R2: Usability Analysis

Key Question: What makes certain medical instrumentation problematic or exemplary?

Motivation.

Research Program R1 identifies and analyzes the major barriers to healthcare access, utilization, and delivery for individuals with disabilities and activity limitations. This program, Research Program R2, begins with the problem instrumentation identified through those activities and conducts structured usability analyses to understand the nature of the problems associated with the identified instrumentation as well as the state of the art in that area. These activities will build a foundation for design activities in Development Program D2.

Objectives:

• To understand what characteristics of specific instrumentation make it particularly usable for persons with disabilities
• To understand what characteristics of specific instrumentation cause difficulties for persons with disabilities.

Project R2.1: Study of Exemplary Instrumentation will conduct usability analyses of exemplary instrumentation, in order to understand the features that make some instrumentation particularly usable by people with disabilities or activity limitations.

Project R2.2: Study of Instrumentation that is Problematic Yet Essential will conduct usability analyses of instrumentation identified to be essential for healthcare but problematic for people with disabilities or activity limitations to use and for which no exemplary solutions exist.

Results of Research Program R2 will be used in Development Program D2 and in Training/Dissemination Program T1, T3 and T4.

Progress to Date:

Of the many approaches to usability/human factors/ergonomic analysis, the approach used in R2 assumes that user problems and needs are understood as part of R1 (Needs Assessment) research, and that conventional early methods of usability analysis (e.g., cognitive walkthrough, heuristic reasoning and Universal Design) normally would have been employed as part of Project R1.4 (problem definition and refinement), or in some cases early D2 (Product Design) activities. Thus R2 Usability Analysis targets advanced analysis, typically involving study of how the target technology is used by individuals with a diversity of abilities. It is anticipated that the R2 will take on 2-3 in-depth studies per year. The output of R2 activities is a formal report, often one that helps guide a D2 activity.

Working with Project D1, RERC staff have developed a Mobile Usability Lab (MU-Lab) that enables this project to conduct advanced usability testing activities in medical facilities and other appropriate environmental contexts. This is now being thoroughly evaluated. Project staff received approval from the Institutional Review Boards for the Protection of Human Subjects (IRBs) at the University of California at San Francisco and Berkeley for this project ( "Ergonomic Evaluation of Hand Tools"), and from Marquette University for those studies as well as four related studies.

IRB approval for usability testing at the facilities of Kaiser Permanente is being sought. These studies will focus initially on examination tables, identified by the R1.1 consumer survey as the most problematic type of medical equipment, and later will focus on additional types of equipment. Full testing is expected to begin in the early 2005.

Pilot testing of the MU-Lab for usability testing is underway, with several studies, such as the evaluation of MU-Lab for understanding the biomechanical aspects of accessibility for nine different medical devices, part of the MS Thesis of Melissa Lemke (see also image below, from one of the 12 subjects, here using a standard weight scale).

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Example Video Clips:

Click here to view the representative video clips of real users' experiences with different medical devices. Many examples of accessibility barriers experienced by subjects with disabilities are available for viewing. Video clips are available for the following devices: examination table, dental chair, weight scale, pill bottles, pill organizers, pill splitters, x-ray, and fluoroscopy.