Usability and Human Factors

1. Usability and Human Factors Unit 4a Human Factors and Healthcare

2. Overview • Introduction to human factors principles • Applied cognitive psychology/selective attention • Patient safety • Understanding human errors • A Systems-centered approach to human errors • Mental workload • Medical devices Health IT Workforce Curriculum Version 1.0/Fall 2010

3. Human Factors & Health Care Health Devices Electronic Health Record Systems Component 15/Unit 4 Health IT Workforce Curriculum Version 1.0/Fall 2010 Health IT Workforce Curriculum Version 1.0/Fall 2010 3

4. Differences: Histories, journals, academic and professional societies HCI focused on computing and innovative design HF focused on any system and greater emphasis on work/workplace and on devices Safety is a core issue in HF Human Factors and HCI Redux Health IT Workforce Curriculum Version 1.0/Fall 2010

5. SiUser-centered and systems approach Draws on cognitive psychology and other social sciences Similar methods with regards to usability evaluation Cognitive task analysis Usability testing milarities: User-centered and systems approach Draws on cognitive psychology and other social sciences Similar methods with regards to usability evaluation Cognitive task analysis Usability testing Human Factors and HCI Redux Health IT Workforce Curriculum Version 1.0/Fall 2010

6. 1900-1945: Industrial efforts to increase worker productivity 1945 – 1960: Formal beginning of the profession – military 1960 – 1980: rapid growth and expansion – space program, product design, workplace design 1980 – 1990: Human computer interaction, safety/human error 1990 – Present expansion e.g., healthcare, aging, aviation safety, standardization History of Human Factors Health IT Workforce Curriculum Version 1.0/Fall 2010

7. Why is Human Factors Increasingly Important • Diversity of user groups • Complexity of systems • Increased use of technology • Increased “costs” of human error • Societal emphasis on well-being and quality of life Health IT Workforce Curriculum Version 1.0/Fall 2010

8. Focus: Human beings and their interactions with products/equipment, tasks, environments (Micro, macro, ambient) Goal: Design systems and system components to match the capabilities and limitations of humans who use them Optimize working & living conditions Human Factors Objective Health IT Workforce Curriculum Version 1.0/Fall 2010

9. Examples of Application Areas • Military • Highway systems • e.g. readability and comprehensibility of signs • Automobile design and driver behavior • Human-computer systems • Healthcare and patient safety • Aging and accessibility • Nuclear power • Workplace layout and furnishings • Airline industry • e.g. pilot workload, aircraft design, automation, aircraft maintenance • Quality control Health IT Workforce Curriculum Version 1.0/Fall 2010

10. Nuclear Power Plant Control Room Health IT Workforce Curriculum Version 1.0/Fall 2010

11. Airplane Cockpit Health IT Workforce Curriculum Version 1.0/Fall 2010

12. Human Factors in Medicine • Infusion pumps • Anesthesia equipment • Medication errors • Effects of fatigue on resident’s performance • Judgmental limitations in medical decision making • Inadequate infection control • Unintended consequences of automation Health IT Workforce Curriculum Version 1.0/Fall 2010

13. Human Factors/Ergonomics (Carayon, 2007) • Scientific discipline concerned with the understanding interactions • Among humans • Other elements of a system • Profession that applies theory, principles, data, methods to design in order to optimize human well-being and overall system performance • System can be a technology, device, person, team, organization, policy, guideline or physical environment Health IT Workforce Curriculum Version 1.0/Fall 2010

14. Physical Ergonomics Cognitive Ergonomics Organizational / Macroergonomics Human Factors Ergonomics:3 Major Domains Health IT Workforce Curriculum Version 1.0/Fall 2010

15. Concerned with physical activity Topics: Repetitive movements, workplace layout, safety and health Application to Health: Reducing and preventing injury, designing workstations and work rooms for optimal human performance Examples: Designing a patient room to facilitate and support patient care Designing medical labels so that they are readable and understandable Physical Ergonomics Health IT Workforce Curriculum Version 1.0/Fall 2010

16. Concerned with sociotechnical systems Topics: communication, teamwork, participatory design, quality management Application to Health: Reducing stress and burnout, improving satisfaction and retention, implementing improvement activities Examples: Management training in surgery teams Designing work schedules for reduced fatigue and enhanced performance Organizational Ergonomics Health IT Workforce Curriculum Version 1.0/Fall 2010

17. Concerned with mental processes Topics: mental workload, decision making, skilled performance, HCI, work stress, Application to Health: usability, designing training systems, usable interfaces Examples: Event report systems Implementing incident analysis system Cognitive Ergonomics Health IT Workforce Curriculum Version 1.0/Fall 2010

18. Human Factors & Applied Cognitive Psychology • Applies knowledge about human strengths and limitations to design of interactive systems, equipment, and their environment to ensure their effectiveness, safety, and ease of use • Perception, attention, memory, mental models and decision making are central to human factors research and analysis Health IT Workforce Curriculum Version 1.0/Fall 2010

19. Selective Mechanism Resource needed for information processing Limited Sharable Flexible Human Attention Health IT Workforce Curriculum Version 1.0/Fall 2010

20. Ability to ignore extraneous information and focus on relevant inputs Performance typically declines as the number of sources of information increases Humans can only process information at a finite rate Information overload contributes to errors Selective Attention Health IT Workforce Curriculum Version 1.0/Fall 2010

21. Speed Stress Speed/Accuracy Tradeoff Load Stress Information Overload Health IT Workforce Curriculum Version 1.0/Fall 2010

22. Four factors drive the selection of channels to attend (and the filtering of channels to ignore): Salience: Events or stimuli that are salient capture attention (this represents a bottom-up process) Expectancy and Value: We tend to “sample” the world where we expect to find information, and attend to channels based on how valuable it is to look or costly to miss Effort: Selective attention may be inhibited if it is effortful Selective Attention Health IT Workforce Curriculum Version 1.0/Fall 2010

23. Divided Attention or Time Sharing • Time-sharing: • ability to perform more than one cognitive task by attending to both at once or rapidly switching back and forth between them • Because cognitive resources for attention are relatively limited, time-sharing often results in a drop in performance for one or both tasks • People can also “modulate” the resources given to one task or the other Health IT Workforce Curriculum Version 1.0/Fall 2010

24. Human Factors Design Implications • Reduce the number of competing channels of information • Make sources of information as distinct as possible • Provide feedback • Use redundant cues • Work/rest scheduling • Training Health IT Workforce Curriculum Version 1.0/Fall 2010