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Medical Informatics Period 2, 2013
Bengt Göransson
Isabella Scandurra
Division of Visual Information and Interaction
Human-Computer Interaction (HCI)
Dept of Information Technology
Uppsala University
http://www.it.uu.se/research/vi2
Course home page: http://www.it.uu.se/edu/course/homepage/medinf/ht13
Bengt Göransson User Centered Systems Design, Usability & Interaction Design
Employed at a GE Healthcare , Life Sciences in Uppsala.
Part time researcher at Uppsala University.
Been working as researcher and consultant in the IT business since 1984.
Started out as a developer. Computer science background. Moved on to
user-centered design and usability.
Domains: business support (public authorities, case-handling, medicine),
products (hard- and software), web-applications, e-services, etc..
Developing methods: user-centered systems design in practice, Scrum and
usability.
Currently at GE Healthcare working on the usability for laboratory
instruments for protein purification and related areas. Also processes for
User Experience Design.
Ph.D. from Uppsala University, Sweden, in HCI.
19121212 1212Patient Svensson, Sven Byt patient Avanc. sök… Varning
BlodsmittaVårdåtagandeVårdåtagande VårdkontaktVårdkontakt
Välj uppgift
Dokumentera
Under 1
Under 2
Under 3
»»
Remiss och svar »»
Ny beställning
Lab.-listan
Resultat
Patientöversikt
»»
Läkemedelslista
»»
Journaltorget »»
Under 1
Under 2
JournaltorgetDokumentera Patientöversikt Läkemedelsöversikt
Översikt »»
Visning »»Hälsoproblem »»
Aktuella diagnoser »»Aktuella diagnoserAktuella diagnoser »»
Aktuella recept »»Aktuella receptAktuella recept »»
Aktiviteter »»
xx xx xx xx
2006-01-21 15:01 | Dr. Annika Kovacs |
19121212-1212 Svensson, Sven | 2004-08-11 Vårdåtagande… Hem Under 1 Under 2Meny Hem Under 1 Under 2MenyMenyxx
Agenda
Dagbok
mediPal – huvudsida 14.45
Status
16.00: 1 tbl Madopark Depot 25mg
17.30: Rörlighet
18.00: 1 tbl Madopark Depot 25mg
19.30: Rörlighet
20.00: 1 tbl Madoprak Depot 25mg
12.02: 1 tbl Madopark Depot 25mg
13.55: 1 kopp kaffe
14.10: 1 tbl Madopark Depot 25mg
Spontan registrering
Övriga…Rörlighet Smärta
1 missad påminnelse
ÅtgärdaFlyttaAvståVila…
Agenda
Dagbok
mediPal – huvudsida 14.45mediPal – huvudsida 14.45
Status
16.00: 1 tbl Madopark Depot 25mg
17.30: Rörlighet
18.00: 1 tbl Madopark Depot 25mg
19.30: Rörlighet
20.00: 1 tbl Madoprak Depot 25mg
12.02: 1 tbl Madopark Depot 25mg
13.55: 1 kopp kaffe
14.10: 1 tbl Madopark Depot 25mg
Spontan registrering
Övriga…RörlighetRörlighet SmärtaSmärta
1 missad påminnelse
ÅtgärdaFlyttaAvståVila…
Guide Redina | Demo av IT- stöd för arbetsmarknadsenheten | september 2006 sida 1
KAMS HjälpInloggad som: handläggare, Bengt Göransson Personliga inställningar Logga utxx
Portalen
Mitt arbete
Klienter
Senaste
Rapporter
Inkorgen
Scheman
Tidsbokning
Admin
Uppföljning
Sök på allt
Mitt arbete
Mina senaste klienter Min vecka
Mina nya ansökningar/remisser Mina dokument
Min nästa bevakning
Uppdaterad Namn Personnr Status
2006-09-10 Per Persson 720315-1425 Deltagare
2006-09-10 Lars Larsson 630920-1415 Intressent
2006-09-09 Anna Andersson 810127-1425 Deltagare
2006-09-07 Bente Bengtsson 551117-1415 Avslutad
Dag Datum Tid Ämne Plats
Tisdag 09-19 08.30 – 12.00 Infomöte Sal A
13.00 – 15.00 Enskilt möte Mitt rum
Onsdag 09-20 08.00 – 17.00 Nätverksmöte Sal B
Torsdag 09-21 10.00 – 12.00 Annat möte Rum 317
Fredag 09-22
Måndag 09-25 08.00 – 10.00 Nätverksmöte Sal B
Inkom Typ Namn Avs handläggare Min
2006-08-30 Remiss Karin Persson Hans Håkansson X
2006-09-01 Uppdrag Lars Nilsson Ann Ek
2006-09-09 Egen Maria Andersson
2006-09-10 Remiss Albin Bengtsson Hans Håkansson X
Dokumentnummer Dokumentnamn
2006/300560-1 Kallelse Nätverksmöte 2006-09-25.doc
2006/24891-12 Presentation ny organisation.ppt
2005/05003-2 Förslag till förändring.doc
2006/88307-7 Protokoll från 2006-07-21.doc
2006/800325-5 Utvärdering Frans Olsson.doc
2006/343423-9 Brev.doc
Förfallodatum Namn Vad
2006-10-01 Östen Karlsson Revidering insatsplan
2006-10-12 Jakobina Fransson Uppföljning av insats
Mina meddelanden
Mottaget Ämne Avsändare
2006-09-19 08.25 Mötet börjar 08.30 Lisa Pettersson
2006-09-19 08.09 Tårta 10.15!!! Evert Andersson
2006-09-19 07.13 Ny ansökan Gunilla Ekström
Guide Redina | Demo av IT- stöd för arbetsmarknadsenheten | september 2006 sida 1
KAMS HjälpInloggad som: handläggare, Bengt Göransson Personliga inställningar Logga utxx
PortalenPortalen
Mitt arbeteMitt arbete
KlienterKlienterKlienter
SenasteSenaste
RapporterRapporterRapporter
InkorgenInkorgen
SchemanScheman
TidsbokningTidsbokning
AdminAdminAdmin
UppföljningUppföljningUppföljning
Sök på alltSök på alltSök på allt
Mitt arbete
Mina senaste klienter Min vecka
Mina nya ansökningar/remisser Mina dokument
Min nästa bevakning
Uppdaterad Namn Personnr Status
2006-09-10 Per Persson 720315-1425 Deltagare
2006-09-10 Lars Larsson 630920-1415 Intressent
2006-09-09 Anna Andersson 810127-1425 Deltagare
2006-09-07 Bente Bengtsson 551117-1415 Avslutad
Dag Datum Tid Ämne Plats
Tisdag 09-19 08.30 – 12.00 Infomöte Sal A
13.00 – 15.00 Enskilt möte Mitt rum
Onsdag 09-20 08.00 – 17.00 Nätverksmöte Sal B
Torsdag 09-21 10.00 – 12.00 Annat möte Rum 317
Fredag 09-22
Måndag 09-25 08.00 – 10.00 Nätverksmöte Sal B
Inkom Typ Namn Avs handläggare Min
2006-08-30 Remiss Karin Persson Hans Håkansson X
2006-09-01 Uppdrag Lars Nilsson Ann Ek
2006-09-09 Egen Maria Andersson
2006-09-10 Remiss Albin Bengtsson Hans Håkansson X
Dokumentnummer Dokumentnamn
2006/300560-1 Kallelse Nätverksmöte 2006-09-25.doc
2006/24891-12 Presentation ny organisation.ppt
2005/05003-2 Förslag till förändring.doc
2006/88307-7 Protokoll från 2006-07-21.doc
2006/800325-5 Utvärdering Frans Olsson.doc
2006/343423-9 Brev.doc
Förfallodatum Namn Vad
2006-10-01 Östen Karlsson Revidering insatsplan
2006-10-12 Jakobina Fransson Uppföljning av insats
Mina meddelanden
Mottaget Ämne Avsändare
2006-09-19 08.25 Mötet börjar 08.30 Lisa Pettersson
2006-09-19 08.09 Tårta 10.15!!! Evert Andersson
2006-09-19 07.13 Ny ansökan Gunilla Ekström
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Bengt Göransson User Centered Systems Design, Usability & Interaction Design
Isabella Scandurra in a nut shell • Research > 10 yrs
– Uppsala University; Social, Medical, Tech Faculties
– Centre for eHealth, Uppsala
– CMIV, Linköping
– R&D Seniorium, Stockholm
• Industry:
– Ericsson Network Technologies
– XLENT technology – SD
– InView & Strikersoft – Senior PM
– APRI group: APRI | eHealth and APRI | Innovations
• Health & social care:
– Akademiska hospital, Uppsala
– Linköping University hospital
– Hudiksvall Municipality & County Council of Gävleborg
– Uppsala Municipality & County Council of Uppsala
– Göteborg Municipality/Kortedala
– Bromma (SDF) District Administration, Stockholm
– 6 Municipalities in northern part of Sthlm
– Municipality of Örnsköldsvik, Sundsvall
• A life in Örnsköldsvik – In the MID (!) of Sweden
– With a husband and 2+1 daughters + 1 NN…
4
eHealth
Usability and
Process-related issues
Building usability into Health Informatics
Med. Dr. Isabella Scandurra Uppsala University, Dept of IT, Vi2
• Ph.D in Medical Informatics – M. Sc in System Engineering
• Human-Computer interaction, pedagogy/human resources
– Usability in homecare applications, integrated care processes
• Action Researcher Applied research, close to practice
Improved healthcare for elderly
OLD@HOME – digital support to homecare
Sustainable services for Social care for elderly
Sustainable health for modern ageing
Norrlandicus Care Lab
DOME – ePaceit consortium
Usability of eHealth system in National eHealth Strategy
• Usability architect/Chief Science Officer – Business development
– Requirements gathering, workflow processes
– Design & evaluation of health information systems
– Usability & benefit evaluations
– Project leader – process manager
– Lean Production and Essential Unified Process = EssUP
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Aim with this MI course Period 2, 2013
http://www.it.uu.se/edu/course/homepage/medinf/ht13
To give you an overview of health/ medical informatics in relation to Usability and usefulness of eHealth
An opportunity to get deeper insights
Hopefully an interest in continuous studies/work in our domain
Have you ever...
• ...visited a healthcare unit?
• Who did you meet there?
• Did you see any computers? Technology?
Have you ever taken a ”Usability Course”?
• The Usability Standard ISO 9241-11
• Development methods – User Centered Design
• Evaluation methods
• Guidelines to create ”good software” or ”good systems”
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Medical technology
From tele medicine to eHealth
• 104 definitions…
• Here: eHealth systems =
ICT for communication & delivery of health and social services
for health and social care staff
for patients
also for prevention
eHealth
Application and evaluation
Healt
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Met
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.g. te
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Health informatics applied eHealth
The use of computers and information technology contributes to better and more efficient healthcare?
Many different kinds of applications
Important for safety, efficiency
From life saving systems...
...to administration
“Standard” Image processing
Novel visualization of medical data
• CMIV Linköping
• Sectra Visualization Table – for medical education
• https://www.tii.se/projects/autopsy
Ambulance systems
Mobile emergency care
Home care – mobile work
Elderly at home
Feel safe and participate!
Physician (GP)
Reads updated info!
Relatives
Partcipate in the care process and are updated!
Home helpers
Read, write, communicate!
Nurse
Has access when working in the field!
My health record – 2 visits @ LUL
Elderly care?
Wearables & health apps
Consumer devices/apps
• Wearables as preventive care?
• Responsible for your personal health?
Self care
• “Quantify Self“organizations appear world wide
Health Informatics / eHealth
• Hospital care, Primary care, Emergency care,
• Home care, Home help services, Elderly care,
• Personal care, Self care, Consumer devices,
• Preventive care, Public care, Mobile care
…From birth to death…
We are trying to create good and secure CARE!
”We do not know much
about the future,
but we are all part of
shaping it!”
25
What do you think about medical informatics/eHealth after this walkthrough?
• Technology is used in a variety of ways in today's healthcare
• Technology is so obvious often invisible
• Medical technology/eHealth is extremely heterogeneous and therefore difficult to understand
• Development of a technology that is aiming, or referred to, be useful in clinical environments
This causes an area that is defined by its innovations and applications. The innovation arise in practice.
The patients’ changing situation.
The professionals’ changing situation.
Are there problems??
• Yes, many!!
• E.g.:
– Low usability – users often not satisfied
– Systems not adjusted to the context
– Many systems not integrated
– Expensive/slow development – high costs
– Introduction & training problems
– Safety risks
– Security risks, privacy problems
• Why do these problems exist?
What makes IT in healthcare so special (and difficult)?
Some examples from the media
Uppgraderat Explorer slår ut vårdjournaler
Karlskrona. Ny nödlösning ska minska
journalstrulet inom hemsjukvården
Example 1 • The NHS National Programme for IT (NPfIT) is an initiative by
the Department of Health in England to move the National Health Service (NHS) in England towards a single, centrally-mandated electronic care record for patients and to connect 30,000 General practitioners to 300 hospitals, providing secure and audited access to these records by authorised health professionals.
• NPfIT is said by the NHS CFH agency to be "the world's biggest civil information technology programme“.
• Originally expected to cost £2.3 billion (bn) over three years, in June 2006 the total cost was estimated by the National Audit Office to be £12.4bn over 10 years. Today??
• http://www.connectingforhealth.nhs.uk/ • Leading British computer scientists have called for an
independent audit of the NHS’s information technology programme to verify that the network of systems being installed in England is technically feasible and secure.
Example 2
• “Patient record notes were by mistake taken from another patient’s record – the patient got the wrong drug”
• – In the information system, electronic patient record, the medical data is not presented clear enough. The focus is often on “administrative data”.
• Safety for patients depend on the correct availability of medical notes.
Example 3 – Dialysis
”Dialysmålet” – The Dialysis case
On 28 Nov 1983 three patients died during dialysis in a Swedish hospital. ”They died when diluted dialysis fluid damaged the red blood cells, causing acute cell damage in vital tissues. The dialysis concentrate was not available, and water was pumped into the system”. “The court found that a nurse has caused the accident when she by mistake turned off the alarm system. She was convicted to have caused the death of the three patients and seriously injured several others.”
What is your opinion?
What can we do about this?
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• The demands in healthcare equals the potential benefit that ICT can provide…
• How to accomplish this?
Healthcare supported by a HCI framework
• It is crucial to involve users in the development… …We’ve said that for a long time…
• How to involve the users, and how to work with them effectively & efficiently is still not clear…
• Based on Human-Computer Interaction Science
• Users, Usability and User Centred Development – Usability standard ISO 9241-11
– User centred design ISO 9241-201/210
– User analysis (context/usage analysis)
– Usability evaluations
35
The MI course goal
The course will give you a basis for applying information technology in medicine and health care. We will explain some important concepts
and problem areas.
Especially we will focus on what is needed for development of efficient and usable ICT-systems
in healthcare /eHealth.
You know IT – now you will learn (some aspects) how to apply it to the healthcare domain.
You will learn about:
• Systems development in healthcare
• Design for usability of eHealth systems
• Medical documentation, patient records and communication
• Health terminology
• Medical image processing
• Patient-centred eHealth and Decision support systems
• Standards, laws and regulations
Site visits – Don’t miss this!
Radiology
Digital X-ray
Heart surgery
Course content
• Overview, Assignment specification • Usability in health care and mobile systems • Documentation, patient records • Medical image analysis and systems • University Hospital: Heart surgery • University Hospital: Radiology department • IT and usability in radiotherapy • IT development and usability in industry • Supervision • Examination • Group reports
Assignment
• A small project, assignment, to be performed in groups of 4-5 persons.
• HANDS-ON: To analyse an existing system, evaluate its usability and suggest preliminary solutions to usability problems. – or.....
• LITERATURE STUDY: To investigate, by literature studies etc., some interesting facts related to the use of IT in medicine or healthcare.
• There is a list of projects that you can choose from, Isabella knows more.
• Start early, i.e. now!!!
Assignment
• In both types of assignments, the focus should be on usability, design of the user interface and the benefit for the healthcare professionals and/or for the patients.
• You are supposed to spend one week working time per person for the assignment (~40 hours).
The purpose of the assignment is
• To get a feeling for how professionals in healthcare use IT as a tool in their everyday work,
• to understand problems that are associated with use of IT in healthcare,
• to understand problems related to development and deployment of IT in healthcare,
• to see which positive effects that potentially could be reached, if everything was made in an optimal way.
Assignment, logistics 1/2
• Step 1: Form groups of 5 persons. This should be done latest Monday Nov 4. Each group should send an (one) email to Bengt Göransson ([email protected]) and Isabella Scandurra ([email protected]) with a list of the group members’ names. Write “Medical Informatics” on the subject line.
Assignment, logistics 2/2
• Step 2: You must specify your assignment and get an approval before starting the assignment work. Also here, write an email to [email protected], [email protected] and specify your assignment, the application area, contact persons and a few lines about how you plan to perform your assignment project.
• You will get a reply with an OK or some advice how to proceed. This should be done latest Monday Nov 11.
Assignment
As the time for the assignment is rather short you should especially consider: • It takes time to specify the objectives, to establish
contacts, to book meetings etc. So start as early as possible!
• It is much better to study a very small application/system/problem and have time to analyse it in more detail. Do not try to look at larger systems. It is better to study a (very) small isolated part of a larger application or system.
• Focus on users, usability and benefits.
The written report - outline suggestions
• Abstract – Short summary. • Background – Describe the application area and the system you study. • Problem description – Describe the problem you find outgoing from the
users’ perspective. • Describe the system under study in more detail. • Analysis - Describe the method, the analysis and the results. This should be
related to usability issues. • Describe your ideas for improvements of the system, how the usability
problems could be solved. Give some preliminary descriptions of what the solution could look like. Motivate and try to evaluate your ideas.
• Discussion. – For instance: Potential different solutions or things you could have done alternatively. Knowledge you gained during the work that is worth bringing forward.
• Conclusion – a short section describing your most important findings. • References – interviews as well as other sources should be stated.
Assignment – hand in and presentation
The presentation of your assignment work must be made both orally and in written form.
• Send the written report by mail to Bengt Göransson ([email protected]) and Isabella Scandurra ([email protected]) no later than Monday Dec 9, 13.00
• The oral presentation is specified in the course schedule (Wednesday December 11).
• The written report will normally be approx. 6-10 pages.
Start to work on the Assignment!
• Suggestion list of projects to work with, Isabella will tell you more on next lecture (31 Oct)
• Isabella is your contact for the 2 LUL projects – Search and analyse EHR (SUSTAINS) data
– Interview with patients regarding knowledge about EHR online in LUL
Litterature
• No formal text book, however we recommend: A Guide to Health Informatics by Enrico Coiera, 2003, publ. Hodder Arnold This is a good and comprehensive book.
• We will provide you with enough material for the course, as lecture notes and complementary documents, web-links etc.
Home page
http://www.it.uu.se/edu/course/homepage/medinf/ht13
Contents – News – Registration – Schedule – Literature – Examination – Assignments
Literature • We recommend: A Guide to Health Informatics by Enrico Coiera, 2003, publ. Hodder Arnold
This is a good and comprehensive book. We will provide you with enough material for the course, as lecture notes and complementary documents, web-links etc.
Examination • The examination is performed through the assignment (written, oral presentation) and a short
written examination. The assignment is 60% and the written exam 40% of the basis for course credits.
Lecture notes • Will continuously be added here. Assignments • Assignment instructions
