USABILITY EVALUATION OF AN INTERACTIVE SYSTEM PART ONE: THE INTERACTIVE SYSTEM AND ITS USERS Medical Examination Direct Iconic and Graphic Augmented Text Entry (MEDIGATE) System An interactive system is associated with the modern systems that are friendly to their users because of incorporation of human factors into their designing processes. For instance, operating and understanding how these systems functions requires less human skills and knowledge. This system is a very important tool that is used by health care professionals. It was developed to enhance the relationship between patients and the physicians. In addition, it is used by physicians to keep track of the patient’s information. Previously, it was difficult for the physicians to gather and keep the information of their patients after examining their conditions. Besides, this system is used to analyze another methods or systems that are used by physicians whether they are effective or not. For instance, these systems are used to explain in detail the inability of other interfaces to achieve their purpose of keeping the information of their patients. (Stanton et al 2017). Description of user populations Physicians are the main users of MEDIGATE system. The chief aim of physicians is to collect the information concerning the conditions of the patients. Also, physicians are also supposed to gather the information about the history of their patients. Some information that they are concerned with includes the year or the time in which the problem was developed by the patient ranging from its initial stage to its current stage. The forms in which a condition has changed over time is also described by the physicians. In addition, physicians are supposed to describe the appropriate treatment that should be given to the patient. For instance, the medicine that the patient should use are also prescribed in advance by physicians (Baek et al 2011). The medical professionals that use MEDIGATE system include medical officers, consultant specialists and health care professionals such as the pathologists. Ancillary medical specialists are not directly involved in day to day patient management but are required to take clinical
history and physical examination to aid in diagnosis and direct the management of patients by the general physician. Assumption of user capabilities The physician should have a background medical knowledge on medical disciplines such as Anatomy, Physiology, Biochemistry, Pathology, Microbiology and Pharmacology in order to seek support from MEDIGATE system.The physician should be competent enough in acquisition of physical findings, coexisting problems, that may be significant to the original diagnosis and may alter the plan of management. The physician should be able to confirm some elements of the clinical history during physical examination, such as inability to use a certain part of the body. However,it is assumed that physicians can gather information that is susceptible to misinterpretation by other medical specialists such as the surgeons; hence the development of MEDIGATE system, (Deterding et al 2011). PART TWO: THE USE CASES The focus of MEDIGATE system is recording of physical examination findings. It was developed basing on the idea that the use of icons to represent different objects in the of medicine can assist the physicians to modify and record patient’s information with a lot of ease. MEDIGATE is designed to provide positive reinforcement and on-line training and to aid the health care professional in obtaining immediate feedback following data input by eliminating the data entry clerk. Furthermore, this system ensures that the information collected is secured from attacks. The core function of MEDIGATE system is to enhance the process of examining patient’s problems and conditions with a lot of comfort and ease. Also, the system provides the physicians with a better platform of analyzing the parts of the human body, therefore, making it easy for them to describe an appropriate treatment to the patients. This system is capable of satisfying the needs of the physicians as described by the following attributes: 1) using of an icon to represent different object, 2) interfaces that enables the physicians to develop different instances of the same command, 3) physician can enter some commands to this system anytime when the need arises, 4) the use of multithreading enabling the
users to carry out more than one task at the same time, and 5) this system can be adopted with a lot of ease. Description of the use cases The primary patient medical record is subdivided into three distinctive categories which are;1) the information regarding the history of the patient that is made up of the following; the core problem that need to be examined, the time when the problem started or developed, the previous treatments to the patient including the operations that have been carried out if any and the background of the family that the patient is coming from, 2) the results of the examination by the physician, and 3) the record of laboratory result and the medical imaging findings. These medical records that are collected forms the baseline of prescribing the appropriate treatment that should be given to the specified patient by the physicians. (Proctor and Zandt 2018). PART THREE: THE EVALUATION METHODOLOGY Evaluation is the process of appraising the usability and acceptability of a product, looking at its adaptability to the user’s needs and problems encountered by the user during use in an attempt to initiate the process of making relevant modifications that are tailored towards improving the user’s experience. The questions below are to be considered in the evaluation of MEDIGATE system physical examination interface: • Can the physical examination findings be enumerated? • What are the characteristics that can be used assess the quality of the collected information? • What are the different ways that are used by the physician to collect information? • What are the guidelines that are followed by physicians when collecting data? • What are some of the types of data that are very essential to the physician? • How can a patient determine the prerequisites of the physician when examining their conditions? • What are the challenges that are encountered when studying how the MEDIGATE system operates?
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• What are some of the conditions that MITIGATE system cannot be applied? USABILITY TESTING EVALUATION PROCEDURE GUIDING PRINCIPLES The Intention, Metrics, People, Activities, Context and Technologies (IMPACT) model for user evaluation will be employed. The role of users: to carry out specified tasks Controller: evaluators strongly in control Location: clinical setup When used: with a mock patient Type of data: Quantitative statistically validated data. Data can be gathered using many ways including observation and using of a questionnaire. The functionality of the MITIGATE system can be determined with how its applied by the physicians in different conditions without resulting in conflicts. Philosophy: Applied approach based on experimentation THE PLAN Aims of the test session; to evaluate the effectiveness, efficiency and physician’s satisfaction with the use of the MEDIGATE system. Piloting will be conducted to fix unforeseen difficulties.
The evaluation will be conducted using a patient, for at most fifteen minutes. MEDIGATE system will be used and data collected by audio recording, questionnaires and interviews. Numbers and types of user: 5 physicians and at least one ancillary consultant per specialty. Tasks to be performed with successful completion highlighted by arriving at top differential diagnoses. Both qualitative and quantitative data to be collected and analyzed using Microsoft Excel. EVALUATION PROCEDURE 1.The initial step of evaluating the system is marked the following processes; determining the goals that the system is set to achieve, identifying the users of the system and the description of the environment that the system will be used such as the field of medicine among others. 2.Identify the guidelines under which the system will be evaluated. 3.Re-visit the ideas of the system developer. 4.Prepare users for testing the system basing on the requirements of the system. 5.Select the users that will meet certain criterion that has been specified along with determination of the place of testing the system. 6.Pilot the evaluation to fix unforeseen errors 7.Examine the functioning of the system. USER TASKS The physician will be expected to evaluate the MEDIGATE System by examining the abdomen based on: comfort of using the system, capability of the system to achieve its core purpose and the problems that are associated when using the system. TASK DESCRIPTION Clarity of MEDIGATE system. The functionality of the system.
Appropriate response by the system when interacting with its users. Any errors that are associated with the functioning of the system. The preference of the users to use this system as compared to the other systems. The pragmatism of test tasks The limpidity of test instructions Debriefing questions What is the best and worst thing about the MEDIGATE System? What feature(s) need changes? How easy was it using the MEDIGATE System? How the MITIGATE system carried out the tasks provided? Did the MEDIGATE system develop some problems while collecting the information from the patient? Would you prefer pen and paper over the system? Are the features of the system easy to learn? PART FOUR: THE EVALUATION EVALUATION PERFORMANCE The properties of the MEDIGATE system are determined using the information that has been gathered by the physicians. This information exhibited the challenges that are encountered when entering the information into the system. In addition, the challenge of using the stored data correctly by the physicians is also expressed. Over the years, programmers and the developers of the systems were concerned much about how the information was to be kept rather than the problems that are encountered while using the system.
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Developing a better computer system requires the need of correcting all the errors and problems that are encountered while using the system. Also, incorporating of all the prerequisites that have been specified by the system users is also very crucial. The proposed system must be able to satisfy the needs of its users. The programmers and developers have developed the MITIGATE system basing on all the necessities that are required when developing and designing modern computer systems. This system has been developed using icons whereby different icons are used to represent different objects. The principles underlying the process of designing the MEDIGATE System can be incorporated in any upcoming systems that uses the voice identification techniques. Also, they can be incorporated in the systems that uses pens as one of the tools. Therefore, this can enhance the ease of adopting and using the system. MEDIGATE system can be applied in many digital systems enabling them to achieve their purpose and functions. THE EVALUATION PROCEDURE 1.Write a draft list of tasks using scenarios prepared earlier. These must be the actual tasks that can be completed successfully by the MITIGATE system. The tasks must also be able to test all the functioning of the system. 2.Test the specific functions of the system and approximate the period that the users can take to finish a certain task using the system. 3.Create a list of tasks that should be completed by the physicians. Describe the tasks clearly in such a way that the newbie can comprehend how the tasks are to be performed. 4.Get ready for the test session. Have the MEDIGATE system ready in a suitable environment and list of prompt questions, notebook and pens ready, and an audio recorder. 5.Inform the users that the system is under the trial process and has not yet been implemented. Define clearly how the tasks should be done. Physicians should not work as a group for ease of monitoring. Start recording if an audio recorder has already been set in place.
6.Physician starts using the system. Record all the problems that are encountered by physicians while using the system. Provide some assistance to the physicians in case they are not able to comprehend how the system is used to carry out some tasks. 7.Motivate the health care professionals to give out their suggestions by asking them some questions. 8.Have a conservation with the physicians one-by-one regarding the functionality of the system. 9.Record your findings concerning the functionality of the system. Questions that the users should be asked when testing the functionality of the system Which process are you carrying out currently? What were you expecting to take place? What is the response of the MEDIGATE system? What are the reasons why the system has given out such responses? What are you planning to do next? EVALUATION RESULTS Usability aimEffectiveness measuresRating Overall usabilityThe percentage of tasks fully accomplished 70% The number of physicians successfully finishing tasks 40% Meeting the expectations of experienced or trained users The percentage of complex tasks accomplished 40% The percentage of pertinent functions used 80% Meeting the needs for emergency tasks The percentage of assignments that were carried out successfully during the first test 60% Meeting the demands for occasional or sporadic use The percentage of tasks accomplished after a one-month 50%
period of non-use LearnabilityThe percentage of functions learnt 80% The percentage of the users managed to understand how the system was used. 70% Usability aimEfficiency measuresRating Overall usabilityThe time taken to accomplish a task 10 minutes The time taken on unproductive actions 5 minutes Meeting the expectations of experienced or trained users The time spent on accomplishing tasks, in comparison to the minimum time 7 minutes Meeting the demands for first time use The duration of completing a task on first attempt 15 minutes The time taken on using help functions 3 minutes Meeting the demands for occasional or sporadic use The taken to learn the usability of the repeated objects 5 minutes The number of persistent errors3 LearnabilityThe time taken to learn criterion5 minutes Usability aimSatisfaction measuresRating (1-5)
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Meeting the expectations of experienced or trained users The rating scale for satisfaction with progressed features 4 Meeting the demands for walks up and use The rate of voluntary use4 Meeting the demands for occasional or sporadic use The frequency of re-use3 LearnabilityThe rating scale for ease of learning 2 Evaluation parameters of the MEDIGATE System were assessed using the data that was provided by the physicians after inspecting their patients basing on the abdominal pathologies. The summary of the information that was gathered related to the cause of the diseases, management, or keeping the track of the abdominal pathologies were developed. The physicians recorded the results of examining their patients manually by writing on a book by using of the pens previously. The information that was collected from this analysis provided the basics of assessing MEDIGATE system 1) comfort of using the system, 2) initial skills that are needed when running the system, 3) ease of understanding how the system is used, 4) problems that are related to the functionality of the system, 5) usefulness, and 6) what is salvaged. This analysis furnished a comparison of the MEDIGATE System and normal pen and paper documentation. The physician acquires this information basing on the “chief complaint” (through interviewing their patients by asking them some questions like– what made you to come to hospital?), then supporting the chief complaint(s) when describing the “History of Presenting Illness”. Subsequently, the physician goes on to an organized simple query “Review of Systems,” where there are short questions that are asked on different parts of the human body. Similarly, these questions require short answers. But then, the inspection of the specified part of the body with an aim of identifying the cause of the conditions or problems can be analyzed further (Wiegmann and Shappell 2017).
An investigation that is carried out regarding the part of the body that is having unusual functioning is very important in the entire field of medicine. The physicians identify how the part was functioning previously before developing a problem. This process requires development of a computer system that can assist the physicians in carrying out the examination on their patients. The application of MITIGATE system in the hospitals has changed the entire processes that are used by physicians to examine their patients. The common methods that are used to record the results of the patient’s examination such as using of a book can also be applied in this system thus enhancing the interaction with its users. The MEDIGATE System is used in hospitals by physicians to retrieve and generate the information of their patients currently. As specified, the system uses icons in representing different objects. The physicians are also allowed to record the details of their patients that can be used for the future reference in case the problem develops again. Afterwards, the physician can describe the reason for the problem identified in form of drawing representations. Complex of multiple findings in a given region may be formed with various iconic designs, hence depicting graphically a state of associated findings. The MEDIGATE System centers on helping the medical practitioner in developing and maintaining physical examination findings record. This system keeps the results of the patients after the checkup. These results are stored in this system in form of pictures rather than words for easy understanding by health care professionals. This is facilitated by using icons. The parts of the human body are exhibited in this form to make them clear and visible thus enabling health care professionals to inspect their patients with a lot of ease. Subsequently, a physician can then describe his results regarding the condition of their patients basing on the problem has been detected using this system that is associated with patient’s conditions. The results of different areas that have been specified by physicians can be separated or differentiated using different pictures. MEDIGATE system has the capability of keeping the information concerning certain conditions in form of pictures. Different objects are kept in this system using bits rather than bitmapped images because of the huge spaces that are occupied by these images when keeping them. These objects that are stored in this system are aware of their properties and the ways on which they are
separated from each other. Simply, different objects are used to store different information in this system (Schwedhelm et al 2008). The health care professionals such as surgeons can interact with this objects that are running currently on the computer system showing a specific part of the human body such as the heart that is being checked at the moment. There are different ways on which the physicians can record their results including using the manual method of sketching their results using their hands or by making different instances of the same objects that were kept in the system early on. PART FIVE: SUMMARY OF RESULTS AND ASSESSMENT OF USABILITY From the above results, it is evident that up to 70% of designated tasks were successfully completed by the physicians but a paltry 40% of the physicians were able to complete the given tasks. Although many physicians (80%) were able to learn the functions of the system, only half could successfully complete tasks after a period of one-month non-use. This implies that the system is not easily adaptable to the physicians. As regards efficiency, most physicians took up to 10 minutes to complete a task, 5 of which were spent on unproductive actions, pointing out the need to develop a more simplified user interface to cut down on time wasted on unnecessary functions. However, first time accomplishment of tasks took up to 15 minutes, reducing the suitability of the system when employed in emergency set ups. On a scale of 1 to 5, most physicians were satisfied (4/5) with using the system voluntarily but embraced the use of advanced features. CRITICAL APPRAISAL The solution to the unique problems attendant upon the MEDIGATE system is based on acting on the usability interface to make the system more adaptable to the physician and not the physician adapting to the system. The process of recording data has been enhanced in the current years as compared to the past. This has resulted in development of many systems that can be used by the physicians while recording their patient’s results.
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Human factors are very essential when developing these systems. Over the recent years, developers and programmers of the computer systems have not been incorporating human factors into the process of system designing. Modern developments in system designing has facilitated the development of complicated systems that can be used in the field of medicine by the physicians (Oinas-Kukkonen and Harjumaa 2009). The properties of the MEDIGATE system are determined using the information that has been gathered by the physicians. This information exhibited the challenges that are encountered when entering the information into the system. In addition, the challenge of using the stored data correctly by the physicians is also expressed. Over the years, programmers and the developers of the systems were concerned much about how the information was to be kept rather than the problems that are encountered while using the system. Developing a better computer system requires the need of correcting all the errors and problems that are encountered while using the system. Also, incorporating of all the prerequisites that have been specified by the system users is also very crucial. The proposed system must be able to satisfy the needs of its users. The programmers and developers have developed the MITIGATE system basing on all the necessities that are required when developing and designing modern computer systems. This system has been developed using icons whereby different icons are used to represent different objects. The principles underlying the process of designing the MEDIGATE System can be incorporated in any upcoming systems that uses the voice identification techniques. Also, they can be incorporated in the systems that uses pens as one of the tools. Therefore, this can enhance the ease of adopting and using the system. MEDIGATE system can be applied in many digital systems enabling them to achieve their purpose and functions. With the availability of diverse multimedia technologies, the integration of audio and video links may be vey crucial and vital to the MEDIGATE system. It will enable the physician to call up a medical reference or a video picture of a procedure of concern, hence getting prompt feedback and reminders.
It is believed that these principles will play an important role in future computer-based medical information systems by enabling the collection of relevant information and providing for presentation and maximum utilization of the data, hence promoting the ways on which the patients are taken care of, management and controlling of the errors in the systems, and enhancing the researches that are related to the field of medicine. However adequate analyzation of the functionality of the system is only useful when the defects of the system are dealt upon in a timely manner. Evaluators and designers need an organized list of findings for prioritizing redesign work. The programmers should solve the errors that are detected while the system is functioning. The report should be arranged according to either areas of the system concerned, or by severity of the problem. For the latter, a five-point scale should be adopted, ranging from ‘would prevent user from proceeding further’ to ‘minor irritation’. Adding a note of the general usability principle concerned may help designers understand why there is a difficulty, but often more particular elaboration will be required. In lieu, sometimes the problem is so apparent that explanation is redundant. A face-to-face meeting may have more influence than a written document alone and this would be the ideal venue for showing short video clips and playing audio records of user problems, (Czaja et al 2009). Suggested solutions increases the likelihood of something being done. The users can seek the assistance in running and operating the system from the programmers who developed the system, although it has been revealed that this can lead to the development of many problems. Handling of the computer systems that have been developed is a great challenge to many hospitals. The error can be corrected by involving the system users such as the physicians in all the entire process of testing the system to ascertain that it meets its requirements. However, the system that has been developed can be susceptible to errors. These can be the errors that were developed during the process of system designing by the programmers and developers of the system. Controlling of these errors is one of the necessities of becoming a good system developer. These errors can be corrected by establishing of a team of experts that will be checking the entire process of designing and developing systems.
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