Yunqiu Li

Integration of human factors and ergonomics during medical device design and development: It's all about communication

Manufacturers of interactive medical devices, such as infusion pumps, need to ensure that devices minimise the risk of unintended harm during use. However, development teams face challenges in incorporating Human Factors. The aim of the research reported here was to better understand the constraints under which medical device design and development take place. We report the results of a qualitative study based on 19 semi-structured interviews with professionals involved in the design, development and deployment of interactive medical devices. A thematic analysis was conducted. Multiple barriers to designing for safety and usability were identified. In particular, we identified barriers to communication both between the development organisation and the intended users and between different teams within the development organisation. We propose the use of mediating representations. Artefacts such as personas and scenarios, known to provide integration across multiple perspectives, are an essential component of designing for safety and usability.

The benefits of formalising design guidelines: a case study on the predictability of drug infusion pumps

A demonstration is presented of how automated reasoning tools can be used to check the predictability of a user interface. Predictability concerns the ability of a user to determine the outcomes of their actions reliably. It is especially important in situations such as a hospital ward where medical devices are assumed to be reliable devices by their expert users (clinicians) who are frequently interrupted and need to quickly and accurately continue a task. There are several forms of predictability. A definition is considered where information is only inferred from the current perceptible output of the system. In this definition, the user is not required to remember the history of actions that led to the current state. Higher-order logic is used to specify predictability, and the Symbolic Analysis Laboratory is used to automatically verify predictability on real interactive number entry systems of two commercial drug infusion pumps—devices used in the healthcare domain to deliver fluids (e.g., medications, nutrients) into a patient’s body in controlled amounts. Areas of unpredictability are precisely identified with the analysis. Verified solutions that make an unpredictable system predictable are presented through design modifications and verified user strategies that mitigate against the identified issues.

Exploring the Effect of Pre-operational Priming Intervention on Number Entry Errors

Managing and reducing error in number entry tasks is important, especially in safety critical contexts. Understanding factors that can affect number entry accuracy could help the design of more dependable systems. We present three interventions for number entry tasks, inspired by known priming effects (where exposure to prior stimuli can impact task performance). The interventions were questions for the operator to answer before entering each number. Questions related to the value/size of the number, its structure, and the context of the number entry task respectively. Results of a within-subject study show that although there was no significant difference amongst performance across interventions, all three interventions helped to improve the accuracy of number entry by reducing entry errors (by up to 40.8%) and unnoticed errors (by up to 60.7%). These are impressive gains and suggest the importance of more work in this area.

IWC Special Issue in Human Factors and Interaction Design for Critical Systems

The study of Human Factors (HF) and Interaction Design (ID) plays a central role in critical systems design. HF discovers and applies information about human behaviour, abilities, limitations and other characteristics to the design of tools, machines, systems, tasks, jobs and environments, for productive, safe, comfortable and effective human use. Successful ID is inherently multidisciplinary, forward looking, and aims to sketch, synthesise and prototype the future. Although the two fields are closely related, there are critical differences in approaches. Interaction designers typically seek to shape, create and explore future solutions, whereas HF researchers seek to operationalize social, psychological and behavioural theory to optimize design, often with constraints, such as error-free interaction, generally for skilled workers. HF work has a long tradition in the workplace, often concerned with dangerous and critical activities performed by skilled operators, whereas ID is increasingly focused on the huge market of discretionary consumers, often concerned with the likes and dislikes of people. When focused on common problems, however, HF and ID should be complementary, but also there is a need to understand how best to achieve this. In the worst case, designers make things that are just attractive (increasing profit, which marketing likes), whereas human factors experts make things that are just reliable (decreasing risk). We need both, and a wider perspective than ‘just’! These two forces seem to be splitting HCI. HCI it is either UX and fun or technical and industrial. The dominance of social media and consumer products makes UX seem ‘natural’ to many, but it may be inappropriate or misleading in critical applications. Our heritage of thinking in HCI, such as the Nielsen/Shneiderman guidelines, was established before this split became apparent. This special issue of Interacting with Computers focuses on the relation, tensions and trade-offs between HF and ID specifically in healthcare domains, aiming to effectively support design practice and research by showcasing the use of human factors/studies of human performance during the design, evaluation and use of interactive devices (e.g. findings relating to human error, cognitive performance and perceptual-motor control). We selected five papers for this special issue after a rigorous peer review process, as well as hosting an international workshop, the International Symposium on Interaction Design and Human Factors, in 2014 that we held in Kochi, Japan (see http://idhf.xrenlab.com) where many of the papers now in this issue were presented and exposed to critical discussion. The paper by Xiaojuan Ma investigated user ability of comprehending pictorial representations of medical conditions and accordingly proposed design guidelines for a visual vocabulary of electronic medical information to improve health literacy. The paper by Grace Begany et al. analysed human factors affecting user perception of search interfaces (e.g. in medical systems) through voice and touch gesture input and textual input, such as familiarity with the interface. Based on the understanding of human motor control ability of interacting with large displays, Kibum Kim et al. proposed a novel technique to aid elder people in remote target selection on large touch screens. Aiming to reduce number transcription errors in medical device interaction, Huawei Tu et al. explored user

QOC-E: A Mediating Representation to Support the Development of Shared Rationale and Integration of Human Factors Advice

Designing and manufacturing medical devices is a complex and specialist effort. Throughout the process, there is an opportunity to consult across those involved in various aspects of development (for example Human Factors (HF), Human Computer Interaction (HCI), Design and Manufacture). Developers report difficulties in this area, speaking of isolated team members and organizational / cultural barriers. We illustrate the use of a mediating representation (Questions, Options, Criteria and Evidence – QOC-E) that promotes shared reasoning and can be used to capture design rationale. Application is demonstrated using an illustrative example involving the specification of a number entry mechanism. The benefits of the QOC scheme include making tacit reasoning explicit, articulation of trade-offs, traceability, allowing compartmentalization of the design and avoidance of fixation in any one particular area. Downsides include the fact that the representation may require prohibitive amounts of effort to maintain or fail to scale to large or complex systems. These issues are discussed and directions for further investigation outlined.

ViM: Vital Signs in Music Creatively Facilitating Effective Long-Term Wellbeing Self-Management

The effectiveness of telehealth and mHealth technologies in long-term well being management relies on their acceptability with users. Factors such as low self-efficacy and poor peer support are frequently noted barriers that inhibit users from taking an active part in self-management. Here we report a work-in-progress research project, Vital signs in Music (ViM), using automatically-generated short music pieces from vital sign readings as an additional personalised data format to encourage sharing and to help establish peer support amongst users.