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Peute LW, Wildenbos GA, Engelsma T, Lesselroth BJ, Lichtner V, Monkman H, Neal D, Velsen LV, Jaspers MW, Marcilly R. Overcoming Challenges to Inclusive User-based Testing of Health Information Technology with Vulnerable Older Adults: Recommendations from a Human Factors Engineering Expert Inquiry. Yearb Med Inform 2022; 31:74-81. [PMID: 35654432 DOI: 10.1055/s-0042-1742499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES Involving representative users in usability testing of health information technology (HIT) is central to user-centered design. However, (vulnerable) older adults as representative users have unique requirements. Aging processes may affect physical capabilities and cognitive skills, which can hamper testing with this demographic and may require special attention and revised protocols. This study was performed to provide expert-based recommendations for HIT user-testing with (vulnerable) older adults to support inclusive HIT design and evaluation. METHODS First, we conducted a structured workshop with ten experts in HIT implementation and research, recruited through purposeful sampling, to generate insights into how characteristics of older adults may influence user-testing. Next, five Human Factor researchers experienced in HIT user-testing with (vulnerable) older adults validated the results and provided additional textual insights to gain consensus on the most important recommendations. A thematic analysis was performed on the resulting inquiries. Applied codes were based on the User-Centered Design framework. RESULTS The analysis resulted in nine recommendations for user-testing of HIT with older adults, divided into three main themes: (1) empathetic approach and trust-building, (2) new requirements for testing and study design, and (3) adjustments to usability evaluation methods. For each theme a checklist of relevant items to follow-up on the recommendation is provided. CONCLUSIONS The recommendations generated through expert inquiry contribute to more effective usability testing of HIT with older adults. This provides an important step towards improved accessibility of HIT amongst older adults through inclusive user-centered design.
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Affiliation(s)
- Linda W Peute
- Center for Human Factors Engineering of Health Information Technology, eHealth Living & Learning Lab Amsterdam, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Department of Medical Informatics, Amsterdam, the Netherlands
| | - Gaby-Anne Wildenbos
- Center for Human Factors Engineering of Health Information Technology, Amsterdam Public Health Research Institute, Department of Medical informatics, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
| | - Thomas Engelsma
- Center for Human Factors Engineering of Health Information Technology, eHealth Living & Learning Lab Amsterdam, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Department of Medical Informatics, Amsterdam, the Netherlands
| | - Blake J Lesselroth
- School of Health Information Science, University of Victoria, Victoria, Canada.,University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, USA
| | | | - Helen Monkman
- School of Health Information Science, University of Victoria, Victoria, Canada
| | - David Neal
- Amsterdam UMC, location VUmc Department of Psychiatry, Amsterdam
| | - Lex Van Velsen
- Roessingh Research and Development, eHealth group, Enschede, The Netherlands
| | - Monique W Jaspers
- Center for Human Factors Engineering of Health Information Technology, eHealth Living & Learning Lab Amsterdam, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Department of Medical Informatics, Amsterdam, the Netherlands
| | - Romaric Marcilly
- Université de Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France. INSERM-CIC-IT 1403/Evalab, Lille, France
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Hurmuz M, Jansen-Kosterink S, Flierman I, Fard B, Van Velsen L. The First Introduction of Social Robotics in Rehabilitation Care. Stud Health Technol Inform 2022; 294:890-894. [PMID: 35612237 DOI: 10.3233/shti220619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Can you imagine to receive treatment through a robot? When talking about the future of healthcare, this is the vision many people have. Currently, the predominant role of social robots in care is entertaining patients. However, this does not have an impact on care process itself. In this paper, we focus on defining use cases other than merely keeping patients' company by implementing a Pepper robot in inpatient rehabilitation setting, and expand upon usability testing the use cases. Our findings showed that, to ensure sustainable implementation of social robots in care organizations, we need excessive collaboration with the target population.
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Affiliation(s)
- Marian Hurmuz
- eHealth department, Roessingh Research and Development, The Netherlands
- Biomedical Signals and Systems Group, University of Twente, The Netherlands
| | - Stephanie Jansen-Kosterink
- eHealth department, Roessingh Research and Development, The Netherlands
- Biomedical Signals and Systems Group, University of Twente, The Netherlands
| | - Ina Flierman
- Roessingh Center for Rehabilitation, The Netherlands
| | - Behrouz Fard
- Roessingh Center for Rehabilitation, The Netherlands
| | - Lex Van Velsen
- eHealth department, Roessingh Research and Development, The Netherlands
- Biomedical Signals and Systems Group, University of Twente, The Netherlands
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Peute LW, Lichtner V, Baysari MT, Hägglund M, Homco J, Jansen-Kosterink S, Jauregui I, Kaipio J, Kuziemsky CE, Lehnbom EC, Leite F, Lesselroth B, Luna D, Otero C, Pedersen R, Pelayo S, Santos R, Silva NA, Tyllinen M, Van Velsen L, Zheng WY, Jaspers M, Marcilly R. Challenges and Best Practices in Ethical Review of Human and Organizational Factors Studies in Health Technology: a Synthesis of Testimonies. Yearb Med Inform 2020; 29:58-70. [PMID: 32303100 PMCID: PMC7442520 DOI: 10.1055/s-0040-1701979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE Human and Organizational Factors (HOF) studies in health technology involve human beings and thus require Institutional Review Board (IRB) approval. Yet HOF studies have specific constraints and methods that may not fit standard regulations and IRB practices. Gaining IRB approval may pose difficulties for HOF researchers. This paper aims to provide a first overview of HOF study challenges to get IRB review by exploring differences and best practices across different countries. METHODS HOF researchers were contacted by email to provide a testimony about their experience with IRB review and approval. Testimonies were thematically analyzed and synthesized to identify and discuss shared themes. RESULTS Researchers from seven European countries, Argentina, Canada, Australia, and the United States answered the call. Four themes emerged that indicate shared challenges in legislation, IRB inefficiencies and inconsistencies, general regulation and costs, and lack of HOF study knowledge by IRB members. We propose a model for IRB review of HOF studies based on best practices. CONCLUSION International criteria are needed that define low and high-risk HOF studies, to allow identification of studies that can undergo an expedited (or exempted) process from those that need full IRB review. Enhancing IRB processes in such a way would be beneficial to the conduct of HOF studies. Greater knowledge and promotion of HOF methods and evidence-based HOF study designs may support the evolving discipline. Based on these insights, training and guidance to IRB members may be developed to support them in ensuring that appropriate ethical issues for HOF studies are considered.
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Affiliation(s)
- Linda W Peute
- Centre for Human Factor Engineering of Health Information technology - Amsterdam UMC, University of Amsterdam, department of Medical Informatics, Amsterdam, The Netherlands
| | - Valentina Lichtner
- Centre for Medication Safety and Service Quality, UCL School of Pharmacy, UK
| | - Melissa T Baysari
- The University of Sydney, Faculty of Medicine and Health, Sydney, Australia
| | - Maria Hägglund
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Juell Homco
- Department of Medical Informatics, University of Oklahoma - Tulsa School of Community Medicine, USA
| | | | - Ignacio Jauregui
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Johanna Kaipio
- Department of Computer Science, Aalto University, Finland
| | | | - Elin Christina Lehnbom
- Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Norway; Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Sweden
| | | | - Blake Lesselroth
- Department of Medical Informatics, University of Oklahoma - Tulsa School of Community Medicine, USA
| | - Daniel Luna
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Carlos Otero
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Rune Pedersen
- Norwegian Centre for E-health Research, University Hospital of North Norway HF, Norway; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Norway
| | - Sylvia Pelayo
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, INSERM-CIC-IT 1403/Evalab, Lille, France
| | | | | | - Mari Tyllinen
- Department of Computer Science, Aalto University, Finland
| | - Lex Van Velsen
- Roessingh Research and Development, eHealth group, Enschede, The Netherlands
| | - Wu Yi Zheng
- The University of Sydney, Faculty of Medicine and Health, Sydney, Australia
| | - Monique Jaspers
- Centre for Human Factor Engineering of Health Information technology - Amsterdam UMC, University of Amsterdam, department of Medical Informatics, Amsterdam, The Netherlands
| | - Romaric Marcilly
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, INSERM-CIC-IT 1403/Evalab, Lille, France
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Van Velsen L, Wildevuur S, Flierman I, Van Schooten B, Tabak M, Hermens H. Trust in telemedicine portals for rehabilitation care: an exploratory focus group study with patients and healthcare professionals. BMC Med Inform Decis Mak 2016; 16:11. [PMID: 26818611 PMCID: PMC4728819 DOI: 10.1186/s12911-016-0250-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 01/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND For many eServices, end-user trust is a crucial prerequisite for use. Within the context of Telemedicine, the role of trust has hardly ever been studied. In this study, we explored what determines trust in portals that facilitate rehabilitation therapy, both from the perspective of the patient and the healthcare professional. METHODS We held two focus groups with patients (total n = 15) and two with healthcare professionals (total n = 13) in which we discussed when trust matters, what makes up trust in a rehabilitation portal, what effect specific design cues have, and how much the participants trust the use of activity sensor data for informing treatment. RESULTS Trust in a rehabilitation portal is the sum of trust in different factors. These factors and what makes up these factors differ for patients and healthcare professionals. For example, trust in technology is made up, for patients, mostly by a perceived level of control and privacy, while for healthcare professionals, a larger and different set of issues play a role, including technical reliability and a transparent data storage policy. Healthcare professionals distrust activity sensor data for informing patient treatment, as they think that sensors are unable to record the whole range of movements that patients make (e.g., walking and ironing clothes). CONCLUSIONS The set of factors that affect trust in a rehabilitation portal are different from the sets that have been found for other contexts, like eCommerce. Trust in telemedicine technology should be studied as a separate subject to inform the design of reliable interventions.
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Affiliation(s)
- Lex Van Velsen
- Telemedicine group, Roessingh Research and Development, P.O. box 310, 7500AH, Enschede, The Netherlands. .,University of Twente, P.O. box 217, 7500AE, Enschede, The Netherlands.
| | - Sabine Wildevuur
- Waag Society, Sint Antoniesbreestraat 69, 1011HB, Amsterdam, The Netherlands. .,VU University, Talma Institute, De Boelelaan 1081, 1081HV, Amsterdam, The Netherlands.
| | - Ina Flierman
- Roessingh Center for Rehabilitation, P.O. box 310, 7500AH, Enschede, The Netherlands.
| | - Boris Van Schooten
- Telemedicine group, Roessingh Research and Development, P.O. box 310, 7500AH, Enschede, The Netherlands.
| | - Monique Tabak
- Telemedicine group, Roessingh Research and Development, P.O. box 310, 7500AH, Enschede, The Netherlands. .,University of Twente, P.O. box 217, 7500AE, Enschede, The Netherlands.
| | - Hermie Hermens
- Telemedicine group, Roessingh Research and Development, P.O. box 310, 7500AH, Enschede, The Netherlands. .,University of Twente, P.O. box 217, 7500AE, Enschede, The Netherlands.
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Van Velsen L, Wentzel J, Van Gemert-Pijnen JE. Designing eHealth that Matters via a Multidisciplinary Requirements Development Approach. JMIR Res Protoc 2013; 2:e21. [PMID: 23796508 PMCID: PMC3815432 DOI: 10.2196/resprot.2547] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 03/27/2013] [Accepted: 05/01/2013] [Indexed: 11/13/2022] Open
Abstract
Background Requirements development is a crucial part of eHealth design. It entails all the activities devoted to requirements identification, the communication of requirements to other developers, and their evaluation. Currently, a requirements development approach geared towards the specifics of the eHealth domain is lacking. This is likely to result in a mismatch between the developed technology and end user characteristics, physical surroundings, and the organizational context of use. It also makes it hard to judge the quality of eHealth design, since it makes it difficult to gear evaluations of eHealth to the main goals it is supposed to serve. Objective In order to facilitate the creation of eHealth that matters, we present a practical, multidisciplinary requirements development approach which is embedded in a holistic design approach for eHealth (the Center for eHealth Research roadmap) that incorporates both human-centered design and business modeling. Methods Our requirements development approach consists of five phases. In the first, preparatory, phase the project team is composed and the overall goal(s) of the eHealth intervention are decided upon. Second, primary end users and other stakeholders are identified by means of audience segmentation techniques and our stakeholder identification method. Third, the designated context of use is mapped and end users are profiled by means of requirements elicitation methods (eg, interviews, focus groups, or observations). Fourth, stakeholder values and eHealth intervention requirements are distilled from data transcripts, which leads to phase five, in which requirements are communicated to other developers using a requirements notation template we developed specifically for the context of eHealth technologies. Results The end result of our requirements development approach for eHealth interventions is a design document which includes functional and non-functional requirements, a list of stakeholder values, and end user profiles in the form of personas (fictitious end users, representative of a primary end user group). Conclusions The requirements development approach presented in this article enables eHealth developers to apply a systematic and multi-disciplinary approach towards the creation of requirements. The cooperation between health, engineering, and social sciences creates a situation in which a mismatch between design, end users, and the organizational context can be avoided. Furthermore, we suggest to evaluate eHealth on a feature-specific level in order to learn exactly why such a technology does or does not live up to its expectations.
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Affiliation(s)
- Lex Van Velsen
- Center for eHealth Research and Disease Management, Department of Psychology, Health, and Technology, University of Twente, Enschede, Netherlands.
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