Usability and Human
Factors
Unit 4a
Human Factors and
Healthcare
Overview
• Introduction to human factors principles
• Applied cognitive psychology/selective
attention
• Patient safety
• Understanding human errors
• A Systems-centered approach to human
errors
• Mental workload
• Medical devices
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Health IT Workforce Curriculum
Version 1.0/Fall 2010
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Human Factors & Health Care
Health Devices
Component 15/Unit 4
4a
Electronic Health Record
Systems
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Version 1.0/Fall 2010
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Human Factors and HCI
Redux
Differences:
• Histories, journals, academic and
professional societies
• HCI focused on computing and innovative
design
• HF focused on any system and greater
emphasis on work/workplace and on
devices
• Safety is a core issue in HF
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Health IT Workforce Curriculum
Version 1.0/Fall 2010
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Human Factors and HCI
Redux
Similarities:
• User-centered and systems approach
• Draws on cognitive psychology and
other social sciences
• Similar methods with regards to
usability evaluation
• Cognitive task analysis
• Usability testing
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Health IT Workforce Curriculum
Version 1.0/Fall 2010
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History of Human Factors
1900-1945:
• Industrial efforts to increase worker productivity
1945 – 1960:
• Formal beginning of the profession – military
1960 – 1980:
• rapid growth and expansion – space program, product design,
workplace design
1980 – 1990:
• Human computer interaction, safety/human error
1990 – Present expansion
• e.g., healthcare, aging, aviation safety, standardization
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Health IT Workforce Curriculum
Version 1.0/Fall 2010
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Why is Human Factors
Increasingly Important
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Diversity of user groups
Complexity of systems
Increased use of technology
Increased “costs” of human error
Societal emphasis on well-being and
quality of life
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Health IT Workforce Curriculum
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Human Factors Objective
Focus:
Goal:
• Human beings and
their interactions with
products/equipment,
tasks, environments
• (Micro, macro,
ambient)
• Design systems and
system components
to match the
capabilities and
limitations of humans
who use them
• Optimize working &
living conditions
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Health IT Workforce Curriculum
Version 1.0/Fall 2010
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Examples of Application Areas
• Military
• Highway systems
– e.g. readability and comprehensibility of signs
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Automobile design and driver behavior
Human-computer systems
Healthcare and patient safety
Aging and accessibility
Nuclear power
Workplace layout and furnishings
Airline industry
– e.g. pilot workload, aircraft design, automation, aircraft
maintenance
• Quality control
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Health IT Workforce Curriculum
Version 1.0/Fall 2010
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Nuclear Power Plant Control
Room
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Health IT Workforce Curriculum
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Airplane Cockpit
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Human Factors in Medicine
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Infusion pumps
Anesthesia equipment
Medication errors
Effects of fatigue on resident’s performance
Judgmental limitations in medical decision
making
• Inadequate infection control
• Unintended consequences of automation
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Health IT Workforce Curriculum
Version 1.0/Fall 2010
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Human Factors/Ergonomics
(Carayon, 2007)
• Scientific discipline concerned with the
understanding interactions
– Among humans
– Other elements of a system
• Profession that applies theory, principles,
data, methods to design in order to optimize
human well-being and overall system
performance
• System can be a technology, device, person,
team, organization, policy, guideline or
physical environment
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Health IT Workforce Curriculum
Version 1.0/Fall 2010
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Human Factors Ergonomics:
3 Major Domains
Physical
Ergonomics
Cognitive
Ergonomics
Organizational /
Macroergonomics
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Health IT Workforce Curriculum
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Physical Ergonomics
Concerned with physical activity
• Topics: Repetitive movements, workplace layout,
safety and health
• Application to Health: Reducing and preventing
injury, designing workstations and work rooms for
optimal human performance
• Examples:
• Designing a patient room to facilitate and
support patient care
• Designing medical labels so that they are
readable and understandable
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Health IT Workforce Curriculum
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Organizational Ergonomics
Concerned with sociotechnical
systems
• Topics: communication, teamwork,
participatory design, quality management
• Application to Health: Reducing stress and
burnout, improving satisfaction and retention,
implementing improvement activities
• Examples:
• Management training in surgery teams
• Designing work schedules for reduced
fatigue and enhanced performance
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Health IT Workforce Curriculum
Version 1.0/Fall 2010
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Cognitive Ergonomics
Concerned with mental processes
• Topics: mental workload, decision making, skilled
performance, HCI, work stress,
• Application to Health: usability, designing training
systems, usable interfaces
• Examples:
• Event report systems
• Implementing incident analysis system
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Health IT Workforce Curriculum
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Human Factors & Applied
Cognitive Psychology
• Applies knowledge about human strengths
and limitations to design of interactive
systems, equipment, and their
environment to ensure their effectiveness,
safety, and ease of use
• Perception, attention, memory, mental
models and decision making are central to
human factors research and analysis
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Health IT Workforce Curriculum
Version 1.0/Fall 2010
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Human Attention
Selective Mechanism
Resource needed for information processing
Limited
Sharable
Flexible
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Selective Attention
Ability to ignore extraneous information and focus on
relevant inputs
Performance typically declines as the number of sources
of information increases
Humans can only process information at a finite rate
Information overload contributes to errors
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Health IT Workforce Curriculum
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Information Overload
Speed Stress
Speed/Accuracy
Tradeoff
Load Stress
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Selective Attention
Four factors drive the selection of channels to
attend (and the filtering of channels to ignore):
Salience:
• Events or stimuli that are salient capture attention (this represents
a bottom-up process)
Expectancy and Value:
• We tend to “sample” the world where we expect to find information,
and attend to channels based on how valuable it is to look or costly
to miss
Effort:
• Selective attention may be inhibited if it is effortful
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Health IT Workforce Curriculum
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Divided Attention or
Time Sharing
• Time-sharing:
– ability to perform more than one cognitive task by
attending to both at once or rapidly switching
back and forth between them
• Because cognitive resources for attention are
relatively limited, time-sharing often results in
a drop in performance for one or both tasks
• People can also “modulate” the resources
given to one task or the other
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Health IT Workforce Curriculum
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Human Factors Design
Implications
• Reduce the number of competing
channels of information
• Make sources of information as distinct as
possible
• Provide feedback
• Use redundant cues
• Work/rest scheduling
• Training
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Health IT Workforce Curriculum
Version 1.0/Fall 2010
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