HCI for health and wellbeing: Challenges and opportunities

May combine two claims.

Issues emerge in the broader setting for infusion pumps, such as ensuring they cannot be tampered with when there is no direct clinical supervision and supporting troubleshooting when anything goes wrong.

“issues emerge in the broader setting, such as ensuring that they cannot be tampered with when there is no direct clinical supervision (Vincent and Blandford, 2017) and supporting troubleshooting when anything goes wrong (Lyons and Blandford, 2018)”

• cites Vincent and Blandford, 2017Not checked yet

  Not checked in the free run.

• cites Lyons and Blandford, 2018Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In the UK National Health Service, a National Programme for IT was terminated around 2005 and did not deliver on its expectations.

“In the UK National Health Service, a National Programme for IT was, for a while, the largest IT project worldwide, but was terminated around 2005 and did not deliver on its expectations (e.g., Currie and Guah, 2007).”

• cites Currie and Guah, 2007Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based).

Most interactive health technologies currently deployed at scale are difficult to use.

“most interactive health technologies that are currently deployed at scale are difficult to use”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

The pace of cultural change varies across contexts.

“culturally, the pace of change varies across contexts”

Probably not a substantial claim: may not pass S4 (based).

Few innovative health technologies have achieved significant market penetration.

“few innovative technologies have achieved significant market penetration”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.

While there has clearly been progress in the intervening 50 years, that progress has been much slower than anyone might have anticipated, and many of the challenges highlighted by Anderson and Woodroffe remain.

“While there has clearly been progress in the intervening 50 years, that progress has been much slower than anyone might have anticipated, and many of the challenges highlighted by Anderson and Woodroffe remain.”

May combine two claims.

The larger issue in medication administration is commonly the way that multiple different devices are used together, the consistency between user interfaces, and the ways they support or disrupt clinical practices in medications management.

“the larger issue is commonly the way that multiple different devices are used together, the consistency between user interfaces, and the ways they support or disrupt clinical practices in medications management”

• cites Koppel et al, 2008 sourceNot checked yet

  Not checked in the free run.

• cites Schiff et al, 2015 sourceNot checked yet

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• cites van der Veen et al, 2017 sourceNot checked yet

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Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.

There is a lot of hype about the potential of digital technologies as vehicles of innovation, transformation and disruption, most of it implicitly assuming that people will take up the technologies and use them seamlessly.

“there is also a lot of hype about the potential of digital technologies as vehicles of”

Classified as probably not a substantial claim. May combine two claims.

One of the persistent challenges in developing useful, usable EHRs is that health data are used by different people for different purposes; even different health professionals ask different questions of the health record, and patients come with yet other questions.

“One of the persistent challenges in developing useful, usable EHRs is that health data are used by different people for different purposes; even different health professionals ask different questions of the health record, and patients come with yet other questions.”

Classified as probably not a substantial claim. May combine two claims.

HCI can provide valuable input in better understanding and supporting the processes of information discovery and in developing relevant and valid approaches to evaluating visual analytics systems.

“Such studies highlight areas where HCI can provide valuable input, in better understanding and supporting the processes of information discovery and in developing relevant and valid approaches to evaluating visual analytics systems.”

Probably not a substantial claim: may not pass S4 (based).

The new experiences, changed relationships, and reliance on technology interaction in telecare are not suited to all patients or circumstances.

“However, the new experiences, changed relationships, and reliance on technology interaction are not suited to all patients or circumstances.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The four user groups identified were controllers, collaborators, co-operators, and avoiders.

“The first group,”

• cites Schneider et al (2016) sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Skills in biomedical sciences and engineering are fundamental to the success of haemodialysis in an obvious way that skills in computer science or HCI are not.

“Skills in biomedical sciences and engineering are fundamental to the success of haemodialysis in an obvious way that skills in computer science or HCI are not”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

In contrast with most medical devices, information systems are generally 'digital first' (not closely linked to biomedical systems), so the history of digital health information systems is comparatively short.

“In contrast with most medical devices, information systems are generally”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

An improved understanding of the importance of usability and user experience by those designing, procuring and evaluating interactive medical devices may result in earlier consideration of HCI and human factors in device development processes.

“an improved understanding of the importance of usability and user experience by those designing, procuring and evaluating interactive medical devices may result in earlier consideration of HCI and human factors in device development processes”

May combine two claims.

Technology that is challenging to use adds to emotional stress, increasing the risk of compromising patient safety.

“Technology that is challenging to use (whether in normal operation or when anything goes wrong) adds to emotional stress, increasing the risk of compromising patient safety.”

May combine two claims.

Two concerns about telecare are knock-on effects on traditional healthcare organisation and limited validation of algorithms underpinning patient interactions and diagnoses.

“Two particular causes of concern are the knock-on effects on traditional healthcare organisation, which may be required to manage more people with complex health needs than they have capacity for, and limited validation of the algorithms underpinning patients' interactions and the delivery of diagnoses (The Lancet, 2018).”

• cites The Lancet, 2018Not checked yet

  Not checked in the free run.

May combine two claims.

Many patients or families are largely responsible for their own health management, particularly for long-term conditions, which puts the burden of care on the individual and family.

“Even when under the care of a clinical team, many patients or families are largely responsible for their own health management, particularly for long-term conditions.This puts the burden of care on the individual and their family (Mair and May, 2014).”

• cites Mair and May, 2014 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The author is not aware of any studies of dual interfaces in home healthcare, other than patient portals to health records.

“In principle, good design can make the ways responsibilities are shared clearer -e.g., through separate interfaces for different user groups -but I am not aware of any studies of such dual interfaces in home healthcare, other than patient portals to health records (e.g.Osborn et al, 2013).”

• cites Osborn et al, 2013 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

There is substantial investment in innovative health technologies, especially in big data analytics and personal health technologies.

“there is substantial investment in innovative health technologies, particularly around”

May combine two claims.

Patients have variable levels of health literacy, technology literacy, and general education, making usability a priority because use is typically not discretionary and errors may compromise safety.

“Since patients come with variable levels of health literacy, technology literacy and general education, this makes usability a priority since use is typically not dis cretionary and errors may compromise safety.”

May combine two claims.

Changes in care delivery through telecare are attractive to some patients, typically technologically sophisticated people without complex care needs, but require substantial changes in care delivery.

“Such changes in care delivery have been found to be attractive to some patients -typically, technologically sophisticated people without complex care needs -but it requires substantial changes in the ways that care is delivered (Liaw et al, 2019).”

• cites Liaw et al, 2019 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Classic HCI techniques, particularly task analysis, implicitly assume that systems can be decomposed to simple tasks, which is not the case when the system is complex.

“Classic HCI techniques, particularly those that involve task analysis or task descriptions, also implicitly assume that systems can be decomposed to simple tasks, which is not the case when the system is complex.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

As well as being well engineered and addressing user-centred requirements, health technologies also have to deliver clinical benefits by being safe, clinically effective and scalable across care contexts.

“According to this view, as well as being well engineered (hardware and software perform as intended) and addressing user-centred requirements at different levels of abstraction (being usable, useful, engaging, and fitting the context of use), health technologies also have to deliver clinical benefits by being safe, clinically effective and scalable across care contexts.”

Probably not a substantial claim: may not pass S3 (load-bearing).

People engage in an information journey involving recognising a need, seeking information, validating and interpreting it, and using it.

“People engage in an”

• cites Blandford and Attfield, 2010Not checked yet

  Not checked in the free run.

May combine two claims.

There is widespread recognition that user-centred design is needed for health apps, but relatively little evidence that this is followed through in practice.

“Broadly, there is widespread recognition that user-centred design is needed, but (as yet) relatively little evidence that this is followed through in practice.”

May combine two claims.

Advances in interactive health technologies are often triggered by advances in physical technologies and in understanding of human physiology and psychology, and user interaction and engagement are afterthoughts.

“As illustrated in the haemodialysis example above, advances in interactive health technologies are often triggered by advances in physical technologies and in understanding of human physiology and psychology for different areas of the care pathway, and user interaction and engagement are afterthoughts (or not explicitly considered at all).”

Probably not a substantial claim: may not pass S2 (checkable).

HCI has a central role to play if health technologies in the future are to be truly fit for purpose.

“In summary: HCI has a central role to play if health technologies in the future are to be truly fit for purpose.”

Classified as probably not a substantial claim. May combine two claims.

Input of clinician and patient end users is often missing when a mental health app is designed, resulting in apps that do not align with preferences and goals of intended users.

“They note that”

• cites Torous et al, 2019 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Many health professionals specialise in particular clinical areas, and most interactive medical devices support care pathways for particular conditions.

“Another area whose importance is becoming increasingly apparent is that of managing multi-morbidities: many health professionals specialise in particular clinical areas, and most interactive medical devices support care pathways for particular conditions.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

There is growing recognition that individual health is complex, particularly when managing multiple conditions, and that healthcare systems are most appropriately considered as complex adaptive systems.

“There is a growing recognition that even individual health is complex, particularly when managing multiple health conditions (e.g., Lupton, 2013), and that healthcare systems are most appropriately considered as complex adaptive systems.”

• cites Lupton, 2013 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

Care systems in some low and middle income countries facilitate innovation by exploiting mobile technologies and community-based care, while in other cases lack of resources limits investments.

“The care systems in some low and middle income countries facilitate innovation -e.g., exploiting the prevalence of mobile technologies and a greater emphasis on communitybased care, making more agile innovations possible; in other cases, a lack of resources limits where investments can be made.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

People are often managing multiple health conditions in parallel, or managing wellbeing while also dealing with particular conditions.

“However, people are often managing multiple health conditions in parallel, or managing wellbeing while also dealing with particular conditions.”

May combine two claims.

Many prototype systems are only deployed and tested for short periods because of inadequate consideration of sustainability, or only deployed within small communities due to lack of consideration of scaling.

“A further issue to address is”

• cites Huang et al, 2017 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based).

Digital health technologies can help people live longer and healthier lives.

“I have highlighted many of the benefits of digital health technologies -from enabling people to live longer, healthier lives to empowering people to better understand and manage their own health and that of others.”

Probably not a substantial claim: may not pass S2 (checkable).

HCI has the potential to make a substantial difference to health and wellbeing through design of technologies that are socially and culturally appropriate, as well as addressing health concerns specific to particular regions.

“These are areas in which HCI has the potential to make a substantial difference to health and wellbeing through the design of technologies that are socially and culturally appropriate, as well as addressing health concerns specific to particular regions.”

Probably not a substantial claim: may not pass S4 (based).

The challenges for HCI in health arise from the scale and complexity of health and care.

“Challenges for HCI in health lie in the scale and complexity of health and care”

• AssumptionRests on an assumption: Healthcare systems are complex.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

For acute conditions, online health information makes it possible for people to access information readily, though this depends on urgency, severity, motivations, and literacy.

“For acute conditions, the availability of online health information makes it possible for people to access information readily, though this depends on the urgency and severity of the condition as well as people's motivations and literacy, including digital and health literacy.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Classic user-centred design does not make reliance on what is technically possible or clinically evidenced explicit.

“Conversely, classic user-centred design does not make reliance on what is technically possible or clinically evidenced explicit.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

These themes have not been widely discussed in the HCI literature and merit more attention.

“These themes have not been widely discussed in the HCI literature, and merit more attention if HCI is to have an impact on the usability and utility of health technology, facilitating both care delivery and the use of reliable health data for managing population health (Figure 1).”

May combine two claims.

There is little evidence of user-centred design in the development of many devices, or of systems thinking about the ecology of technologies, interoperability, or legacy systems.

“There is little evidence of user-centred design in the development of many devices, or of systems thinking -i.e., considering the ecology of technologies that an individual health professional is expected to use in their work, how those technologies interoperate, or how legacy systems are maintained or replaced.”

May combine two claims.

People's experiences of digital health technologies rely on their confidence in appropriate data privacy, safety from hacking, and ability to trust health information.

“People's experiences of digital health technologies rely on their confidence in appropriate data privacy (Valdez and Ziefle, 2019), in their safety from hacking (e.g.Dyer, 2017), and in their ability to trust health information (e.g.Sillence et al, 2006); these are areas in which substantial research has already been conducted but more is needed.”

• cites Valdez and Ziefle, 2019Not checked yet

  Not checked in the free run.

• cites Dyer, 2017Not checked yet

  Not checked in the free run.

• cites Sillence et al, 2006 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S2 (checkable).

There is significant scope for improvement in the usability, utility, safety and user experience of current health technologies, and in how they fit into individuals' lives and professionals' workflow.

“In the preceding sections, we have seen that there is significant scope for improvement in the usability, utility, safety and user experience of current health technologies , and in how they fit into the lives of individuals and the workflow of professionals.”

Probably not a substantial claim: may not pass S2 (checkable).

There are substantial difficulties in making health technology more suitable and empowering for both health professionals and patients.

“From a user perspective, there are significant challenges in making health technology more fit for purpose and empowering, to health professionals and patients alike.”

• AssumptionRests on an assumption: Healthcare systems are complex.

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Often, particularly where advances are technology-led, it is necessary to focus initially on early adopters and develop a strategy for diffusion; this has rarely been a focus for HCI research.

“Often, particularly where the advances are technology-led, it is necessary to focus initially on early adopters within the target community and develop a strategy for diffusion of the innovation; this has rarely been a focus for HCI research.”

May combine two claims.

Based on a survey, people's reported acceptance of mHealth apps was high, but their reported engagement with such apps for managing their clinical condition was low.

“Based on a survey on attitudes to diabetes apps, Conway et al (2016) report that although people's reported acceptance of mHealth apps was high, their reported engagement with such apps for managing their clinical condition was low.”

• cites Conway et al, 2016 sourceNot checked yet

  Not checked in the free run.

May combine two claims.

For chronic conditions, people can become 'expert patients' through access to information and education programmes, though such programmes initially faced resistance from health professionals who perceived these patients as overly demanding.

“For chronic conditions, it is possible for people to become”

• cites Tattersall, 2002 sourceNot checked yet

  Not checked in the free run.

• cites Shaw & Baker, 2004Not checked yet

  Not checked in the free run.

May combine two claims.

The most successful digital interventions, with greatest penetration and positive impact, are likely to be those with a clinical champion, addressing a well understood problem.

“The most successful digital interventions, with greatest penetration and positive impact, are likely to be those with a clinical champion (Ingebrigtsen et al, 2014), addressing a well understood problem.”

• cites Ingebrigtsen et al, 2014 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based).

Digital health technologies can help people better understand and manage their own health and the health of others.

“I have highlighted many of the benefits of digital health technologies -from enabling people to live longer, healthier lives to empowering people to better understand and manage their own health and that of others.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

There is a necessary interplay between what is optimal in terms of user experience and clinical outcomes and what is technically feasible.

“There is a necessary interplay between what is optimal in terms of user experience and clinical outcomes (Figure 4) and what is technically feasible.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Funding mechanisms, care systems, health priorities, and access to technology resources vary from country to country and region to region, and these differences shape how digital health interventions are designed, fit into lives, and are integrated with care systems.

“Funding mechanisms, care systems, health priorities and access to technology (and other) resources vary from country to country and region to region.These differences shape the ways that digital health interventions are designed, fit into people's lives and are integrated with care systems.”

Probably not a substantial claim: may not pass S2 (checkable).

The domain of digital health technologies inherently depends on varied expertise and interdisciplinary collaboration.

“I have presented models that enable us to map out the”

Classified as probably not a substantial claim. May combine two claims.

The overall system is not designed; rather, components are designed and overall system effectiveness depends on implementation as an ongoing, evolving process of 'muddling through' and co-design.

“In other words, the overall system is not designed; rather, components are designed and the key to overall system effectiveness is in the implementation, which is an ongoing and evolving process of”