NURSING INFORMATICS
CHAPTER 4
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IMPROVING THE HUMAN
TECHNOLOGY INTERFACE
CHAPTER OBJECTIVES
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1. Define human-technology interface.
2. describe problems with human-technology
interfaces currently available in healthcare
3. describe models, strategies, and exemplars for
improving interfaces during analysis, design and
evaluation phases of the development life cycle.
4. Reflect on the future of the human-technology
interface
CHAPTER INTRODUCTION
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 In today’s healthcare settings, we encounter a
wide variety of human-technology interfaces.
 Scientists and engineers are making excellent
efforts in understanding Human Technology
Interface problems and proposing solutions.
 Any time a human uses technology, there is some
type of hardware and/or software that enables and
supports the interaction.
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 Human-Technology Interface (HTI): The
hardware and software through which the user
interacts with any technology (e.g., computers,
patient monitors, telephone)
 Human-Technology Interaction (HTI): How users
interact with technology; also the study of that
interaction.
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 Human Computer Interaction (HCI): The
processes, dialogues and actions that a user
employs to interact with a computer; also the study
of interaction between people (users) and
computers; deals with people, software
applications, computer technology and the ways
they influence each other.
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Examples of human-technology interfaces the
nurse might encounter include:
 Defibrillators
 Intravenous pumps
 Patient-controlled analgesia (PCA) pumps
 Physiologic monitoring systems
 Electronic thermometers
 Cardiac Monitoring systems
 Telephones & Pagers
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 The human interfaces for each of these
technologies are different—and can even differ
among different brands or versions of the same
device.
 Our healthcare technologies may present
information to us via computer screen, printer, or a
personal data assistant (PDA).
 Sometimes Telehealth interfaces allow patients to
interact with a virtual nurse or clinician.
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 Human-technology interfaces may present
information using text, numbers, pictures, icons, or
sound.
 The growing use of large databases for research
has led to the design of novel human-technology
interfaces that help researchers visualize and
understand patterns in the data that generate new
knowledge or lead to new questions.
 The human-technology interface is everywhere in
healthcare and takes many forms.
Human Technology Interface Problem
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 Human-technology interface problems are the
major cause of up to 87% of all patient monitoring
incidents.
 The technology may perform flawlessly, but the
interface design may lead the human user to make
errors.
Improving Human Technology Interface
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 We can learn a lot from the related fields of
Cognitive Engineering, Human Factors, and
Ergonomics about how to make our interfaces
more compatible with their human users and the
context of care.
 The design process should be literative, allowing
for evaluation and correction of identified problems
 Iteration: means the act of repeating a process
usually with the aim of approaching a desired goal
or target or result
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 Ergonomics: In the United States, this term is
used to describe the physical characteristics of
equipment, for example, the optimal fit of a
scissors to a human hand. In Europe, the term is
synonymous with Human Factors. It is the
interaction of humans with physical attributes of
equipment or the interaction of humans and the
arrangement of equipment in the work
environment.
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 Formal evaluation should take place using rigorous
experimental and/or qualitative methods.
 Task Analysis examines how a task must be
accomplished.
 Cognitive Task Analysis (CTA) usually starts by
identifying, through interviews or questionnaires,
the particular task and its typicality and frequency.
 Cognitive Work Analysis (CWA) was developed
specifically for the analysis of complex, high
technology work domains.
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 A complete CWA includes five types of analysis:
work domain, control tasks, strategies, socialorganizational, and worker competencies.
 Today there are available both principles and
techniques for developing human-technology
interfaces that people will be able to use with
minimal stress and maximal efficiency.
 Perhaps one of the best characteristics of that any
interface can achieve is that it is “transparent.”
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 An interface becomes transparent when it is so
easy to use that users no longer think about it, but
only about the task at hand.
 The more transparent the interface, the easier the
interaction should be.
 Usability is a term that denotes the ease with
which people can use an interface to achieve a
particular goal.
 Usability of a new human-technology interface
needs to be evaluated early and often throughout
its development.
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 Typical usability indicators include: ease of use,
ease of learning, satisfaction with using, efficiency
of use, error tolerance, and fit of the system to the
task.
 Increased attention to improving the humantechnology interface through human factors
approaches has already led to significant
improvement in one area of healthcare—
anesthesiology.
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Example:
Anesthesia machines that used to have hoses
that would fit into any delivery port now have
hoses that can only be plugged into the proper
port, thus reducing the chance for error.
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 Anesthesiologists have also been actively working
with engineers to improve the computer interface
through which they monitor their patients’ status
and are among the leaders in investigating the use
of audio techniques as an alternative way to help
anesthesiologists stay “situationally aware.”
 As a result, anesthesia-related deaths dropped
from 1 in 10-20,000 to 1 in 200,000 in under 10
years.
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 The increased amount of informatics research in
this area is encouraging, but there is a long way to
go.