PubMed on Tap: Access PubMed on Handheld, Wireless Devices Dina Demner-Fushman University of...
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Transcript of PubMed on Tap: Access PubMed on Handheld, Wireless Devices Dina Demner-Fushman University of...
PubMed on Tap: Access PubMed on Handheld, Wireless Devices
Dina Demner-Fushman
University of Maryland, College Park
and
CEB/LHNCBC/NLM/NIH/HHS
PubMed on Tap• a pilot R&D project of the Communications Engineering Branch,
Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health,Health and Human Services
• Goal– Develop a stable system to study design principles for delivery
of medical information to handheld devices at the point-of-care
• Designers/Developers– Susan Hauser, project leader
– Glenn Ford
– Dina Demner-Fushman
Outline
• Motivation
• PubMed at a glance
• Design questions
• Usability study
• Next steps
Why patients need just-in-time information for clinicians:
Patient Fact Sheet20 Tips to Help Prevent Medical Errors ….Medical errors are one of the Nation's leading causes of death and
injury. A recent report by the Institute of Medicine estimates that as many as 44,000 to 98,000 people die in U.S. hospitals each year as the result of medical errors. This means that more people die from medical errors than from motor vehicle accidents, breast cancer, or AIDS…..
Ask your doctor if your treatment is based on the latest evidence
AHRQ Publication No. 00-PO38, February 2000. Agency for Healthcare Research and Quality http://www.ahrq.gov/consumer/20tips.htm
motivationPubMeddesignusabilityfuture
Doctors are encouraged to search for evidence based answers to
their questions about patient care but most go unanswered
Fifty nine obstacles were found while attempting to answer clinical questions with evidence3. Obstacles related to seeking information3.1.3. Lack of time to initiate search3.2.1. Uncertainty about where to look for information3.3.1. Resource physically distant3.3.9. Resource not current3.3.10. …. Most general resources do not allow real time interaction with the searcher
(Ely et al., British Medical Journal. 2002)
motivationPubMeddesignusabilityfuture
Where to look for information
motivationPubMeddesignusabilityfuture
Current interactive resource at hand
• Speed up search – Navigation– Presentation
• Provide expected PubMed functionality
motivationPubMeddesignusabilityfuture
PubMed Search
motivationPubMeddesignusabilityfuture
Advanced Search
("variola virus"[MeSH Terms] OR "smallpox"[MeSH Terms]) AND hasabstract[text] AND Clinical Trial[ptyp] AND jsubsetaim[text] AND "adult"[MeSH Terms] AND ("hominidae"[MeSH Terms] OR "Human"[MeSH Terms]) AND ("2000"[PDAT] :"2004"[PDAT])
motivationPubMeddesignusabilityfuture
Clinical Queries
motivationPubMeddesignusabilityfuture
Search Results
motivationPubMeddesignusabilityfuture
Working with Search Results Navigating results pages
motivationPubMeddesignusabilityfuture
Working with Search ResultsViewing selected citations and links
motivationPubMeddesignusabilityfuture
Working with Search ResultsSaving selected citations
motivationPubMeddesignusabilityfuture
Saving Search Strategy
Use the Cubby to store search strategies and LinkOut preferences. Access Cubby on the PubMed sidebar. You need to register for the Cubby and then login whenever you want to use it. Your web browser must be set to accept cookies.
motivationPubMeddesignusabilityfuture
Interface Design Challenges• Maximize utilization of 160x160 pixels, but don’t
lose readability• Decide what information is essential for an
overview and how to organize ‘detail on demand’• Organize content in an easy to navigate manner,
avoid scrolling• Find clear graphical metaphors for task objects
and actions• Maximally approximate users’ model of the
existing desktop application
motivationPubMeddesignusabilityfuture
Our Approach• Identify most likely target user’s tasks• Develop a working prototype, and present
to potential users for feedback• Develop a stable system with a usable
interface and sufficient features to be useful• Conduct usability study• Release the improved system to health care
professionals, listen to users’ feedback, and study aggregate user statistics
motivationPubMeddesignusabilityfuture
Organizing Content
motivationPubMeddesignusabilityfuture
usability study
prototype presentation
Organizing Content continued
motivationPubMeddesignusabilityfuture
Finding Metaphors is Hard
motivationPubMeddesignusabilityfuture
Maintaining common feel and look for different platforms and operating systems is hard
motivationPubMeddesignusabilityfuture
Usability Study• Conducted at the National Cancer Institute (NCI)
usability laboratory, facilitator Gregory Alexander, RN• 9 subjects (informatics students, nurses, physicians,
and medical librarians)• 3 test tasks embedded in clinical scenarios• 6 observers taking “stream of consciousness” notes,
while viewing participant’s face and the PDA projected on a large screen
• Post-test questionnaire
motivationPubMeddesignusabilityfuture
Usability Study Results All participants were able to find Medline citations containing answers to
questions described in all test scenarios
motivationPubMeddesignusabilityfuture
Time to complete three scenarios
0
10
20
30
40
50
min
ute
s
There is strong correlation between time to completion and problems in locating functions and navigation
Usability Study Observations234 unique observations
Most frequent observations. Participants:• Found brief mode (more titles per screen) useful
• Were confused by the related articles icon
• Did not know how to get back to the search tab from the profiles
• Did not know how to drill down to a citation
• Expected more information messages, e.g. on saving profiles
• Hesitated tapping the search globe
motivationPubMeddesignusabilityfuture
Next Steps
• Organize content using key points of clinical scenario
• Conduct usability testing of all alternative layouts
• Include other NLM resources, e.g. practical guidelines
motivationPubMeddesignusabilityfuture
PMOT homehttp://archive.nlm.nih.gov/proj/pmot/pmot.php
Contact:[email protected]@mail.nih.gov