Consumer Health Information Technology in the Home A Guide for Human Factors Design Considerations (2011) / Chapter Skim
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Consumer Health Information Technology in the Home
Consumer Health Information Technology in the Home
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Consumer Health Information Technology in the Home A GUIDE FOR HUMAN FACTORS DESIGN CONSIDERATIONS
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This guide introduces designers and developers to the practical realities and complexities of managing health at home. It provides guidance and human factors design considerations that will help designers and developers create consumer health IT applications that are useful resources to achieve better health.
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• Software designers, • Hardware and device designers, • Product marketing teams, • Information systems staff in health care organizations who want patients to make use of their portals, and • Home health professionals responsible for selecting health tools for patients to use. What are some examples of consumer health information technologies?
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This triad is embedded in ever-expanding environments, beginning with the physical developers create layout of the house, the social structure of people's relationships with their friends and fami new consumer lies, the community where they reside, and the health policy context, which influences the type of health services available and the presence (or absence) of funding for care, home health information based technologies, and care personnel.
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involved in Not all consumer health information technologies will be used by people in the categories identified above. Sometimes family, friends, or health professionals provide assistive care.
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Blood pressure meters and glucose monitors provide people with important information about their own health state and guide them toward healthy choices about medications and eating patterns. Many consumer health IT Care should be applications are developed for use with a computer, ranging from health-related Websites taken to design that help individuals better understand health conditions to game controllers and interfaces that engage people in exercise and mental challenges.
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Individuals engage in a number of everyday tasks (characterized by the attributes in the circle diagram) in addressing their health and health care, which may be supported by appropriate design of equipment and technologies: • Self-monitoring.
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The following tables offer design guidance related to the dimensions of the user, the physical environment, and the social and community environments, which should be considered when creating consumer health information technologies. Considerations of the task being performed are interwoven into the guidance.
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• Difficulties with • Devices should provide • Numeracy skills executing the feedback to users and be • Illness (e.g., appropriate response tolerant of user error dementia) • Health and • Difficulties with learning technology • Interfaces should be consistent • Side effects of literacy and remembering step- throughout a single device and medication by-step procedures across devices • Stress • Reduced ability • Content should be presented to comprehend • Learning disabilities as simply as possible instructions • Developmental • Increased need for disabilities assistance 9
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• Devices that are meant • Reduced stability and to be portable should balance be lightweight, easy to disconnect/disassemble, and • Reduced ability to easy to grasp execute movements precisely or operate controls Sensory or • Visual • Age • Difficulties seeing or • Devices should be perceptual reading content customizable to account • Auditory • Injury abilities for diverse sensory and • Difficulties hearing perceptual abilities (e.g., • Tactile • Illness alarms or instructions volume controls, font size, line spacing) • Olfactory • Disease • Difficulties distinguishing among • Devices should be flexible • Environmental smaller buttons and use redundancies (e.g., factors (e.g., noise visual, auditory, tactile signals)
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space for the attachments to reduce space • Devices may be device and its requirements during storage • Floor plan (proximity of placed out of reach attachments different types of living • Create devices that are • Increased likelihood spaces) • Width of doors and durable, waterproof, easily of electrical hallways cleaned • Cleanliness of home shortages • Height of cabinets • Minimize the power demand • Socioeconomic status • Devices may be of devices through the use of family • Electricity (outlet used in unintended of long-acting batteries or location, voltage, locations chargers i.e., 110 vs.
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of devices to be used independently of • Devices can devices in the home other devices when possible • Connectivity to or malfunction • Age of devices • Devices should be designed to compatibility with • Missing needed other devices be compatible with different • Socioeconomic status devices due to lack brands and models of other of family of space or access devices • Reduced use of • Product information should devices that rely on include the necessary other devices technical requirements 12
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• Air quality • Preferences of harder to use homeowner • Incorporate protection • Adequate lighting • Devices can create for devices (e.g., covers, • Socioeconomic status other hazards filters, surge protectors) to • Environmental of family protect from dust, grease, hazards (e.g., particulates, fumes, water, water, open and open flames flames)
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Social and Community Environments Understanding the social and community environments in which health information technologies are being used Varying Types of varying Reasons for Effects of Design considerations to social and social and varying social varying meet the varying social and community community and community social and community environmental environmental environmental environmental community aspects aspects aspects aspects environmental aspects • Children • Different family • Choking hazards • Devices should be designed to be Nonusers in the home structures portable for both private and shared • Adults • Tripping hazards use and easy storage • Visitors • Aging adults • Electrical • Devices should be cordless or have • Caregiving hazards minimal cord exposure • Pets • Preferences of home • User may feel • Devices should build in fail-safe • Caregivers owner self-conscious options (e.g., immediate cutoff of or embarrassed power when device is immersed in • Other individuals liquid) with limiting • May cause user cognitive, physical, to withdraw • Devices should be sold with or perceptual from socializing appropriate storage and casings for abilities in home small parts and fragile hardware • Reduced user • Devices should contain stands that privacy are sturdy and not easily toppled • Devices should be inconspicuous and blend into the rest of the home • Devices should allow for both private and shared use (e.g., screens with the option of being visible only from specific angles)
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Social and Community Environments (continued) Varying Types of varying Reasons for Effects of Design considerations to social and social and varying social varying meet the varying social and community community and community social and community environmental environmental environmental environmental community aspects aspects aspects aspects environmental aspects • Stress • Illness • Lack of social • Devices should provide easy-to-use Family dynamics support control over privacy settings • Cohesion • Disability • Stigma and • Devices' menus and choices should • Power structure • Competing demands shame be simplified • Communication • Age of family • Expectations for • Devices should offer a variety of patterns development privacy interaction and communication modes • Burden of • Devices should be lightweight and caregiving portable • User as caregiver • Different family • Increased • Devices should require minimal Other responsibilities for others structures workload and time and effort for use stress that can • Work • Caregiving obligations • Devices should be lightweight and affect device for parents, children, portable with long battery life use • Child care neighbors, family, • Devices should be inconspicuous • Devices may friends • Driving for use in communal settings be used in • Household obligations locations other • Devices should be durable to (e.g., mortgage, rent, than the home withstand use on the go bills)
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caregivers structures • Lack of device • Provide effective technical support • Access to • Location of neighbors, use assistance through different media transportation family, friends • Reduced • Devices should be designed to • Access to device • Public transportation relationship facilitate use by taking advantage training options with health care of affordances (cues built into the providers device) and appropriate mapping • Access to device • Distance of home to (relationship between control and technical support health care facilities • Difficulties with resulting action)
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They shape design dimensions that include type of technology, content, functionality, interface, and related decisions, such as where in the home the technology may be used. Cultural considerations affecting design dimensions are incorporated in the discussion of users, physical environment, and social and community environment.
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Social and Community Environment Care management. Cultural groups may differ as to how they expect their family, friends, neighbors, and other community members to be involved in their health and health management (e.g., who acts as a caregiver, what are the roles of formal and informal caregivers, how caregivers are expected to respond to the caregiving experience)
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Physical Abilities ■ Device requires minimal physical effort ■ Device is operable from a neutral body position ■ Device requires minimal force, repetitive action, and sustained physical effort for operation Device is customizable to accommodate variations in anthropometric measurements, such as height, ■ reach, and grip size, and ranges of motion, such as finger dexterity, neck movement, and walking distance ■ Device is portable, lightweight, easy to disconnect/disassemble, and easy to grasp Sensory or Perceptual Abilities Device is customizable to account for diverse sensory and perceptual abilities (e.g., volume controls, font ■ size, line spacing) Device is flexible and uses redundancies (e.g., visual, auditory, tactile signals)
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of the Home Layout of the Home ■ Product contains layout templates to help users choose space wisely Device includes storage containers for the device and its attachments to reduce space requirements ■ when not in use ■ Device is durable, waterproof, and easily cleaned ■ Device minimizes power demand through the use of long-acting batteries or chargers Device contains packing labels that alert consumers to the need for grounded outlets when needed for its ■ operation Services to the Home ■ Device is useable both online and offline Device is designed to facilitate different ways of transferring data from the home to the health care ■ system (e.g., a device designed to be compatible with home printers) Device contains content that can be downloaded both with and without graphics or in simpler formats for ■ people with slow Internet connections ■ Device contains redundancies in the ways in which interactions can take place (e.g., email, chat, phone)
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Family Dynamics ■ Device provides easy-to-use control over privacy settings ■ Device menus and choices are simplified ■ Device offers a variety of interaction and communication modes ■ Device is lightweight and portable Other Responsibilities ■ Device requires minimal time and effort for use ■ Device is inconspicuous for use in communal settings ■ Device is durable to withstand use on the go Resources ■ Device comes with compatible training (e.g., hands-on, verbal instructions, written instructions) ■ Device comes with effective technical support through different media Device is designed to facilitate use by taking advantage of affordances (cues built into the device)
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RELEVANT RESOURCES AND LINKS TO RESOURCES AVAILABLE ONLINE Agency for Healthcare Research and Quality http://www.ahrq.gov/ American Medical Informatics Association http://www.amia.org/ Association for Computing Machinery Special Interest Group on Computer Human Interaction http://www.sigchi.org/ Environmental Protection Agency http://www.epa.gov/ Healthcare Information Technology Standards Panel http://www.hitsp.org/ Home Care Technology Association of America http://www.hctaa.org/ Human Factors and Ergonomics Society http://www.hfes.org/ International Electrotechnical Commission http://www.iec.ch/ National Association for Homecare & Hospice http://www.nahc.org/ National Institute of Standards and Technology http://www.nist.gov/ University of Wisconsin–Madison Trace Center http://trace.wisc.edu/ 22
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Eric DeJonge, Washington Hospital Center, Washington, DC; Daryle Jean Gardner-Bonneau, Bonneau & Associates, Portage, Michigan; Michael Christopher Gibbons, Johns Hopkins Urban Health Institute, Johns Hopkins University Center for Community Health; Laura N Gitlin, Johns Hopkins School of Nursing; Judith Tabolt Matthews, Department of Health and Community Systems, University of Pittsburgh School of Nursing; Misha Pavel, Division of Biomedical Engineering, Department of Science and Engineering, Oregon Health and Science University; P
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