Using Interaction Design to Improve Usability of a PHR User Interface Based on Visual Elements

Using Interaction Design to Improve Usability of a PHR User Interface Based on Visual Elements

Stefano Forti (e-Health Applied Research Unit, FBKFondazione Bruno Kessler, Italy), Barbara Purin (e-Health Applied Research Unit, FBKFondazione Bruno Kessler, Italy) and Claudio Eccher (e-Health Applied Research Unit, FBKFondazione Bruno Kessler, I)
Copyright: © 2009 |Pages: 16
DOI: 10.4018/978-1-60566-016-5.ch010
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This chapter presents a case study of using interaction design methods for exploring and testing usability and user experience of a Personal Health Record (PHR) user interface based on visual and graphical elements. To identify problems and improve the design of PHR user interface we conducted two taskoriented usability testing based on the think-aloud technique for observing users during their interaction with a high-fidelity PHR prototype, and questionnaires and semistructured interviews for measuring user satisfaction. Our study demonstrates that a user-centered approach to interaction design involving the final users in an iterative design-evaluation process is important for exploring innovative user interfaces and for identification of problems in the early stages of the development cycle of a PHR.
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The Markle Foundation’s Connecting for Health working group in its report “Connecting Americans to their healthcare” (Markle Foundation, 2004) defines Personal Health Record (PHR) as: “an electronic application through which individuals can access, manage and share their health information in a secure and confidential manner” (pp. 13). In the last years, PHR has been gaining great attention from healthcare institutions and organizations, due to its potential for a more active involvement of citizens in their care and improvement of relationships and communication between patients and their healthcare providers (Brailer, 2004; Cohn, 2007). Recently, in its report on the prevention of medication errors (IOM, 2007), the Institute of Medicine has identified PHR systems as a viable technology to support consumers’ self-management.

Worldwide research institutions, government and healthcare authorities have identified PHR as a top priority, established broad areas for research and evaluation of PHR systems, and acknowledged the necessity of demonstration and pilot projects as a critical next step to address and exploit the full potential of PHR-based systems and services (Brailer, 2004; Cohn, 2007; Markle Foundation, 2004; Tang, Joan, Ash, Bates, Overhage, & Sands, 2006).

In order to design a working system, the involvement of final users is a crucial phase, even though it is often undervalued (Nielsen, 1993). For example, in healthcare settings, it has been demonstrated that the most innovative project could fail because of a rushed interface design (i.e., an interface limited to a subjective taste) that can compromise the user’s acceptability, strongly influencing the use of a system (Bates, Kuperman, Wang, Gandhi, Kittler, Volk, Spurr, Khorasani, Tanasijevic, & Middleton, 2003). This seems to be particularly true in the context of development of a PHR-based system, since we are dealing with citizens, a deeply nonhomogeneous group, due to the disparity of age, cultural level, living context, healthcare and computer literacy.

Interaction design emphasizes the importance of involving final users throughout the whole process of design of the product or system within an iterative design-evaluation process. Preece, Rogers, and Sharp (2002, pp. 170, 285) state that a user-centered approach to development “forms a central plank” of interaction design process and “the real user and their goals, not just technology, should be the driving force behind development of a product.”

In the last years, several groups have applied user-centered approaches and usability testing in healthcare settings for the design and implementation of clinical information systems (Coble, Karat, Orland, & Kahn, 1997; Kushniruk & Patel, 2004; Kushniruk, Patel, Cimino, & Barrows, 1996; Zhang, Johnson, Patel, Paige, & Kubose, 2003). To our knowledge, only few studies have applied a user-centered approach to design and development of a PHR system (Tran, Zhang, Stolyar, & Lober, 2005).

During the last year, the Department of Health of the Autonomous Province of Trento (NE Italy) has promoted a feasibility study on the design of a PHR-based system. One of the preliminary research questions of the study was to explore whether and how visual design solutions can promote user’s usability and acceptance of a PHR-based system. A first requirement for using a visual approach in the design of the PHR system was to create a clean nonredundant interface that would reassure and communicate calm and serenity to users and guide them through a user-friendly navigation throughout the PHR. A second, but not less important, requirement is that a user interface based on visual elements would be portable and usable in a touch-screen paradigm on mobile devices (i.e., palm top) with minor modifications.

This chapter describes the use of interaction methods, particularly usability testing, for exploring and testing usability and user experience of a PHR user interface based on visual elements.

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List of Reviewers
Table of Contents
Joseph Tan
E. Vance Wilson
Chapter 1
Juanita Dawson, Bengisu Tulu, Thomas A. Horan
This chapter provides a conceptual foundation by exploring the existing literature on traditional healthcare, patient-centered healthcare, and the... Sample PDF
Towards Patient-Centered Care: The Role of E-Health in Enabling Patient Access to Health Information
Chapter 2
Alejandro Mauro
This chapter introduces a series of techniques and tools useful for developing patient-centered e-health. As information technology (IT) is... Sample PDF
Patient-Centered E-Health Design
Chapter 3
Jan-Are K. Johnsen
In this chapter, we look at some fundamental aspects of communicating about ourselves and our health through technology. In particular, we examine... Sample PDF
Connecting with Ourselves and Others Online: Psychological Aspects of Online Health Communication
Chapter 4
Ebrahim Randeree
An increasing focus on e-health and a governmental push to improve healthcare quality while giving patients more control of their health data have... Sample PDF
Personal Health Records: Patients in Control
Chapter 5
Elaine A. Blechman
Newly disabled workers are often unemployed, uninsured, and indigent. They are in desperate need of Social Security OASDI monthly benefits, and the... Sample PDF
Disability Determinations and Personal Health Records
Chapter 6
E-Health Marketing  (pages 70-80)
Muhammad F. Walji, John A. Valenza, Jiajie Zhang
In this chapter, we review key concepts, using the marketing mix framework, to identify the needs of healthcare consumers, and the tools and... Sample PDF
E-Health Marketing
Chapter 7
Olli P. Järvinen
This chapter introduces the privacy management framework as a means of studying patient-centered e-health. The chapter raises some important issues... Sample PDF
Privacy Management of Patient-Centered E-Health
Chapter 8
Richard Klein
Patient-centered e-health (PCEH) offerings see the emergence of divergent, new third parties, through initiatives, including (a) medical content... Sample PDF
Trust in Patient-Centered E-Health
Chapter 9
John Powell, Natalie Armstrong
This chapter deals with the principles and practice of patient and public involvement in e-health research, and discusses some of the issues raised.... Sample PDF
Involving Patients and the Public in E-Health Research
Chapter 10
Stefano Forti, Barbara Purin, Claudio Eccher
This chapter presents a case study of using interaction design methods for exploring and testing usability and user experience of a Personal Health... Sample PDF
Using Interaction Design to Improve Usability of a PHR User Interface Based on Visual Elements
Chapter 11
Jiao Ma
This chapter explores the use of Web sites to provide patients with understandable information about the quality and price of healthcare (healthcare... Sample PDF
Healthcare Quality and Cost Transparency Using Web-Based Tools
Chapter 12
Ann L. Fruhling
This chapter is drawn from a comprehensive study that examined the effect Human-Computer Interaction usability factors had on rural residents’... Sample PDF
Perceptions of E-Health in Rural Communities
Chapter 13
Elizabeth Cummings, Stephen Chau, Paul Turner
This chapter explores how in developing patient-centred e-health systems it is possible to accommodate heterogeneous characteristics of end-users... Sample PDF
Assessing a Patient-Centered E-Health Approach to Chronic Disease Self-Management
Chapter 14
Michel J. Sassene
This chapter investigates asthmatics’ reasons for not adopting an e-health system for asthma selfmanagement. An understanding of these reasons is... Sample PDF
Incompatible Images: Asthmatics' Non-Use of an E-Health System for Asthma Self-Management
Chapter 15
Linda M. Gallant, Cynthia Irizarry, Gloria M. Boone
An extended version of the technology acceptance model (TAM) is applied to study hospital Web sites, one specific area of e-health. In a review of... Sample PDF
Exploring the Technology Adoption Needs of Patients Using E-Health
Chapter 16
E. Vance Wilson, Nancy K. Lankton
This chapter presents a new rational-objective (R-O) model of e-health use that accounts for effects of facilitating conditions as well as patients’... Sample PDF
Predicting Patients' Use of Provider-Delivered E-Health: The Role of Facilitating Conditions
About the Contributors