NURSING INFORMATICS (LEC AND LAB) | Sir Jameson M.
Leonardo
Transes by: MJ SABADO | BSN 2E | BulS.U - College of Nursing
Chapter 9: Human Computer Interaction
Keywords
● Human–Computer Interaction
● Information technology
● Patient care
● Patient safety
● System design
Introduction
● Human–Computer Interaction (HCI) is
broadly defined as an intellectually rich
and highly impactful phenomenon
influenced by four disciplines: (1) Human
Factors and Ergonomics, (2) Information
Systems, (3) Computer Science, and (4)
Library and Information Science (Grudin,
2012).
HUMAN FACTORS: A BUILDING BLOCK FOR
HUMAN–COMPUTER INTERACTION
● Human factors is a discipline that tries to
optimize relationships between
technology and people (Kantowitz & Sorkin,
1983; McCormick & Sanders, 1982).
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Table 9.1 Examples of Digital Healthcare
Technologies Requiring HCI-Focused
Methodologies (From Picture)
● Technologies for preventative health and
self-management: To help people gather
information about symptoms and conditions
through online knowledge databases and
repositories for self-management of chronic
conditions.
● Technologies to make administration
more effective: Increasing extent of IT use
in administrative activities may provide
better administrative oversight of clinical
processes and risk management that might
be useful for identifying residents at risk and
improving care delivery.
● Electronic health records: Sharing clinical
information across healthcare organizations
(e.g., hospitals and nursing homes) through
an interoperable health information
exchange to support decisions about
admission and discharge needs for patients.
● Digital skills for information and
communication: Establishing realistic and
measurable benchmarks for eHealth literacy
levels for consumer health.
● Technology supporting synchronous and
asynchronous medical decision-making:
Access and usability of technologies in
remote, rural areas to support synchronous
and asynchronous medical diagnosis,
treatment, and monitoring of people with
chronic conditions.
● Sensor technologies and remote
monitoring: Use of meaningful interfaces
and data visualization techniques from
sensor systems that integrate multiple types
of clinical information captured from people
NURSING INFORMATICS (LEC AND LAB) | Sir Jameson M. Leonardo
Transes by: MJ SABADO | BSN 2E | BulS.U - College of Nursing
living in the community, including activities
of daily living, fall risk, and vital signs
capturing (e.g., heart rate, respirations, bed
restlessness).
● Computers in trauma and disaster
management: Augmented virtual reality
systems to rehabilitate and restore function
to a person’s body after a traumatic injury.
● Medication administration technology:
Electronic medication reminder systems for
patients or clinical decision support tools for
healthcare providers to assure proper
medication dosing and management.
Frameworks for HCI Nursing Research
● Early pioneers in nursing informatics set
the stage for development of nursing
information systems and their use in
storing information, knowledge
development, and development of
technology in caregiving activities (Graves &
Corc1989; Schwirian, 1986; Turley, 1996;
Werley & Grier, 1981).
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Human Factors Definition (From Picture)
1. Weinger, Pantiskas, Wiklund, and
Carstensen
● 1998
● Human factors is the study of the
interrelationships between humans, the
tools they use, and the environments in
which they live and work.
2. Rogers, Lamson, and Rousseau
● 2000
● A general tenet of human factors design is
that safety should be ensured through
design of the system. If potential hazards
cannot be designed out, then they should
be guarded against. If guarding against the
hazards is not possible, then an adequate
warning system should be developed.
3. Lin, Vicente, and Doyle
● 2001
● This discipline focuses on the interaction
between technology, people, and their work
context. Human factors have sometimes
been narrowly associated with
human–computer interaction design
guidelines.
4. Gosbee
● 2002
● A discipline concerned with the design of
tools, machines, and systems that take into
account human capabilities, limitations, and
characteristics.
5. Bates and Gawande
● 2003
● Principles of design using human factors
suggest it is important to make warnings
that are more serious and look different than
those that are less serious.
NURSING INFORMATICS (LEC AND LAB) | Sir Jameson M. Leonardo
Transes by: MJ SABADO | BSN 2E | BulS.U - College of Nursing
6. Potter, Boxerman, Wolf, Marshall,
Grayson, Sledge, and Evanoff
● 2004
● The study of human beings and their
interactions with products, environments,
and equipment in performing tasks and
activities.
7. Boston-Fleischhauer
● 2008
● The discipline that studies human
capabilities and limitations and applies that
knowledge to the design of safe, effective,
and comfortable products, processes, and
systems for the human beings involved.
8. Sharples, Martin, Lang, Craven, O’Neill,
and Barnett
● 2012
● The discipline of human factors has
demonstrated that if a device is well
designed then this will have positive
implications for usability, defined as “the
extent to which a product can be used by
specified users to achieve specified goals
with effectiveness, efficiency, and
satisfaction in a specified context of use.”
(ISO 9241-11)
9. Vincent, Li, and Blandford
● 2013
● The application of theory, principles, data,
and methods to design in order to optimize
human well-being and overall system
performance.
10. Guastello
● 2014
● Although it still stays true to its original
concerns about the person–machine
interface, it has expanded to include new
developments in stress research, accident
analysis and prevention, and nonlinear
dynamic systems theory (how systems
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change over time), and some aspects of
human group dynamics and environmental
psychology.
11. Wachter and Gupta
● 2018
● Human factors engineering is an applied
science of systems design that is concerned
with the interplay between humans,
machines, and their work environments. Its
goal is to assure that devices, systems, and
working environments are designed to
minimize the likelihood of error and optimize
safety.
12. Alexander, Frith, and Hoy
● 2019
● The scientific discipline concerned with the
understanding of the interactions among
humans and other elements of a system,
and the profession that applies theory,
prin-ciples, data, and methods to design in
order to optimize human well-being and
overall system performance.
Designing for Amount of NCI
● The discipline of HCI incorporates
proponents of interaction design. Interaction
designers are concerned with shaping
digital things for people’s use to maximize
efficiency and minimize error (Lowgren,
2013).
User Experience (UX) in HCI
● UX encompasses all aspects of the
end-user experience (Norman & Nielsen,
2019).
● Current UX pain points in nursing that are
impacting clinical practice include health IT
design/usability, IT fit to workflow,
excessive documentation,
NURSING INFORMATICS (LEC AND LAB) | Sir Jameson M. Leonardo
Transes by: MJ SABADO | BSN 2E | BulS.U - College of Nursing

interoperability, and lack of information

to support care processes (Staggers et al.,
2018).

Contextual Task Analysis

Health IT Design/Usability in HCI

● Cognitive research is used to describe
psychological processes associated with the
● Usability evaluation determines the extent
acquisition, organization, and use of
that a technology is easy and pleasurable to
knowledge (Hollnagel & Hollnagel, 2003).
use by determining if it is well adapted to
users, their tasks, and that negative
outcomes are minimized as a result of use Usability Tests
(Bastien, 2010).
● The International Organization for
Contextual Inquiry Standardization’s definition of usability is
“The extent to which a product can be used
by specified users to achieve specified
● Contextual inquiry is qualitative in nature.
goals with effectiveness, efficiency, and
This methodology is derived from
satisfaction in a specified context of use”
ethnography, which focuses on scientific
(Iso/Iec, 1998).
descriptions and illustrations of social
groups and systems.
Heuristics

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NURSING INFORMATICS (LEC AND LAB) | Sir Jameson M. Leonardo
Transes by: MJ SABADO | BSN 2E | BulS.U - College of Nursing
● This type of HCI evaluation involves a small
group of experts, who evaluate
quantitatively how well a device meets
established design standards, called
heuristics (Sharp, Rogers, & Preece, 2008).
Cognitive Walkthrough
● Similar to heuristic evaluation, cognitive
walkthrough is conducted using expert
evaluators who are not necessarily part
of the population of end users of a
technological device (Martin et al., 2008).
● Cognitive walkthrough evaluations are
task-specific, as compared to heuristic
evaluation, which provides a holistic view of
the interface and system features.
Tasks
● Tasks. Tasks involve interplay between
physical and cognitive activities and may
be considered to follow a continuum
between nearly pure physical tasks, such as
transporting a patient to an X-ray to nearly
pure cognitive tasks such as assessing
hemodynamic status.
Task Composition
● Task Composition. A task or action
sequence starts with a goal, then steps are
initiated based upon user intentions,
followed by the sequence of actions to be
performed or intended to be performed, and
the steps in the execution of the task.
Feedback
● Conditions that have been found to hinder
feedback in healthcare environments
include incomplete awareness that system
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failures have occurred, time and work
pressures, delays in action or outcome
sequences, case infrequence, deficient
follow-up, failed communication, deficient
reporting systems, case review biases, shift
work, and handoffs (Croskerry, 2000)
Focus Groups
● Focus groups are an excellent method to
cumulate rich qualitative descriptions of
how people interact with technological
systems. These are low cost
methodologies that require little overhead to
conduct, but can provide a significant
amount of information about usefulness of
technologies, system processes, and
satisfaction of people using technology.
Delphi Technique
● The Delphi technique is used to gain
consensus from experts on a subject.
This method uses multiple rounds of data
collection from experts, with each round
using data from previous rounds. The
questions posed focus on the opinions,
forecasts, and judgments of experts on a
specific topic.
Outcomes of HCI
● Traditional outcomes associated with
HCI methods are efficiency, effectiveness,
and satisfaction, which, as stated, are
highly related to how usable a piece of
technology is.