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We have an extensive and broad program looking at human factors in health care

Last Updated: Feb 27, 2018

Human factors of improving health care data quality

Duration: January 2014-December 2020

This multiyear project has had several stages.  First we looked at the data quality tradeoffs that primary care physicians make.  Then we implemented a persuasive solution to improve their data entry experience.  Now we are looking at data quality in other contexts.

  1. St. Maurice*, J. and Burns, C.M. (2017). Using cognitive work analysis to compare complex system domains.  Theoretical Issues in Ergonomics Science. Available online at https://doi.org/10.1080/1463922X.2017.1406556
  2. St. Maurice*, J. and Burns, C.M. (2017). Modeling patient treatment with medical records: An abstraction hierarchy to understand competencies and needs. JMIR Human Factors 4(3):e16. 10.2196/humanfactors.6857
  3. St. Maurice*, J. and Burns, C.M. (2017). An exploratory case study to understand primary care users and their data quality tradeoffs. Journal of Data and Information Quality 8, 3-4, 24 pages. 10.1145/3058750
  4. St. Maurice*, J and Burns, C.M. (2016). A method for developing data quality metrics for primary care data. HFES 2016 International Symposium on Human Factors and Ergonomics: Shaping the Future. San Diego, CA. April 13-16. 2016.
  5. St. Maurice*, J., Burns, C.M. (2015). Using comparative cognitive work analysis to identify design priorities in complex socio-technical systems. 2015 International Symposium on Human Factors and Ergonomics in Health Care: Improving the Outcomes, vol 4 no 1, 118-123. doi: 10.1177/2327857915041019.

Human factors in medication management

Duration: January 2015-December 2020.

This multiyear project has been looking at the human side of medication management.  What decision support do pharmacists need? How do patients manage their medications?  How do we improve adherence to medication based treatment?  This project is funded by TELUS Health and through NSERC and CIHR grants.

  1. Mercer, K., Burns, C., Guirguis, L., Abidi, S., Borsema, J., Chabot, C., Chin*, J., Dogba, J., Dolovich, L., Guenette, L., Legare, F., McKinnon, A., Waked, K., Grindrod, K. (2017). What patients want: Understanding how patients view decision making about treatment. CAHSPR: Canadian Association for Health Services and Policy Research. May 24-26, 2017. Toronto, ON.
  2. Grindrod, K., Burns, C., Guirguis, L., Abidi, S., Borsema, J., Chabot, C., Chin*, J., Dogba, J., Guenette, L., Legare, F., Mercer, K., McKinnon, A., Waked, K. (2017). Playing telephone: Understanding the state of medication decision making in growing healthcare teams in the time of electronic health records. CAHSPR: Canadian Association for Health Services and Policy Research. May 24-26, 2017. Toronto, ON.
  3. McMurray, J., Grindrod, K.A., and Burns, C.M. (2017). How appropriate is all this data sharing? Building consensus around what we need to know about shared electronic health records in extended circles of care. Healthcare quarterly 4: 28-36.

  4. Chin*, J., Üreten*, E., Burns, C. (2018). Search for health information across the lifespan: Validation, confirmation or learning. Poster presented at the Cognitive Aging Conference 2018,  Atlanta, GA.

  5. Keresteglioclu*, D., Burns, C.M., Grindrod, K. (2016). Building Bridges Between Physicians And Pharmacists: An Interprofessional Approach to Electronic Health Record Requirements. HFES 2016 International Symposium on Human Factors and Ergonomics: Shaping the Future. San Diego, CA. April 13-16, 2016.
  6. Grindrod, K., Tran*, P., Burns, C.M. (2015). Medication reconciliation: More than just a check. 2015 International Symposium on Human Factors and Ergonomics in Health Care: Improving the Outcomes,vol 4 no 1, 206-212. doi: 10.1177/2327857915041014

The Monitoring Messenger: Mobile Patient Monitoring for the Intensive Care Unit

Duration: January 2011 - March 2014

Critically ill patients in the intensive care unit (ICU) require constant specialized observation by a number of clinicians (nurses, respiratory therapists, doctors) at a given time. To make decisions and plan treatments, these clinicians need to observe, combine and understand a wide range of information from various devices located at the bedsides of multiple patients. The problems with existing technology are: a) fixed location of monitoring devices at the bedside; b) information overload from too many devices, each with its own display; c) no integration and interaction between devices; d) displays which do not show information in a way that is easy to understand; and e) lack of historical information to support understanding of data and clinical decision making.

To develop the Monitoring Messenger device we have completed a detailed analysis of the work-flow in a pediatric ICU. Based on the results of this analysis we have developed mock-ups of the device. Now we will improve and finalize the device with the direct involvement of healthcare providers. 

The novelty of our project is in its use of a formal design approach and transferring technology developed for the OR into the ICU.

Related Publications:

  1. Görges, M., Morita, P.P., Burns, C.M., Ansermino, J.M. (2013). Mobile Patient Monitoring for the Pediatric Intensive Care Unit – Work Domain Analysis and Rapid Prototyping Results*. IEEE International Conference on Systems, Man, and Cybernetics, 3765-3770.

Sponsors and Partners:

  1. CIHR
  2. NSERC

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Ecological Interface Design for an Automated Rehabilitation Supporting System

Duration: November 2012 - Present

With the rising number of hip and knee replacement surgeries, more patients are requiring rehabilitation to accelerate the healing process. Rehabilitation clinics are led by physiotherapists who prescribe and customize workout programs based on a clinical assessment of the patient’s progress. These assessments are performed by visual observation, patient questionnaires and goniometry, which can measure range of motion of only a single joint while the patient is at rest. However, even when carefully performed, human errors and biases are likely to occur due to the inherent element of subjectivity in these methods.

To address this concern, an Automatic Rehabilitation System (ARS) is being developed to provide the physiotherapist with quantitative patient data using human motion tracking technologies. Our lab tackles the issue of how to display this information effectively while minimizing the added complexity so that physiotherapists can better assess patient recovery. To this end, evaluations of early prototypes have been conducted with patients and physiotherapists at St. Joseph’s Health Centre (Guelph, ON). This project is in conjunction with the Adaptive Systems Laboratory (Department of Electrical and Computer Engineering) and Cardon Rehabilitation & Medical Equipment Ltd.

Related Publications:

  1. Li*, Y, Kulic, D., and Burns, C.M. (in press). Ecological Interface Design for Knee and Hip Automatic Physiotherapy Assistant and Rehabilitation System. HFES 2014 International Symposium on Human Factors and Ergonomics in Health Care.  Chicago, March 16-19 2014.

Sponsors and Partners:

  1. Adaptive Systems Laboratory (Department of Electrical and Computer Engineering, University of Waterloo)
  2. Cardon Rehabilitation & Medical Equipment Ltd.
  3. NSERC
  4. Ontario Centres of Excellence

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Mobile UI and Persuasive Design for Supporting Patient Adherence and Home Health

Duration: Completed February 2014

Research indicates that behavior change interventions can assist a patient's performance with respect to their health, and empower them to take a proactive role in their well-being. The objective of this research was to identify features that make remote health-monitoring systems more effective. To that end, a persuasive design approach was used to design a prototype application that encourages patients to consult their home monitoring devices appropriately. An exploratory user study was conducted to evaluate the participants’ opinions about the developed prototype, their preferences, as well as their concerns regarding the different components of the mockup.

Related Publications:

  1. Sadat Rezai*, L., Torenvliet, G. and Burns, C.M. (in press). Increasing patient adherence to remote health monitoring systems. HFES 2014 International Symposium on Human Factors and Ergonomics in Health Care.  Chicago, March 16-19 2014.
  2. Sadat Rezai*, L. and Burns, C.M. (in press). Using Work Domain Analysis and Persuasive Design approach for design effective remote health-monitoring systems.  HFES 2014 International Symposium on Human Factors and Ergonomics in Health Care.  Chicago, March 16-19 2014.

Sponsors and Partners:

  • Medtronic
  • NSERC

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Mobile Decision Support for Facilitating Patients in Medical Emergencies 

Duration: Completed September 2013

This research was about developing an effective user interface for a decision support tool for mobile devices, aimed at presenting emergency department waiting-time information to the patient population. The prototype received very positive feedback from a variety of stakeholders, the head of the Emergency Department, and the trained nurses. A user study was also conducted to evaluate the usability of the system. 

Sponsors and Partners:

  • Oculys Health Informatics
  • FedDev Ontario

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Improving Labelling of Pharmaceutical Containers for Injection

Duration: 2006 - 2008

The project provided guidance to improve the labelling of injectable pharmaceutical containers. Existing labels for injectable pharmaceutical containers, specifically ampoules and vials, were evaluated against the Health Canada regulations and the standard developed by the CSA International. A FMEA was performed on the label reading process to identify potential human errors in the process and prioritise their criticality. Based on the results of FMEA, improved label designs will be developed and evaluated via user testing.

Related Publications: 

  1. Jeon*, J. and Burns, C.M. (2009). Standardization and use of colour for labelling of injectable drugs. Proceedings of the International Ergonomics Association World Congress. Beijing, China, August 9-14, 2009.
  2. Jeon*, J., Hyland, S., Burns, CM., Momtahan, K. (2007). Applying FMEA on the process for reading the labels on ampoules and vials for injectable drugs. The 12th World Congress on Health (Medical) Informatics, MEDINFO 2007, 23.
  3. Jeon*, J. Hyland, S. Burns, CM, Momtahan, K. (2007). Applying FMEA on the process for reading the labels on ampoules and vials for injectable drugs. National Healthcare Leadership Conference. Toronto.June 11-12, 2007.
  4. Jeon*, J., Hyland, S., Momtahan, K., and Burns, C.M. (2007). Challenges with applying FMEA to the process for reading the labels on the containers for injectable drugs.  Proceedings of the 51st Annual Meeting of the Human Factors and Ergonomics Society, 735-739.

Sponsors and Partners: 

  1. Institute for Safe Medication Practices Canada (ISMP Canada) 
  2. University of Ottawa Heart Institute (UOHI) 
  3. Canadian Patient Safety Institute (CPSI) 

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CARDIO Project 

Duration: 2004 - 2006

This project developed a mobile decision support tool for cardiac care nursing coordinators doing telephone triage. The support included patient care algorithms, research evidence, electronic record keeping, advanced display ideas, and a mobile drug database. A two month field trial of the support tool showed it was readily adopted, gave useful advice, and supported the triage task well.

Related Publications: 

  1. Burns, C.M., Enomoto*, Y., and Momtahan, K. (2007). The Cognitive Work of Nursing.  The 12th World Congress on Health (Medical) Informatics, MEDINFO 2007, 108.
  2. Momtahan, K.L, Burns, C.M, Labinaz, M, Mesana, T, Sherrard, H.(2007). Using Personal Digital Assistants and Patient Care Algorithms to Improve Access to Cardiac Care Best Practices. The 12th World Congress on Health (Medical) Informatics, MEDINFO 2007, 117-121.
  3. Momtahan, K., Burns, CM.  (2007). Decision Support Tools on Personal Digital Assistants to Promote Knowledge Transfer and Interdisciplinary Communication, and Improve the Quality of Patient Care. National Healthcare Leadership Conference. Toronto.June 11-12, 2007.
  4. Burns, C.M., Momtahan, K., and Enomoto*, Y.  (2006). Supporting the Strategies of Cardiac Nurse Coordinators Using Cognitive Work Analysis. Proceedings of the 50th Annual Meeting of the Human Factors and Ergonomics Society.  San Francisco, CA.  October 16-20, 442-446.
  5. Enomoto*, Y., Burns, C. M., Momtahan, K., and Caves, W. (2006).  Effects of Visualization Tools on Cardiac Telephone Consultation Processes.  50th Annual Meeting of the Human Factors and Ergonomics Society, San Francisco, CA, 1044-1048.
  6. Burns, C.M., Enomoto*, Y., and Momtahan,K. (2008). A cognitive work analysis of cardiac care nurses performing teletriage. Applications of Cognitive Work Analysis.  Bisantz, A. and Burns, C.M. (Eds.). Lawrence Erlbaum and Associates, Mahwah, NJ, p. 149-174.
  7. Momtahan, K., Burns, C.M., Sherrard, H., Labinaz, M., Mesana, T., Caves, W., Enomoto*, Y., Giang*, W., Ho*, V., Pajek*, D., Saunders*, C (2006).. Personal Digital Assistants and Decision Support Software:  New Mechanisms to Improve Access to Cardiac Care Best Practices.  e-HEALTH 2006, Victoria, Canada, May 1-4, 2006.

Sponsors and Partners: 

  1. University of Ottawa Heart Institute (UOHI) 
  2. Ontario Ministry of Health and Long-Term Care 

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Mobile Ecological Interface Design for Diabetes Management 

Duration: 2002 - 2005

The mobile EID (mEID) diabetes management project involved the design and development of a mobile application to help diabetics better visualize elements of their condition, thus improving understanding and management. Variables such as blood glucose and plasma were identified at each level of the Abstraction Hierarchy in the Work Domain Analysis (WDA). The information requirements extracted from the WDA were subsequently used to design the mobile information displays for the application. A usability evaluation of the application revealed that users performed more efficiently with modified task-based mEID displays vs. mEID displays alone.

Related Publications: 

  1. Kwok, J. & Burns, C. M. (2005). Usability Evaluation of a Mobile Ecological Interface Design Application for Diabetes Management. Proceedings of the Human Factors and Ergonomics Society 49th Annual Meeting, 1042-1047.
  2. Thompson, L.K., Hickson, J.C.L., & Burns, C.M. (2003). A Work Domain Analysis for Diabetes Management. Proceedings of the Human Factors and Ergonomics Society 47th Annual Meeting, 1516-1520.

Sponsors and Partners: 

  1. Bell University Labs 
  2. Research In Motion

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