Comp 15 - Usability and
Human Factors
Unit 4a - Human Factors and
Healthcare
This material was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator
for Health Information Technology under Award Number 1U24OC000003.
Overview
• Introduction to human factors principles
• Applied cognitive psychology/selective
attention
• Patient safety
• Understanding human errors
• A Systems-centered approach to human
errors
• Mental workload
• Medical devices
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Health IT Workforce Curriculum
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Human Factors & Health Care
Health Devices
Component 15/Unit 4a
Electronic Health Record
Systems
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Human Factors and HCI
Redux
Differences:
• Histories, journals, academic and
professional societies
• HCI focused on computing and innovative
design
• HF focused on any system and greater
emphasis on work/workplace and on
devices
• Safety is a core issue in HF
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Health IT Workforce Curriculum
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Human Factors and HCI
Redux
Similarities:
• User-centered and systems approach
• Draws on cognitive psychology and
other social sciences
• Similar methods with regards to
usability evaluation
• Cognitive task analysis
• Usability testing
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Health IT Workforce Curriculum
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History of Human Factors
1900-1945:
• Industrial efforts to increase worker productivity
1945 – 1960:
• Formal beginning of the profession – military
1960 – 1980:
• Rapid growth and expansion – space program, product design,
workplace design
1980 – 1990:
• Human computer interaction, safety/human error
1990 – Present expansion
• e.g., healthcare, aging, aviation safety, standardization
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Health IT Workforce Curriculum
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Why is Human Factors
Increasingly Important
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Diversity of user groups
Complexity of systems
Increased use of technology
Increased “costs” of human error
Societal emphasis on well-being and
quality of life
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Human Factors Objective
Focus:
Goal:
• Human beings and
their interactions with
products/equipment,
tasks, environments
• (Micro, macro,
ambient)
• Design systems and
system components
to match the
capabilities and
limitations of humans
who use them
• Optimize working &
living conditions
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Examples of Application Areas
• Military
• Highway systems
– e.g. readability and comprehensibility of signs
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Automobile design and driver behavior
Human-computer systems
Healthcare and patient safety
Aging and accessibility
Nuclear power
Workplace layout and furnishings
Airline industry
– e.g. pilot workload, aircraft design, automation, aircraft
maintenance
• Quality control
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Nuclear Power Plant Control Room
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Airplane Cockpit
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Human Factors in Medicine
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Infusion pumps
Anesthesia equipment
Medication errors
Effects of fatigue on resident’s performance
Judgmental limitations in medical decision
making
• Inadequate infection control
• Unintended consequences of automation
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Human Factors/Ergonomics
(Carayon, 2007)
• Scientific discipline concerned with
understanding interactions
– Among humans
– Other elements of a system
• Profession that applies theory, principles,
data, methods to design to optimize:
– human well-being
– overall system performance
• System can be a technology, device, person,
team, organization, policy, etc.
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Human Factors Ergonomics:
3 Major Domains
Physical
Ergonomics
Cognitive
Ergonomics
Organizational /
Macroergonomics
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Physical Ergonomics
Concerned with physical activity
• Topics: Repetitive movements, workplace layout,
safety and health
• Application to Health: Reducing and preventing
injury, designing workstations and work rooms for
optimal human performance
• Examples:
• Designing a patient room to facilitate and
support patient care
• Designing medical labels so that they are
readable and understandable
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Organizational Ergonomics
Concerned with sociotechnical
systems
• Topics: communication, teamwork,
participatory design, quality management
• Application to Health: Reducing stress and
burnout, improving satisfaction and retention,
implementing improvement activities
• Examples:
• Management training in surgery teams
• Designing work schedules for reduced
fatigue and enhanced performance
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Cognitive Ergonomics
Concerned with mental processes
• Topics: mental workload, decision making, skilled
performance, HCI, work stress,
• Application to Health: usability, designing training
systems, usable interfaces
• Examples:
• Event report systems
• Implementing incident analysis system
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Human Factors & Applied
Cognitive Psychology
• Applies knowledge about human strengths
and limitations to design of interactive
systems, equipment, and their
environment to ensure their effectiveness,
safety, and ease of use
• Perception, attention, memory, mental
models and decision making are central to
human factors research and analysis
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Human Attention
Selective Mechanism
Resource needed for information processing
Limited
Sharable
Flexible
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Selective Attention
Ability to ignore extraneous information and focus on
relevant inputs
Performance typically declines as the number of sources
of information increases
Humans can only process information at a finite rate
Information overload contributes to errors
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Information Overload
Speed Stress
Load Stress
Speed/Accuracy
Tradeoff
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Selective Attention
Four factors drive the selection of channels to
attend (and the filtering of channels to ignore):
Salience:
• Events or stimuli that are salient capture attention (this represents
a bottom-up process)
Expectancy and Value:
• We tend to “sample” the world where we expect to find information,
and attend to channels based on how valuable it is to look or costly
to miss
Effort:
• Selective attention may be inhibited if it is effortful
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Divided Attention or
Time Sharing
• Time-sharing:
– ability to perform more than one cognitive task by
attending to both at once or rapidly switching
back and forth between them
• Because cognitive resources for attention are
relatively limited, time-sharing often results in
a drop in performance for one or both tasks
• People can also “modulate” the resources
given to one task or the other
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Human Factors Design
Implications
• Reduce the number of competing
channels of information
• Make sources of information as distinct as
possible
• Provide feedback
• Use redundant cues
• Work/rest scheduling
• Training
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