The Role of Human Factors in Home Health Care Workshop Summary (2010) / Chapter Skim
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3 Home Health Care Tasks and Tools
3 Home Health Care Tasks and Tools
Pages 29-46
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From page 29... ...
Because the task demands made of home caregivers can exceed human capabilities, these tasks need to be carefully analyzed. Care recipients and care providers are extremely diverse, and all are under more stresses than in the past.
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From page 30... ...
Second, assessing human capabilities draws on the literature on human factors plus contributions from other disciplines, such as psychology and biomechanics, supplemented with professional judgment. In addition, there are two methods of understanding tasks, and both are needed for error-proof designs.
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From page 31... ...
There is a well-developed methodology for task analysis that can be adapted for home caregiving, and other domains also demonstrate how to format the results for maximum impact and how to use the results in a design or redesign context. Task analysis needs both human factors practitioners and subject matter experts to be successful.
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From page 32... ...
Such devices are less likely to be appropriate, to be properly operated or maintained, or even to come with complete instructions. Many different people use medical devices in the home, including physicians, nurses, nurse practitioners, various therapists, workers, home care aides, independent contractors, family members, friends, neighbors, care recipients, or even someone who gets pulled in from the street in an emergency.
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From page 33... ...
Device durability and ruggedness are also factors when a device is taken out of a home or clinic. Taxonomy of Home Medical Devices Story has developed a 12-category taxonomy of home health care devices: 1.
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From page 34... ...
Future technological advances will bring new types of medical devices into the home, like improved pacemakers, cochlear implants, corneal implants, and artificial retinas. Nanotechnology will be embedded into devices, allowing for much more sophisticated biosensing.
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From page 35... ...
"Just as we are not going to have the accessible MRI machine and the regular MRI machine, the same should hold true for all home health care devices as well." 2. Flexibility in use, so that the design accommodates the full range of individual preferences and abilities.
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From page 36... ...
A U.S. human factors engineering process standard, referred to as ANSI/AAMI HE74 and published in 2001, is for use in fulfilling user interface design requirements in the development of medical devices and systems, including hardware, software, and documentation.
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From page 37... ...
And it is vitally important for people with vision impairments. Many different human factors methods can be used to assess device safety, functionality, and usability, including task analysis, risk assessment of potential errors and their consequences, evaluation by a group of testers against a set of heuristics or general principles, expert review, and formative and summative user testing.
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From page 38... ...
• For manufacturers, what factors influence their ability and will ingness to address the human factors needs of their users and customers? • For purchasers, what factors influence the medical device pur chasers and what factors influence prescribers to consider the needs of their end-users when they choose a device?
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From page 39... ...
Technologies falling into this category include telehealth applications, social networking systems, and personal health record systems. Telehealth technologies are a diverse set of devices that collect and transmit data over phone lines or other communications media, so that care providers or others can access data remotely.
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From page 40... ...
Research on telehealth applications has focused on care recipients with chronic conditions, including asthma, diabetes, chronic obstructive pulmonary disease, congestive heart failure, stroke rehabilitation, wound care, oncology, and post-transplant care. This research has produced several important findings with human factors implications: • In most cases a significant component of end-user training is involved.
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From page 41... ...
In addition, Microsoft has introduced Health Vault as a personal health record platform, with an emphasis on chronic conditions and people who frequently use multiple health care providers. Although much effort has been invested in the design of personal health records, they have not been tested extensively to see how they affect the quality of home health care, Demiris said.
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From page 42... ...
For example, many of the vendors introducing personal health records are not covered entities according to HIPAA. "There is a debate about whether we need to actually rethink what it means to be a covered entity and how we would deal with a vendor who collects personal health record information for other purposes," said Demiris.
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From page 43... ...
In addition, telehealth often will involve delivering care across state borders, raising issues bearing on liability and accreditation. Finally, introducing information technology in the home environment can have ethical impacts, such as creating dependence on automation, dehumanizing interpersonal relationships, reducing social interaction, generating stigma associated with the use of technology, or being overly intrusive.
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From page 44... ...
But it remains to be seen if indeed it will become the case." An additional challenge will be interactions between personal health records and electronic medical records, especially if multiple entities desire access to those records. Demiris also said that the category of applications with the best evidence for efficiency and efficacy is telehealth technologies, with clinical trials of web-based virtual communities also showing some effects.
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From page 45... ...
The regulation and surveillance of home-based medical devices need to be reexamined. "We can't just force-fit what we have been using in the institutional-care setting into the home health care setting." For example, different standards may be needed for regulatory clearance of home health care devices.
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From page 46... ...
These individuals could inform discussions about user needs and trust. She also mentioned that current reimbursement structures do not necessarily lend themselves to the widespread adoption of particular medical devices, including telehealth applications.
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