15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Andreas Holzinger
Research Challenges in Bio- & Medical Informatics
New Technologies and the New Computing
15.04.05 Wien
Dr.Andreas Holzinger
Associate Professor of Information Processing
Institute for Medical Informatics,
Statistics & Documentation
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
21 Styrian General Hospitals
Hospitals 21
Beds
approx. 6.900
Inpatients 250.000/year
Physicians approx. 1850
Total staff approx 14.700
Styria Pop.
1.200.000
www.kages.at
15.04.05 Wien
Easy-to-use Interfaces ...
" ... the Vision of ambient intelligence seeks to
place the user, the human being, at the
centre of the future development of the
knowledge based society ..."
IST Framework Programme 6
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Inspirational Muse Leonardo da Vinci (1452-1519)
Renaissance Man
Combined
science & art
Integrated
engineering & esthetics
Balanced
technology advances
& human values
Merged
visionary & practical
Shneiderman (2004)
15.04.05 Wien
Overview
1) Introduction to MI -> “ e-Health ? “
2) Examples of what we have done in the past
3) Current Research and Future Challenges
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
In Medical Informatics we must provide clear
benefits and gain acceptance!
Support of medical action –
Unterstützung des medizinischen
Handelns!
Values for the end-users
15.04.05 Wien
Understanding Humans
Developing Computer Applications
Optimal
User Experience
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Classic Medical Informatics „Klassische Medizininformatik“ – „Standalone
era“ (1970+)
z
Data, in German typical „EDV“ (Electronic Data Processing)
Health Telematics – Influence of Telecommunication (1985+)
z
Regional Health care networks, Telemed, Decision Support etc.
Web era (1995+)
z
Webbased application and services
Pervasive & Ubiquitous Computing - Ambient era (2003+)
z
„Knowledge intensive “ Systems, wearable and implantable systems,
Biomedical informatics for personalized health, Health GRIDs usw.
User Experience – New Quality era (2005+)
z
Technology is now robust – now we can concentrate on people,
information, interaction – on our End-users:
Usefulness – Usability - Enjoyability
From pure data and information to User Experience!
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
IT in Hospitals - everywhere!
Photo by Institute of Medical Informatics
(Computer Guided Surgery)
15.04.05 Wien
Workflows
Medical people are highly nomadic workers
Complex, hectic, ad-hoc, interrupted, collaborative
Intense clinical workload
versus
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andreas.holzinger@meduni-graz.at IMI Graz
One jumbo jet crash every day
Annual Death Rates in US
329 3959 14986 43649 120000 0 50000 100000 150000 commerical aviation deaths
drowning deaths deaths from falls motor vehicle deaths
deaths from medical errors
Source: Philadelphia Enquirer (9/12/99)
15.04.05 Wien
Human-Computer Interaction (HCI)
& Usability Engineering (UE)
Humans
Technology
Tasks
Design
Holzinger, A. (2005), Usability Engineering for Software Developers.
Communications of the ACM,
48, 1, 71-74. Holzinger, A. (2004), Application of Rapid Prototyping to the User Interface Developmentfor a Virtual Medical Campus.
IEEE Software,
21, 1, 92-99.HCI&UE
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Computers enter the hospital: 1960
Information is still
gathered manually
Massive storage and
quick retrieval
Very limited ‘sharing’ due
to restricted network and
proprietary systems
Used mostly for
accounting functions
Hogarth (2003)
Refer to: Bennett (1969), Laska &. Logemann (1971)
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Communication
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Archiving
Photos by Institute of Medical Informatics
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Reporting
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andreas.holzinger@meduni-graz.at IMI Graz
Image Viewing
Photos by Institute of Medical Informatics
15.04.05 Wien
1970
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
1982
Gell (1982)
15.04.05 Wien
Meanwhile Advances in Academia
1977: Release of Apple II with graphical interface
1985: Gould and Lewis promote User-centered Design
1988: Norman and Draper,
User-centered System Design
[1990’s] –
z
Interest in field methods,
z
Rapid increases in computing power and options,
z
Emergence of prototyping tools,
z
Global marketplace,
z
WWW …
1999: ISO standards for Human-centered design
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Industrial Solution Today …
15.04.05 Wien 1986 UCD 1997 2000 User F rien d ly In fo rm a tio n S o ci e ty Ambien t In telli gen ce Future Interfaces Ubiqitou s Comput ing 1993 UCD Impact Web -Usabili ty 1995
UCD Impact is growing, but still rare !!!
It is rare that projects adopt a fully integrated
UCD approach in one strategic shift ...
cf. Norman & Draper (1986), Dray & Siegel (1998),
Gulliksen (1999), Vredenburg (2002), Holzinger (2003)
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Radiological Viewer
Developed by Institute of Medical Informatics Graz
15.04.05 Wien
One Method: UCD
Field studies
Evaluate
real life
Paper
Mock-up
Cognitive walkthroughs
Usability
inspection
Low-fi
Design
Prototype
Thinking aloud
Usability
testing
Hi-fi
Design
Implement
User studies,
function tests
Evaluate
Develop
Identification of
end
-users
Specs
Contextual
inquiry
Analysis
Task
Analysis
Objectives
Holzinger (2005)
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Low-Fi – High Fi Prototyping
15.04.05 Wien
Rapid Prototyping as success story ...
Holzinger, A.
(2004): Application of Rapid Prototyping
to the User Interface Development for a Virtual Medical Campus.
IEEE Software, Vol. 21, Iss. 1, January 2004, 92-99.
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
UCDev, Marcus (2002), Holzinger (2003)
Requirements > User Analysis > Task Analysis > Lo-Fi Prototype >
Evaluation > Reengineering > Prototype > Evaluation > Reengineering
cf. Boehm (1988)
15.04.05 Wien
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Current Research Areas
15.04.05 Wien
Ubiquitous Computing in Health Care …
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Desktop and
laptop PCs
Ubiquitous Clinical Computing: Support of Workflows!
Multimedia
Health
Record
Handheld web tablet
PDA or pager
Wireless
Internet
phone
Future devices
Home
monitors
15.04.05 Wien
Area 1 UbiHealth Example 1
Strategically, it is clear that
RFID and other automatic
identification and tracking
technologies will transform the
healthcare industry.
Operationally, the issues are not
as simple, a lot of research is to
do …
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Holzinger, A. (2004), Mobile Computing in der Medizin: Möglichkeiten und Perspektiven. In: CiniCum, 8/2004, Wien: Manstein Medizin, 28-29.
Area 1 Example
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Our pilot works …
Holzinger
et al. (2005)
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andreas.holzinger@meduni-graz.at IMI Graz
Area 2: MobMedInfo (Example 1)
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Area 2 Current Solution (Example 1)
cf. Holzinger, A. (2002), Finger Instead of Mouse: Touch Screens as a means of enhancing Universal Access. Lecture Notes in Computer Science Vol. 2615. 387-397.
15.04.05 Wien
Area 2: Example 2
Holzinger, A. & Errath, M. (2004), Designing Web-Applications for Mobile Computers: Experiences with Applications to Medicine.
Lecture Notes of Computer Science. Vol. 3196,
262-267.15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Landay & Hong (2002)
... this was not our goal ...
15.04.05 Wien
Rapid User Centered Development ...
who are the end-users? what are the tasks?
iterative design
mock-ups, prototypes
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
During our experiments
we concentrated
especially on ...
•
number and type of errors per task
•
number of errors per unit of time
•
number of navigations necessary
and most of all on
•
time to complete a task ...
15.04.05 Wien
Area 3: Typical experimental setting
107.97
Hand written report
30.32
Dictation to Tape
139.02
Speech
Recognition
Mean Value
(s)
Holzinger et al. (2004)
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Area 2+3 Values with Mobile Devices
Holzinger, A., Nischelwitzer, A. & Meisenberger, M. (2005), Mobile Phones as a Challenge for m-Learning: Examples for Mobile Interactive Learning Objects (MILOs). IEEE PerCom.
15.04.05 Wien
Biometrics
Objects
Active
Behavioural
Characteristics
Passive
Physical
Characteristics
Signature
Voice
Fingerprint
Retina Scan
Iris Scan
ID Card
Password
Digital Signature
Area 4 BioMed ID
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Area 4: BioMedID
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Electronic medical report with signature
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Functionality is not Enough!
For an interface to be a success
z
it must provide
• the right functionality
• at the right time
• in the right place
• and in the right form
•
from the user’s point of view!
usability engineering is the process of
ensuring that a user-interface is usable
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Two different approaches
System Centered
Design
z
Feature driven:
What can be realised
on our platform?
z
Tool driven: What can
be created by using
available tools?
z
Interest Driven: What
do the programmer
find interesting?
User Centered
Design
z
Task based:
What do the users
really need?
z
Ability based: What
abilities do the users
have?
z
Domain based: In
what context do the
users work?
15.04.05 Wien
Conclusion
… must be designed for quick and short
interaction!
... Must provide a clear benefit (added value)
… Must assist people within their workflows
Applications in
Medical Informatics
(MI) …
Holzinger, A. (2004), Usability Engineering und Prototyping,
15.04.05 Wien
andreas.holzinger@meduni-graz.at IMI Graz
Innovation means both:
Doing OLD things more effectively and
more efficiently
AND doing entirely NEW things…
15.04.05 Wien