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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.

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Pubmed on tap access pubmed on handheld wireless devices

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
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
Outline

  • Motivation

  • PubMed at a glance

  • Design questions

  • Usability study

  • Next steps


Why patients need just in time information for clinicians
Why patients need just-in-time information for clinicians:

Patient Fact Sheet

20 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

motivationPubMeddesignusabilityfuture


Pubmed on tap access pubmed on handheld wireless devices
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 evidence

3. Obstacles related to seeking information

3.1.3. Lack of time to initiate search

3.2.1. Uncertainty about where to look for information

3.3.1. Resource physically distant

3.3.9. Resource not current

3.3.10. …. Most general resources do not allow real time interaction with the searcher

(Ely et al., British Medical Journal. 2002)

motivationPubMeddesignusabilityfuture


Where to look for information
Where to look for information to their questions about patient care but most go unanswered

motivationPubMeddesignusabilityfuture


Current interactive resource at hand
Current interactive resource at hand to their questions about patient care but most go unanswered

  • Speed up search

    • Navigation

    • Presentation

  • Provide expected PubMed functionality

motivationPubMeddesignusabilityfuture


Pubmed search
PubMed Search to their questions about patient care but most go unanswered

motivationPubMeddesignusabilityfuture


Advanced search
Advanced Search to their questions about patient care but most go unanswered

("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])

motivationPubMeddesignusabilityfuture


Clinical queries
Clinical Queries to their questions about patient care but most go unanswered

motivationPubMeddesignusabilityfuture


Search results
Search Results to their questions about patient care but most go unanswered

motivationPubMeddesignusabilityfuture


Working with search results navigating results pages
Working with Search Results to their questions about patient care but most go unansweredNavigating results pages

motivationPubMeddesignusabilityfuture


Working with search results viewing selected citations and links
Working with Search Results to their questions about patient care but most go unansweredViewing selected citations and links

motivationPubMeddesignusabilityfuture


Working with search results saving selected citations
Working with Search Results to their questions about patient care but most go unansweredSaving selected citations

motivationPubMeddesignusabilityfuture


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.

Saving Search Strategy

motivationPubMeddesignusabilityfuture


Interface design challenges
Interface Design Challenges 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.

  • 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

motivationPubMeddesignusabilityfuture


Our approach
Our Approach 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.

  • 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

motivationPubMeddesignusabilityfuture


Organizing content

usability study 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.

prototype presentation

Organizing Content

motivationPubMeddesignusabilityfuture


Organizing content continued
Organizing Content continued 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.

motivationPubMeddesignusabilityfuture


Finding metaphors is hard
Finding Metaphors is Hard 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.

motivationPubMeddesignusabilityfuture


Maintaining common feel and look for different platforms and operating systems is hard
Maintaining common feel and look for different platforms and operating systems is hard

motivationPubMeddesignusabilityfuture


Usability study
Usability Study operating systems is hard

  • 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

motivationPubMeddesignusabilityfuture


Usability study results
Usability Study Results operating systems is hard

All participants were able to find Medline citations containing answers to questions described in all test scenarios

There is strong correlation between time to completion and problems in locating functions and navigation

motivationPubMeddesignusabilityfuture


Usability study observations
Usability Study Observations operating systems is hard

234 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

motivationPubMeddesignusabilityfuture


Next steps
Next Steps operating systems is hard

  • Organize content using key points of clinical scenario

  • Conduct usability testing of all alternative layouts

  • Include other NLM resources, e.g. practical guidelines

motivationPubMeddesignusabilityfuture


Pmot home http archive nlm nih gov proj pmot pmot php
PMOT home operating systems is hardhttp://archive.nlm.nih.gov/proj/pmot/pmot.php

Contact:

demner@cs.umd.edu

ddemner@mail.nih.gov