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IF=1.46; International audience; This paper describes a new approach to analyse the way both hands are placed in relation to the steering wheel. The study is based on a 2D-tracking task, in which the stimulus is a steering wheel angle signal recorded while driving on 7 road geometries in real situations at 30 km/h. Hand movements are measured using a 3D-motion capture system. Data analysis is based on the segmentation of the hand angular position using 8 fuzzy angle windows (labelled as approximately 0°, approximately 45°, etc.), when the hand rests on the steering wheel, one window, else. To obtain information about the coordination aspect, 9 × 9 bivariate windows are considered for each time sample (recorded at 25 Hz); then, the average membership values are computed for each individual driving situation. The individual membership value sets related to the road geometries are studied via Correspondence Analysis, allowing to displaying both the inter- and intra-individual differences and the most discriminating bivariate windows. The methodology with 9 × 9 windows is more complex but implies less information loss than alternative ones e.g. when the two hands are separately analysed, which constitutes 9 + 9 windows and contains no information about the coordination aspect.

To improve parents' experience in the pediatric emergency waiting room by means of an information tool, the information needs of parents and pediatric patients need to be determined. It is necessary to find an optimal design for the information needed to be understandable by and useful to the parents. This paper presents the first step of designing an information tool aiming to improve patient/parent experience, encourage the understanding of the care process, and optimize the patient-caregiver relationship. In order to acquire insight into parents' information needs, exploratory interviews were conducted and benchmark research had been performed. Furthermore, one focus group session with parents was conducted to identify their information needs, determine the format of the information tool, and visualize the best ideas by using paper mock-ups. The focus group concluded that parents prefer an information screen to a smartphone application. The designed mock-up visualizes and explains the care process, and represents one's position in the waiting queue. The mock-up was evaluated through questionnaires.

International audience; To improve parents’ experience in the pediatric emergency waiting room by means of an information tool, the information needs of parents and pediatric patients need to be determined. It is necessary to find an optimal design for the information needed to be understandable by and useful to the parents. This paper presents the first step of designing an information tool aiming to improve patient/parent experience, encourage the understanding of the care process, and optimize the patient-caregiver relationship. In order to acquire insight into parents’ information needs, exploratory interviews were conducted and benchmark research had been performed. Furthermore, one focus group session with parents was conducted to identify their information needs, determine the format of the information tool, and visualize the best ideas by using paper mock-ups. The focus group concluded that parents prefer an information screen to a smartphone application. The designed mock-up visualizes and explains the care process, and represents one’s position in the waiting queue. The mock-up was evaluated through questionnaires.

Concerns over high transmission risk of SARS-CoV-2 have led to innovation and usage of an aerosol box to protect healthcare workers during airway intubation in patients with COVID-19. However, only a few studies have examined the impact of these aerosol boxes on the dispersion of droplets and aerosols, which are both thought to be significant contributors to the spread of COVID-19. In addition, to our knowledge, only a few studies have included in the concerned testbeds elements of the work context, which nevertheless have an impact on the use of the device.

Concerns over high transmission risk of SARS-CoV-2 have led to innovation and usage of an aerosol box to protect healthcare workers during airway intubation in patients with COVID-19. However, only a few studies have examined the impact of these aerosol boxes on the dispersion of droplets and aerosols, which are both thought to be significant contributors to the spread of COVID-19. In addition, to our knowledge, only a few studies have included in the concerned testbeds elements of the work context, which nevertheless have an impact on the use of the device.

We collected user needs to define a process for setting up Federated Learning in a network of hospitals. We identified seven steps: consortium definition, architecture implementation, clinical study definition, data collection, initialization, model training and results sharing. This process adapts certain steps from the classical centralized multicenter framework and brings new opportunities for interaction thanks to the architecture of the Federated Learning algorithms. It is open for completion to cover a variety of scenarios.

It is necessary for hospitals to be able to compare the usability of electronic health records (EHR) before acquisition. Adding usability as a critical element of the procurement process is therefore crucial. During the competitive usability evaluation of several EHRs, the usability walkthrough method has the potential of making end-users more active in the procurement process than demonstrations. This case study presents first results of a comparison of three EHRs performed by nine representative end-users. All users uncovered usability problems while performing their scenarios. The results show that none of the EHRs evaluated is without major usability problems. These problems have been well-known to human factors researchers for a long time.

Background The contribution of usability flaws to patient safety issues is acknowledged but not well-investigated. Free-text descriptions of incident reports may provide useful data to identify the connection between health information technology (HIT) usability flaws and patient safety. Objectives This article examines the feasibility of using incident reports about HIT to learn about the usability flaws that affect patient safety. We posed three questions: (1) To what extent can we gain knowledge about usability issues from incident reports? (2) What types of usability flaws, related usage problems, and negative outcomes are reported in incidents reports? (3) What are the reported usability issues that give rise to patient safety issues? Methods A sample of 359 reports from the U.S. Food and Drug Administration Manufacturer and User Facility Device Experience database was examined. Descriptions of usability flaws, usage problems, and negative outcomes were extracted and categorized. A supplementary analysis was performed on the incidents which contained the full chain going from a usability flaw up to a patient safety issue to identify the usability issues that gave rise to patient safety incidents. Results A total of 249 reports were included. We found that incident reports can provide knowledge about usability flaws, usage problems, and negative outcomes. Thirty-six incidents report how usability flaws affected patient safety (ranging from incidents without consequence, to death) involving electronic patient scales, imaging systems, and HIT for medication management. The most significant class of involved usability flaws is related to the reliability, the understandability, and the availability of the clinical information. Conclusion Incidents reports involving HIT are an exploitable source of information to learn about usability flaws and their effects on patient safety. Results can be used to convince all stakeholders involved in the HIT system lifecycle that usability should be considered seriously to prevent patient safety incidents.

BACKGROUND Overcrowding in the emergency departments has become an increasingly significant problem. Patient triage strategies are acknowledged to help clinicians manage patient flow and reduce patients’ waiting time. However, electronic patient triage systems are not developed so that they comply with clinicians’ workflow. OBJECTIVE This case study presents the development of a patient prioritization tool (PPT) and of the related patient prioritization algorithm (PPA) for a pediatric emergency department (PED), relying on a human-centered design process. METHODS We followed a human-centered design process, wherein we (1) performed a work system analysis through observations and interviews in an academic hospital’s PED; (2) deduced design specifications; (3) designed a mock PPT and the related PPA; and (4) performed user testing to assess the intuitiveness of the icons, the effectiveness in communicating patient priority, the fit between the prioritization model implemented and the participants’ prioritization rules, and the participants’ satisfaction. RESULTS The workflow analysis identified that the PPT interface should meet the needs of physicians and nurses, represent the stages of patient care, and contain patient information such as waiting time, test status (eg, prescribed, in progress), age, and a suggestion for prioritization. The mock-up developed gives the status of patients progressing through the PED; a strip represents the patient and the patient’s characteristics, including a delay indicator that compares the patient’s waiting time to the average waiting time of patients with a comparable reason for emergency. User tests revealed issues with icon intuitiveness, information gaps, and possible refinements in the prioritization algorithm. CONCLUSIONS The results of the user tests have led to modifications to improve the usability and usefulness of the PPT and its PPA. We discuss the value of integrating human factors into the design process for a PPT for PED. The PPT/PPA has been developed and installed in Lille University Hospital's PED. Studies are carried out to evaluate the use and impact of this tool on clinicians’ situation awareness and prioritization-related cognitive load, prioritization of patients, waiting time, and patients’ experience.

IF=1.909; International audience; The purpose of this article is to compare Principal Component Analysis (PCA) and a much less used method, i.e. MCA (Multiple Correspondence Analysis) with data being first changed into membership values to fuzzy space windows. For such a comparison, data from an experimental study about turning the steering wheel is used. In a didactic perspective, this article only considers one multidimensional signal with 5 components: 3 linked to the steering wheel angle and hand positions and 2 to hand effort variables. A discussion weighs out the pros and the cons of both methods with criteria such as the possibility to show complex relational phenomena, the analysis/computing time or the information loss inherent to the averaging stage (in the perspective to analyze several hundreds of large multidimensional signals).

The study presents the evaluation of the reliability of the information displayed on the user interface of a homegrown electronic patient prioritization tool dedicated to pediatric emergency department (namely Optimum). Two ergonomists shadowed physicians and nurses throughout their shift in order to (i) identify consistencies and discrepancies between the actual step of the patients in the care process and their assigned step in Optimum and (ii) to understand the causes of the discrepancies. Even if some discrepancies are noted, results show that Optimum provides a quite good reflection of the actual position of the patients in the care process. The use of ethnographic methods allows to understand the cause of the discrepancies.

International audience; This paper presents a web viewer of Fetal Heart Rate (FHR) signals developed on HTML5/JavaScript. It provides an easy solution to remotely consult an FHR signal on a web browser without installing any specific software and it can be used either on a computer or on mobile device. There are three major applications of this tool. First, it is used to build up our FHR database used for research on signal processing and analysis. Secondly, it is used on our E-learning website e.RCF in order to train midwives and obstetricians to interpret FHR signals. At last, it could be used on telemedicine either on tele-monitoring to remotely check the fetal welfare, or on tele-expertise to enable practitioners to ask for specialists’ opinion. This viewer is designed to correspond to practitioners’ habits while including tools to ease the interpretation the FHR signal.

International audience; The fetal heart rate (FHR) is a marker of fetal well-being in utero (when monitoring maternal and/or fetal pathologies) and during labor. Here, we developed a smart mobile data module for the remote acquisition and transmission (via a Wi-Fi or 4G connection) of FHR recordings, together with a web-based viewer for displaying the FHR datasets on a computer, smartphone or tablet. In order to define the features required by users, we modelled the fetal monitoring procedure (in home and hospital settings) via semi-structured interviews with midwives and obstetricians. Using this information, we developed a mobile data transfer module based on a Raspberry Pi. When connected to a standalone fetal monitor, the module acquires the FHR signal and sends it (via a Wi-Fi or a 3G/4G mobile internet connection) to a secure server within our hospital information system. The archived, digitized signal data are linked to the patient’s electronic medical records. An HTML5/JavaScript web viewer converts the digitized FHR data into easily readable and interpretable graphs for viewing on a computer (running Windows, Linux or MacOS) or a mobile device (running Android, iOS or Windows Phone OS). The data can be viewed in real time or offline. The application includes tools required for correct interpretation of the data (signal loss calculation, scale adjustment, and precise measurements of the signal’s characteristics). We performed a proof-of-concept case study of the transmission, reception and visualization of FHR data for a pregnant woman at 30 weeks of amenorrhea. She was hospitalized in the pregnancy assessment unit and FHR data were acquired three times a day with a Philips Avalon® FM30 fetal monitor. The prototype (Raspberry Pi) was connected to the fetal monitor’s RS232 port. The emission and reception of prerecorded signals were tested and the web server correctly received the signals, and the FHR recording was visualized in real time on a computer, a tablet and smartphones (running Android and iOS) via the web viewer. This process did not perturb the hospital’s computer network. There was no data delay or loss during a 60-min test. The web viewer was tested successfully in the various usage situations. The system was as user-friendly as expected, and enabled rapid, secure archiving. We have developed a system for the acquisition, transmission, recording and visualization of RCF data. Healthcare professionals can view the FHR data remotely on their computer, tablet or smartphone. Integration of FHR data into a hospital information system enables optimal, secure, long-term data archiving.

International audience; In order to prevent use errors with their medical devices, manufacturers have to integrate a safety-oriented usability engineering process in their product development lifecycle. A critical step of this process is the identification of potential use-errors. Standards and guidelines recommend to triangulate several sources of information e.g. scientific literature, incident reports, manufacturer's files and user's feedbacks. This paper presents lessons learned from applying these recommendations during an international project. We identify issues with (i) searching literature and databases, and (ii) interpreting collected data. Nevertheless triangulation of information sources allows to identify different types of use errors therefore providing valuable lists of potential use errors. Issuing recommendations aim at making easier this critical task.

International audience; The proposed approach starts performing a fuzzy space windowing from the histogram analysis. Then multiple correspondence analyses is used through two main stages: 1) with the membership value table coming from healthy drivers and 2) with the table from disabled drivers, the table rows being considered as supplementary points. An example is considered with an experimental design involving three factors –individual, road configuration and repetition– and multidimensional signals with 95 components. This article focuses on the analysis of healthy drivers.

International audience; This paper presents how, in compliance with the standard ISO 9241-210:2010, Human Factors activities were implemented in the design of a patient scheduling system in order to decrease the overcrowding in a pediatric emergency department. More specifically, an original method to assess an algorithm with end-users is described. First, a work system analysis was performed through observations and interviews of physicians and nurses from the pediatric emergency department from a French 2965-bed academic hospital. Then, the work system was modeled with a focus on how the patients are arranged and on which criteria the arrangement is based. Those results allowed developing a patients arrangement algorithm along with recommendations to develop a patient scheduling system automatically fed by the existing electronic patient record system. A mock-up of the patient scheduling system has been developed in order to test upstream in the design process the proposed algorithm and a set of icons with healthcare professionals through user testing. Overall, results showed the end-users validated the patients arrangement algorithm and most of the icons. Next steps will be to develop and to implement the patient scheduling system in the pediatric emergency department in order to assess its impact.; Cet article présente l'intégration des aspects facteurs humains et ergonomie, conformément à la norme ISO 9241-210 :2010, dans la conception d'un système d'ordonnancement des patients pour les urgences pédiatriques. L'originalité de ce papier réside dans l'adoption de méthodes classiques d'évaluation de produits impliquant les utilisateurs pour l'évaluation d'un algorithme de tri. Une analyse de l'activité, sous forme d'observations et d'entretiens, a été menée dans le service. Ces résultats ont permis de modéliser la gestion du flux patient, d'identifier les indicateurs pertinents et de formuler des recommandations pour la conception du système d'ordonnancement des patients. Ce système prévoit d'être automatiquement alimenté par le système d'information du service des urgences pédiatriques. Une maquette de l'interface a été réalisée pour simuler le fonctionnement de l'algorithme. L'algorithme de tri et les icônes de l'interface associée ont été évalués via des tests utilisateurs, effectués auprès des médecins et infirmiers du service, avec la maquette du système. Les résultats ont validés le fonctionnement de l'algorithme et l'utilisation de certaines icônes. La prochaine étape est d'implémenter l'algorithme et de déployer le système dans le service afin d'évaluer son impact dans la gestion du flux patient.

Methods for automatic detection of abnormal vital signs occurring during anesthesia are poorly documented in the literature.Existing methods are not reproducible between databases.We have developed a data model and an algorithm that allow automatic detection of abnormal values of vital parameters occurring during anesthesia.Predefined thresholds and various parameters such as time between measurements and time spent outside predefined thresholds provide adaptability to various clinical situations, e.g. hypotension occurring after start of anesthesia.The relation between occurrence of abnormal values of vital parameters and mortality and length of stay may then be studied on a large and automated scale. Abnormal values of vital parameters such as hypotension or tachycardia may occur during anesthesia and may be detected by analyzing time-series data collected during the procedure by the Anesthesia Information Management System. When crossed with other data from the Hospital Information System, abnormal values of vital parameters have been linked with postoperative morbidity and mortality. However, methods for the automatic detection of these events are poorly documented in the literature and differ between studies, making it difficult to reproduce results. In this paper, we propose a methodology for the automatic detection of abnormal values of vital parameters. This methodology uses an algorithm allowing the configuration of threshold values for any vital parameters as well as the management of missing data. Four examples illustrate the application of the algorithm, after which it is applied to three vital signs (heart rate, SpO2, and mean arterial pressure) to all 2014 anesthetic records at our institution.

This paper describes an experimental study focusing onto the way drivers use the steering wheel while performing a 2D tracking task. The stimulus during this task was a steering wheel angle signal recorded in real situations involving turns and straight lines performed at about 30 km/h. The hand positions of 20 volunteers were recorded in 6 steering scenarios involving 7 road geometries using a 3D motion capture system. The hand movement data were analysed via a descriptive/inferential procedure: each hand was considered using nine indicators - eight membership value averages linked to eight fuzzy angle windows and a frequency value related to the off steering wheel position - while the indicators were investigated using multiple correspondence analysis and non-parametric global and post-hoc tests. Results showed that inter-individual differences were larger than intra-individual differences. Considering 2 × 9 = 18 windows, the inter-individual differences mainly appeared during two main kinds of steering hand strategies: with versus without crossing hands, the latter being the most often used (17 among 20 participants). The intra-individual data showed that some drivers maintained a nearly identical strategy for all road geometries, while other drivers changed their hand position with the direction and/or maximum angle value of the turn. Practitioner Summary: Understanding hand position strategy could be used to design steering wheel assistance in relation to a driver's physical resources with a view to adapting the steering wheel to disabled drivers.

International audience

The task of turning a steering wheel requires a minimum amount of strength and amplitude. Such requirements may be lacking in aged and/or disabled drivers. The VOLHAND project aims to ease driving ...

How HCI can change behaviors? Persuasive Design is used through various fields of digital. As many resources for developers are freely available on the web, CIC IT from Lille has developed an online library to encourage and help on how to develop persuasive HCI, using Behavior Change Techniques, Les techniques de persuasive design sont utilisées dans différents domaines du digital pour influencer le comportement des utilisateurs à travers l’Interface Homme Machine (IHM). A l’instar de banques de templates pour le maquettage accessibles gratuitement en ligne, le CIC IT de Lille a développé une librairie web d’illustrations des Techniques de Changement de Comportement utilisées dans le Persuasive Design, afin de favoriser le développement d’interfaces persuasives pour la communauté de concepteurs d'IHM

Electric power steering systems are equipped in modern cars to ease the steering experience of drivers. Torque assistance is based on several parameters but one principle input is the driver steeri...