Evaluating User-Centered Design of E-Health for Older Adults

2017 ◽  
pp. 338-359
Author(s):  
Tracy L. Mitzner ◽  
Katinka Dijkstra
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Technology Acceptance ◽  
Older Adult ◽  
End Users ◽  
User Centered Design ◽  
Care Needs ◽  
Older Users ◽  
The Impact ◽  
User Centered

Health care related technology, or E-health, has the potential to lessen the impact of the growing aging population on the health care system and support older adults' preference for aging in place. However, for technologies to be adopted by older users, research is needed to understand older adults' unique health care needs, their preferences for support, and their perceptions of technologies designed for health care. Specifically directed toward older users, this article highlights the need for user-centered design and the implications for technology acceptance, and describes studies that employed systematic subjective methods such as focus groups, interviews, and questionnaires to provide a rich, detailed depiction of older users' interactions with E-health. User-centered design evaluations involving older adults can help designers create products and services that are more likely to be adopted by older adult end users.

Evaluating User Centered Design of E-Health for Older Adults

2016 ◽  
Vol 1 (2) ◽  
pp. 24-50
Author(s):  
Tracy L. Mitzner ◽  
Katinka Dijkstra
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Technology Acceptance ◽  
Aging In Place ◽  
Health Care Needs ◽  
User Centered Design ◽  
Care Needs ◽  
Older Users ◽  
The Impact ◽  
User Centered

Health care related technology, or E-health, has the potential to lessen the impact of the growing aging population on the health care system and support older adults' preference for aging in place. However, for technologies to be adopted by older users, research is needed to understand older adults' unique health care needs, their preferences for support, and their perceptions of technologies designed for health care. Specifically directed toward older users, this article highlights the need for user-centered design and the implications for technology acceptance, and describes studies that employed systematic subjective methods such as focus groups, interviews, and questionnaires to provide a rich, detailed depiction of older users' interactions with E-health. User-centered design evaluations involving older adults can help designers create products and services that are more likely to be adopted by older adult end users.

E-Health for Older Adults

2011 ◽  
pp. 1-21 ◽  
Author(s):  
Tracy L. Mitzner ◽  
Katinka Dijkstra
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Focus Groups ◽  
Technology Acceptance ◽  
Health Care System ◽  
Aging In Place ◽  
Health Care Needs ◽  
Care Needs ◽  
Older Users ◽  
The Impact

Health care related technology, or E-health, has the potential to lessen the impact of the growing aging population on the health care system, at the same time supporting aging in place. However, for technologies to be developed that are adopted by older users, research is needed to capture a thorough picture of older adults’ unique health care needs. Specifically directed toward older users, this chapter will demonstrate the need for user centered design, discuss technology acceptance, and describe studies that employed systematic subjective methods such as focus groups, interviews, and questionnaires to provide a rich, detailed depiction of older users’ interactions with E-health.

scholarly journals Starting an Older Adult Lecture for First Semester Nursing Students With a Truth or Myth Game

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 14-14
Author(s):  
Lynn Brown ◽  
Pao-feng Tsai
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Nursing Students ◽  
Older Adult ◽  
Care Needs ◽  
Final Exam ◽  
Negative Stereotypes ◽  
First Semester ◽  
Positive Attitudes ◽  
New Information

Abstract False ideas about the physical and psychosocial characteristics of older adults exist in America. It is especially important that nurses are not susceptible to myths and stereotypes as these myths can affect the quality of patient care. For example, some people stereotype older adults as forgetful, disabled, ill, and unable to understand new information. Misconceptions and negative stereotypes are also present in first year nursing students. It is vital that students assess their own attitudes about older adults to form positive attitudes and gain knowledge about aging and health care needs. To achieve this goal, the older adult lecture in a first semester theory and fundamental course begins with a PowerPoint slide presentation asking students to distinguish truths and myths. The truth or myth topics include a) developmental tasks; b) common physiological changes; c) a comparison of delirium, dementia, and depression; and d) addressing health concerns of older adults. Active discussion follows the activity. Seventy to ninety percent of students correctly answered nine of ten questions related to older adult content on the final exam. Considering the increasing number of older adults in the health care setting, nurse educators must dismantle negative stereotypes with creative teaching strategies.

scholarly journals Beyond Getting Rid of Stupid Stuff in the Electronic Health Record (Beyond-GROSS): Protocol for a User-Centered, Mixed-Method Intervention to Improve the Electronic Health Record System

10.2196/25148 ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. e25148
Author(s):  
Ahmed Umar Otokiti ◽  
Catherine K Craven ◽  
Avniel Shetreat-Klein ◽  
Stacey Cohen ◽  
Bruce Darrow
Keyword(s):  
Health Care ◽  
Data Analysis ◽  
Electronic Health Record ◽  
Health Record ◽  
User Centered Design ◽  
Pilot Phase ◽  
Direct Input ◽  
Electronic Health ◽  
The Impact ◽  
User Centered

Background Up to 60% of health care providers experience one or more symptoms of burnout. Perceived clinician burden resulting in burnout arises from factors such as electronic health record (EHR) usability or lack thereof, perceived loss of autonomy, and documentation burden leading to less clinical time with patients. Burnout can have detrimental effects on health care quality and contributes to increased medical errors, decreased patient satisfaction, substance use, workforce attrition, and suicide. Objective This project aims to improve the user-centered design of the EHR by obtaining direct input from clinicians about deficiencies. Fixing identified deficiencies via user-centered design has the potential to improve usability, thereby increasing satisfaction by reducing EHR-induced burnout. Methods Quantitative and qualitative data will be obtained from clinician EHR users. The input will be received through a form built in a REDCap database via a link embedded in the home page of the EHR. The REDCap data will be analyzed in 2 main dimensions, based on nature of the input, what section of the EHR is affected, and what is required to fix the issue(s). Identified issues will be escalated to relevant stakeholders responsible for rectifying the problems identified. Data analysis, project evaluation, and lessons learned from the evaluation will be incorporated in a Plan-Do-Study-Act (PDSA) manner every 4-6 weeks. Results The pilot phase of the study began in October 2020 in the Gastroenterology Division at Mount Sinai Hospital, New York City, NY, which includes 39 physicians and 15 nurses. The pilot is expected to run over a 4-6–month period. The results of the REDCap data analysis will be reported within 1 month of completing the pilot phase. We will analyze the nature of requests received and the impact of rectified issues on the clinician EHR user. We expect that the results will reveal which sections of the EHR have the highest deficiencies while also highlighting issues about workflow difficulties. Perceived impact of the project on provider engagement, patient safety, and workflow efficiency will also be captured by evaluation survey and other qualitative methods where possible. Conclusions The project aims to improve user-centered design of the EHR by soliciting direct input from clinician EHR users. The ultimate goal is to improve efficiency, reduce EHR inefficiencies with the possibility of improving staff engagement, and lessen EHR-induced clinician burnout. Our project implementation includes using informatics expertise to achieve the desired state of a learning health system as recommended by the National Academy of Medicine as we facilitate feedback loops and rapid cycles of improvement. International Registered Report Identifier (IRRID) PRR1-10.2196/25148

scholarly journals A Randomized Trial Comparing Classical Participatory Design to VandAID, an Interactive CrowdSourcing Platform to Facilitate User-centered Design

2017 ◽  
Vol 56 (05) ◽  
pp. 344-349 ◽  
Author(s):  
Sabine Koch ◽  
Kim M. Unertl ◽  
Christoph U. Lehmann ◽  
Kevin R. Dufendach
Keyword(s):  
User Interface ◽  
Randomized Trial ◽  
Real Time ◽  
Participatory Design ◽  
End Users ◽  
User Preferences ◽  
User Centered Design ◽  
Web Based ◽  
The Impact ◽  
User Centered

Summary Background: Early involvement of stakeholders in the design of medical software is particularly important due to the need to incorporate complex knowledge and actions associated with clinical work. Standard user-centered design methods include focus groups and participatory design sessions with individual stakeholders, which generally limit user involvement to a small number of individuals due to the significant time investments from designers and end users. Objectives: The goal of this project was to reduce the effort for end users to participate in co-design of a software user interface by developing an interactive web-based crowd- sourcing platform. Methods: In a randomized trial, we compared a new web-based crowdsourcing platform to standard participatory design sessions. We developed an interactive, modular platform that allows responsive remote customization and design feedback on a visual user interface based on user preferences. The responsive canvas is a dynamic HTML template that responds in real time to user preference selections. Upon completion, the design team can view the user’s interface creations through an administrator portal and download the structured selections through a REDCap interface. Results: We have created a software platform that allows users to customize a user interface and see the results of that customization in real time, receiving immediate feedback on the impact of their design choices. Neonatal clinicians used the new platform to successfully design and customize a neonatal handoff tool. They received no specific instruction and yet were able to use the software easily and reported high usability. Conclusions: VandAID, a new web-based crowdsourcing platform, can involve multiple users in user-centered design simultaneously and provides means of obtaining design feedback remotely. The software can provide design feedback at any stage in the design process, but it will be of greatest utility for specifying user requirements and evaluating iterative designs with multiple options.

scholarly journals Beyond Getting Rid of Stupid Stuff in the Electronic Health Record (Beyond-GROSS): Protocol for a User-Centered, Mixed-Method Intervention to Improve the Electronic Health Record System (Preprint)

2020 ◽  
Author(s):  
Ahmed Umar Otokiti ◽  
Catherine K Craven ◽  
Avniel Shetreat-Klein ◽  
Stacey Cohen ◽  
Bruce Darrow
Keyword(s):  
Health Care ◽  
Data Analysis ◽  
Electronic Health Record ◽  
Health Record ◽  
User Centered Design ◽  
Pilot Phase ◽  
Direct Input ◽  
Electronic Health ◽  
The Impact ◽  
User Centered

BACKGROUND Up to 60% of health care providers experience one or more symptoms of burnout. Perceived clinician burden resulting in burnout arises from factors such as electronic health record (EHR) usability or lack thereof, perceived loss of autonomy, and documentation burden leading to less clinical time with patients. Burnout can have detrimental effects on health care quality and contributes to increased medical errors, decreased patient satisfaction, substance use, workforce attrition, and suicide. OBJECTIVE This project aims to improve the user-centered design of the EHR by obtaining direct input from clinicians about deficiencies. Fixing identified deficiencies via user-centered design has the potential to improve usability, thereby increasing satisfaction by reducing EHR-induced burnout. METHODS Quantitative and qualitative data will be obtained from clinician EHR users. The input will be received through a form built in a REDCap database via a link embedded in the home page of the EHR. The REDCap data will be analyzed in 2 main dimensions, based on nature of the input, what section of the EHR is affected, and what is required to fix the issue(s). Identified issues will be escalated to relevant stakeholders responsible for rectifying the problems identified. Data analysis, project evaluation, and lessons learned from the evaluation will be incorporated in a Plan-Do-Study-Act (PDSA) manner every 4-6 weeks. RESULTS The pilot phase of the study began in October 2020 in the Gastroenterology Division at Mount Sinai Hospital, New York City, NY, which includes 39 physicians and 15 nurses. The pilot is expected to run over a 4-6–month period. The results of the REDCap data analysis will be reported within 1 month of completing the pilot phase. We will analyze the nature of requests received and the impact of rectified issues on the clinician EHR user. We expect that the results will reveal which sections of the EHR have the highest deficiencies while also highlighting issues about workflow difficulties. Perceived impact of the project on provider engagement, patient safety, and workflow efficiency will also be captured by evaluation survey and other qualitative methods where possible. CONCLUSIONS The project aims to improve user-centered design of the EHR by soliciting direct input from clinician EHR users. The ultimate goal is to improve efficiency, reduce EHR inefficiencies with the possibility of improving staff engagement, and lessen EHR-induced clinician burnout. Our project implementation includes using informatics expertise to achieve the desired state of a learning health system as recommended by the National Academy of Medicine as we facilitate feedback loops and rapid cycles of improvement. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/25148

scholarly journals Perceptions of Two Older Adults Regarding the Factors and Barriers that Influence their Oral Health Care: A Case Study

2021 ◽  
Author(s):  
Dinorah Munira Hernandez-Santos ◽  
Irma Fabiola Diaz-Garcia
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Oral Health ◽  
Dental Care ◽  
Structured Interview ◽  
Oral Health Care ◽  
Current Status ◽  
Care Needs ◽  
The Impact

This paper presents the results of a case study about the perceptions of oral health care, factors that influenced current oral health, and barriers to dental attention of two older adults; the study was conducted by researchers from a hospital-school of dentistry at a public university in Mexico. Two adults aged 64 and 70 years participated in this study. First, the oral health status was clinically evaluated using the Decayed/Missing/Filled/Teeth (DMFT) Index. A semi-structured interview was then conducted to learn about the perceptions of oral health care. Thematic content analysis was used to explore the data obtained using the ATLAS.ti software 7.0 version. Four main themes and their subthemes were developed. The main finding of the case study was that oral health was directly and strongly associated with the impact that it has on a participant's life, especially in the functional field of chewing. Also, the participants recognized the importance of having good oral health and see it as a necessity for living. Aspects that influenced the current status of oral health were mainly the care received during their childhood, as well as the previous dental beliefs and treatments. Finally, some of the perceived barriers to dental care treatment were lack of time, finances, and education. These findings challenge professionals to be more sensitive to past and current experiences of older adults at the time of receiving dental care. Knowing their perceptions can support health professionals to strengthen patients’ commitment to prioritizing oral health care needs.

scholarly journals User Centered Virtual Coaching for Older Adults at Home Using SMART Goal Plans and I-Change Model

2021 ◽  
Vol 18 (13) ◽  
pp. 6868
Author(s):  
Andoni Beristain Iraola ◽  
Roberto Álvarez Sánchez
Keyword(s):  
Older Adults ◽  
Behavior Change ◽  
Older Adult ◽  
Healthy Aging ◽  
User Preferences ◽  
Change Model ◽  
Virtual Coaching ◽  
The Impact ◽  
User Centered ◽  
At Home

Preventive care and telemedicine are expected to play an important role in reducing the impact of an increasingly aging global population while increasing the number of healthy years. Virtual coaching is a promising research area to support this process. This paper presents a user-centered virtual coach for older adults at home to promote active and healthy aging and independent living. It supports behavior change processes for improving on cognitive, physical, social interaction and nutrition areas using specific, measurable, achievable, relevant, and time-limited (SMART) goal plans, following the I-Change behavioral change model. Older adults select and personalize which goal plans to join from a catalog designed by domain experts. Intervention delivery adapts to user preferences and minimizes intrusiveness in the user’s daily living using a combination of a deterministic algorithm and incremental machine learning model. The home becomes an augmented reality environment, using a combination of projectors, cameras, microphones and support sensors, where common objects are used for projection and sensed. Older adults interact with this virtual coach in their home in a natural way using speech and body gestures on projected user interfaces with common objects at home. This paper presents the concept from the older adult and the caregiver perspectives. Then, it focuses on the older adult view, describing the tools and processes available to foster a positive behavior change process, including a discussion about the limitations of the current implementation.

scholarly journals Student-Led Fall Prevention Care Management Reduced Fall Risks at Assisted Living Facilities

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 238-238
Author(s):  
Hiroko Kiyoshi-Teo ◽  
Claire McKinley-Yoder ◽  
Erin Lemon ◽  
Olivia Ochoa
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Fall Prevention ◽  
Fall Risk ◽  
Care Management ◽  
Assisted Living Facilities ◽  
Care Needs ◽  
Term Care ◽  
Fall Risks ◽  
The Impact

Abstract Older adults in residential care settings are four times more likely than those not living in care facilities to experience falls. Yet, fall prevention efforts at long-term care settings are under-resourced, under-regulated, and under-studied. To address this gap, we developed and studied the impact of a specialty clinical, Fall Prevention Care Management (FPCM), for nursing students to decrease older adults’ fall risks. We enrolled assisted living residents that facility liaison identified as being high fall risk (fall rates or fall risk were not tracked at the study sites) and MOCA ≥15, in 2 assisted living facilities in Northwest USA. Participants received weekly, 1-hour, individual, semi-structured, Motivational Interviewing-based care management visits by same students over 6 visits. Changes in fall risks were measured by the CDC STEADI assessment (unsteadiness & worry), Falls Self-Efficacy Scale International-Short (FESI-S), and Falls Behavioral Scale (FAB). Twenty-five residents completed the study. Students addressed the following (multiple responses possible): emotional needs (n=23), improved motivation to prevent falls (n=21), and individualized education/coaching (i.e., exercise, mobility aids) (n=10-17). FESI-S score improved from 16.0 to 14.4 (p=.001; decreased fear. FAB score improved from 2.94 to 3.10 (p=.05; more frequent fall prevention behaviors). Frequency of those who felt steady while standing or walking increased (24% to 40%, p=.07) and those who did not worry about falling increased (20% to 36%, p=.08). FPCM clinical offered valuable opportunity to address unmet care needs of older adults to reduce fall risks.

scholarly journals Cohort study of ageing from Bagé (SIGa-Bagé), Brazil: profile and methodology

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine Thumé ◽  
Marciane Kessler ◽  
Karla P. Machado ◽  
Bruno P. Nunes ◽  
Pamela M. Volz ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cohort Study ◽  
Primary Health Care ◽  
Rio Grande ◽  
Cognitive Testing ◽  
Rio Grande Do Sul ◽  
Primary Health ◽  
The Impact

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.

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