operations as part of a US-Israel collaborative research project are described and associated research findings are summarized.

Improving specialist drug prescribing in primary care using task and error analysis: an observational study

BACKGROUND Electronic prescribing has benefited from computerised clinical decision support systems (CDSSs); however, no published studies have evaluated the potential for a CDSS to support GPs in prescribing specialist drugs. AIM To identify potential weaknesses and errors in the existing process of prescribing specialist drugs that could be addressed in the development of a CDSS. DESIGN AND SETTING Semi-structured interviews with key informants followed by an observational study involving GPs in the UK. METHOD Twelve key informants were interviewed to investigate the use of CDSSs in the UK. Nine GPs were observed while performing case scenarios depicting requests from hospitals or patients to prescribe a specialist drug. Activity diagrams, hierarchical task analysis, and systematic human error reduction and prediction approach analyses were performed. RESULTS The current process of prescribing specialist drugs by GPs is prone to error. Errors of omission due to lack of information were the most common errors, which could potentially result in a GP prescribing a specialist drug that should only be prescribed in hospitals, or prescribing a specialist drug without reference to a shared care protocol. Half of all possible errors in the prescribing process had a high probability of occurrence. CONCLUSION A CDSS supporting GPs during the process of prescribing specialist drugs is needed. This could, first, support the decision making of whether or not to undertake prescribing, and, second, provide drug-specific parameters linked to shared care protocols, which could reduce the errors identified and increase patient safety.

Switch and Deliver: Display layouts for MOMV (Multiple Operator Multiple Video feed) environments

‘Switch and Deliver’ is a research project directed to design and develop tools/techniques and procedures to aid operators in handling Multiple Operator Multiple UAV (unmanned aerial vehicles) environments. It aims to identify what information and which tools and layouts will decrease switch-costs and improve overall mission performance. Nevertheless, most tools/techniques can be generalized to any Multiple Operator Multiple Video feed (MOMV) environments, where control of multiple video sources, task switching and/or coordination with other operators are necessary for mission success. In this paper we describe a study conducted on proficient operators, examining three display layouts. It aims to examine how the operating interface facilitates handoffs and video feed switching among operators. Experimental methodology and findings are discussed.

Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement

Background Stroke, like many long-term conditions, tends to be managed in isolation of its associated risk factors and multimorbidity. With increasing access to clinical and research data there is the potential to combine data from a variety of sources to inform interventions to improve healthcare. A ‘Learning Health System’ (LHS) is an innovative model of care which transforms integrated data into knowledge to improve healthcare. The objective of this study is to develop a process of engaging stakeholders in the use of clinical and research data to co-produce potential solutions, informed by a LHS, to improve long-term care for stroke survivors with multimorbidity. Methods We used a stakeholder engagement study design informed by co-production principles to engage stakeholders, including service users, carers, general practitioners and other health and social care professionals, service managers, commissioners of services, policy makers, third sector representatives and researchers. Over a 10 month period we used a range of methods including stakeholder group meetings, focus groups, nominal group techniques (priority setting and consensus building) and interviews. Qualitative data were recorded, transcribed and analysed thematically. Results 37 participants took part in the study. The concept of how data might drive intervention development was difficult to convey and understand. The engagement process led to four priority areas for needs for data and information being identified by stakeholders: 1) improving continuity of care; 2) improving management of mental health consequences; 3) better access to health and social care; and 4) targeting multiple risk factors. These priorities informed preliminary design interventions. The final choice of intervention was agreed by consensus, informed by consideration of the gap in evidence and local service provision, and availability of robust data. This shaped a co-produced decision support tool to improve secondary prevention after stroke for further development. Conclusions Stakeholder engagement to identify data-driven solutions is feasible but requires resources. While a number of potential interventions were identified, the final choice rested not just on stakeholder priorities but also on data availability. Further work is required to evaluate the impact and implementation of data-driven interventions for long-term stroke survivors.