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JMIR Human Factors

Sundas Khan, Safiya Richardson, Andrew Liu, Vinodh Mechery, Lauren McCullagh, Andy Schachter, Salvatore Pardo, Thomas McGinn
BACKGROUND: Successful clinical decision support (CDS) tools can help use evidence-based medicine to effectively improve patient outcomes. However, the impact of these tools has been limited by low provider adoption due to overtriggering, leading to alert fatigue. We developed a tracking mechanism for monitoring trigger (percent of total visits for which the tool triggers) and adoption (percent of completed tools) rates of a complex CDS tool based on the Wells criteria for pulmonary embolism (PE)...
February 20, 2019: JMIR Human Factors
Azizeh Khaled Sowan, Meghan Leibas, Albert Tarriela, Charles Reed
BACKGROUND: The integration of clinical practice guidelines (CPGs) into the nursing care plan and documentation systems aims to translate evidence into practice, improve safety and quality of care, and standardize care processes. OBJECTIVE: This study aimed to evaluate nurses' perceptions of the usability of a nursing care plan solution that includes 234 CPGs. METHODS: A total of 100 nurses from 4 adult intensive care units (ICUs) responded to a survey measuring nurses' perceptions of system usability...
February 12, 2019: JMIR Human Factors
Elaine Zibrowski, Lisa Shepherd, Richard Booth, Kamran Sedig, Candace Gibson
BACKGROUND: Many emergency departments (EDs) have used the Lean methodology to guide the restructuring of their practice environments and patient care processes. Despite research cautioning that the layout and design of treatment areas can increase patients' vulnerability to privacy breaches, evaluations of Lean interventions have ignored the potential impact of these on patients' informational and physical privacy. If professional regulatory organizations are going to require that nurses and physicians interact with their patients privately and confidentially, we need to examine the degrees to which their practice environment supports them to do so...
February 6, 2019: JMIR Human Factors
Sumit Mehra, Bart Visser, Nazli Cila, Jantine van den Helder, Raoul Hh Engelbert, Peter Jm Weijs, Ben Ja Kröse
BACKGROUND: For older adults, physical activity is vital for maintaining their health and ability to live independently. Home-based programs can help them achieve the recommended exercise frequency. An application for a tablet computer was developed to support older adults in following a personal training program. It featured goal setting, tailoring, progress tracking, and remote feedback. OBJECTIVE: In line with the Medical Research Council Framework, which prescribes thorough testing before evaluating the efficacy with a randomized controlled trial, the aim of this study was to assess the usability of a tablet-based app that was designed to support older adults in doing exercises at home...
February 1, 2019: JMIR Human Factors
Megan Winsall, Simone Orlowski, Gillian Vogl, Victoria Blake, Mariesa Nicholas, Gaston Antezana, Geoffrey Schrader, Niranjan Bidargaddi
BACKGROUND: A key challenge in developing online well-being interventions for young people is to ensure that they are based on theory and reflect adolescent concepts of well-being. OBJECTIVE: This exploratory qualitative study aimed to understand young people's concepts of well-being in Australia. METHODS: Data were collected via workshops at five sites across rural and metropolitan sites with 37 young people from 15 to 21 years of age, inclusive...
January 30, 2019: JMIR Human Factors
Sandeep Napa, Michael Moore, Tania Bardyn
BACKGROUND: Care providers and surgeons prepare for cardiac surgery using case conferences to review, discuss, and run through the surgical procedure. Surgeons visualize a patient's anatomy to decide the right surgical approach using magnetic resonance imaging and echocardiograms in a presurgical case planning session. Previous studies have shown that surgical errors can be reduced through the effective use of immersive virtual reality (VR) to visualize patient anatomy. However, inconsistent user interfaces, delegation of view control, and insufficient depth information cause user disorientation and interaction difficulties in using VR apps for case planning...
January 16, 2019: JMIR Human Factors
Doris George, Mohamed Azmi Hassali, Amar-Singh Hss
BACKGROUND: Reporting of medication errors is one of the essential mechanisms to identify risky health care systems and practices that lead to medication errors. Unreported medication errors are a real issue; one of the identified causes is a burdensome medication error reporting system. An anonymous and user-friendly mobile app for reporting medication errors could be an alternative method of reporting medication error in busy health care settings. OBJECTIVE: The objective of this paper is to report usability testing of the Medication Error Reporting App (MERA), a mobile app for reporting medication errors anonymously...
December 21, 2018: JMIR Human Factors
Mavis Jones, Reza Talebi, Jennifer Littlejohn, Olivera Bosnic, Jason Aprile
BACKGROUND: Electronic medical record (EMR) adoption among Canadian primary care physicians continues to grow. In Ontario, >80% of primary care providers now use EMRs. Adopting an EMR does not guarantee better practice management or patient care; however, EMR users must understand how to effectively use it before they can realize its full benefit. OntarioMD developed an EMR Practice Enhancement Program (EPEP) to overcome challenges of clinicians and staff in finding time to learn a new technology or workflow...
December 21, 2018: JMIR Human Factors
Astrid Torbjørnsen, Milada C Småstuen, Anne Karen Jenum, Eirik Årsand, Lis Ribu
BACKGROUND: When developing a mobile health app, users' perception of the technology should preferably be evaluated. However, few standardized and validated questionnaires measuring acceptability are available. OBJECTIVE: The aim of this study was to assess the validity of the Norwegian version of the Service User Technology Acceptability Questionnaire (SUTAQ). METHODS: Persons with type 2 diabetes randomized to the intervention groups of the RENEWING HEALTH study used a diabetes diary app...
December 21, 2018: JMIR Human Factors
Sara Kuppin Chokshi, Devin M Mann
BACKGROUND: Design thinking and human-centered design approaches have become increasingly common in health care literature, particularly in relation to health information technology (HIT), as a pathway toward the development of usable, diffusible tools and processes. There is a need in academic medical centers tasked with digital innovation for a comprehensive process model to guide development that incorporates current industry trends, including design thinking and lean and agile approaches to digital development...
December 19, 2018: JMIR Human Factors
Elaine Zibrowski, Lisa Shepherd, Kamran Sedig, Richard Booth, Candace Gibson
BACKGROUND: The effectiveness of Lean Thinking as a quality improvement method for health care has been contested due, in part, to our limited contextual understanding of how it affects the working conditions and clinical workflow of nurses and physicians. Although there are some initial indications, arising from prevalence surveys and interviews, that Lean may intensify work performed within medical environments, the evidence base still requires detailed descriptions of the changes that were actually introduced to individuals' clinical workflow and how these changes impacted health care professionals...
December 13, 2018: JMIR Human Factors
Devin M Mann, Sara Kuppin Chokshi, Andre Kushniruk
BACKGROUND: Technology is increasingly embedded into the full spectrum of health care. This movement has benefited from the application of software development practices such as usability testing and agile development processes. These practices are frequently applied in both commercial or operational and academic settings. However, the relative importance placed on rapid iteration, validity, reproducibility, generalizability, and efficiency differs between the 2 settings and the needs and objectives of academic versus pragmatic usability evaluations...
November 28, 2018: JMIR Human Factors
Ronit Shtrichman, Stefan Conrad, Kai Schimo, Ran Shachar, Ehud Machluf, Enrique Mindal, Howard Epstein, Shirli Epstein, Alan Paz
BACKGROUND: Medication nonadherence is a major problem in health care, imposing poor clinical outcomes and a heavy financial burden on all stakeholders. Current methods of medication adherence assessment are severely limited: they are applied only periodically, do not relate to actual pill intake, and suffer from patient bias due to errors, misunderstanding, or intentional nonadherence. ReX is an innovative medication management system designed to address poor patient adherence and enhance patient engagement with their therapy...
November 26, 2018: JMIR Human Factors
Malin Tistad, Sara Lundell, Maria Wiklund, André Nyberg, Åsa Holmner, Karin Wadell
BACKGROUND: New strategies are urgently needed to support self-management for people with chronic obstructive pulmonary disease (COPD) in primary care. The use of electronic health (eHealth) solutions is promising. However, there is a lack of knowledge about how such eHealth tools should be designed in order to be perceived as relevant and useful and meet the needs and expectations of the health professionals as well as people with COPD and their relatives. OBJECTIVE: The objective of this study was to explore the aspects of an eHealth tool design and content that make it relevant and useful for supporting COPD-related self-management strategies from the perspective of health care professionals, people with COPD and their relatives, and external researchers...
October 26, 2018: JMIR Human Factors
Manikantan Shanmugham, Lesley Strawderman, Kari Babski-Reeves, Linkan Bian
BACKGROUND: Delayed or no response to impending patient safety-related calls, poor care provider experience, low job satisfaction, and adverse events are all unwanted outcomes of alarm fatigue. Nurses often cite increases in alarm-related workload as a reason for alarm fatigue, which is a major contributor to the aforementioned unwanted outcomes. Increased workload affects both the care provider and the patient. No studies to date have evaluated the workload while caring for patients and managing alarms simultaneously and related it to the primary measures of alarm fatigue-alarm response rate and care provider experience...
October 23, 2018: JMIR Human Factors
Uba Backonja, Sarah C Haynes, Katherine K Kim
BACKGROUND: There exists a challenge of understanding and integrating various types of data collected to support the health of individuals with multiple chronic conditions engaging in cancer care. Data visualization has the potential to address this challenge and support personalized cancer care. OBJECTIVE: The aim of the study was to assess the health care practitioners' perceptions of and feedback regarding visualizations developed to support the care of individuals with multiple chronic conditions engaging in cancer care...
October 16, 2018: JMIR Human Factors
Justin St-Maurice, Catherine Burns, Justin Wolting
BACKGROUND: Persuasive design is an approach that seeks to change the behaviors of users. In primary care, clinician behaviors and attitudes are important precursors to structured data entry, and there is an impact on overall data quality. We hypothesized that persuasive design changes data-entry behaviors in clinicians and thus improves data quality. OBJECTIVE: The objective of this study was to use persuasive design principles to change clinician data-entry behaviors in a primary care environment and to increase data quality of data held in a family health team's reporting system...
October 11, 2018: JMIR Human Factors
Hana AlJaberi
BACKGROUND: A valuable addition to the mobile health (mHealth) space is an exploration of the context of minorities in developed countries. The transition period postmigration, culture, and socioeconomic uniqueness of migratory groups can shed light on the problems with existing prenatal mHealth apps. OBJECTIVE: The objectives of this study were to (1) use the theoretical concept of pregnancy ecology to understand the emotional, physical, information, and social challenges affecting low-income Caribbean immigrant women's prenatal well-being practices and (2) develop a deep understanding of challenges worthy of consideration in mHealth design for these women...
October 10, 2018: JMIR Human Factors
Sally Bromley, Michael Drew, Scott Talpey, Andrew McIntosh, Caroline Finch
BACKGROUND: Electronic methods are increasingly being used to manage health-related data among sporting populations. Collection of such data permits the analysis of injury and illness trends, improves early detection of injuries and illnesses, collectively referred to as health problems, and provides evidence to inform prevention strategies. The Athlete Management System (AMS) has been employed across a range of sports to monitor health. Australian combat athletes train across the country without dedicated national medical or sports science teams to monitor and advocate for their health...
October 9, 2018: JMIR Human Factors
Leah Wolfe, Margaret Smith Chisolm, Fuad Bohsali
BACKGROUND: The transition to the electronic health record (EHR) has brought forth a rapid cultural shift in the world of medicine, presenting both new challenges as well as opportunities for improving health care. As clinicians work to adapt to the changes imposed by the EHR, identification of best practices around the clinically excellent use of the EHR is needed. OBJECTIVE: Using the domains of clinical excellence previously defined by the Johns Hopkins Miller Coulson Academy of Clinical Excellence, this review aims to identify best practices around the clinically excellent use of the EHR...
October 5, 2018: JMIR Human Factors
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