Human factors approach to evaluate the user interface of physiologic monitoring
Abstract
Background As technology infiltrates more of our personal and professional lives, user expectations for intuitive design have driven many consumer products, while medical equipment continues to have high training requirements. Not much is known about the usability and user experience associated with hospital monitoring equipment. This pilot project aimed to better understand and describe the user interface interaction and user experience with physiologic monitoring technology.Design This was a prospective, descriptive, mixed-methods quality improvement project to analyze perceptions and task analyses of physiologic monitors.Methods Following a survey of practice patterns and perceived abilities to accomplish key tasks, 10 voluntary experienced physician and nurse subjects were asked to perform a series of tasks in 7 domains of monitor operations on GE Monitoring equipment in a single institution. For each task analysis, data were collected on time to complete the task, the number of button pushes or clicks required to accomplish the task, economy of motion, and observed errors.Results Although 60% of the participants reported incorporating monitoring data into patient care, 80% of participants preferred to receive monitoring data at the point of care (bedside). Average perceived central station usability is 5.3 out of 10 (ten is easiest).Conclusions High variability exists in monitoring station interaction performance among those participating in this project. Alarms were almost universally silenced without cognitive recognition of the alarm state. Education related to monitoring operations appeared largely absent in this sample. Most users perceived the interface to not be intuitive, complaining of multiple layers and steps for data retrieval. These clinicians report real-time monitoring helpful for abrupt changes in condition like arrhythmias; however, reviewing alarms is not prioritized as valuable due to frequent false alarms. Participants requested exporting monitoring data to electronic medical records. Much research is needed to develop best practices for display of real-time information, organization and filtering of meaningful data, and simplified ways to find information.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Although electronic applications in health care have been implemented for more than a decade, usability-efficient, effective, and safe use of technology-is still not fully optimized for clinical use.
“Although the implementation of electronic applications in health care dates back more than a decade, usability—referring to the efficient, effective, and safe use of technology—is still not fully optimized for clinical use [36,37].”
From Clinical requirements of future patient monitoring in the intensive care unit: qualitative study (2019) · cites this paper as [36]
Cites
(1932) · Medical Entomology and Zoology · Cited by 9,568 · see citing works
A mathematical model of the finding of usability problems
Nielsen, J., & Landauer, T. K. (1993) · Proceedings of the SIGCHI conference on Human factors in computing systems - CHI '93 · doi:10.1145/169059.169166 · Cited by 1,961 · see citing works
Drew, B. J., Califf, R. M., Funk, M., Kaufman, E. S., Krucoff, M. W., Laks, M. M., Macfarlane, P. W., Sommargren, C., Swiryn, S., & Van Hare, G. F. (2004) · Circulation · doi:10.1161/01.cir.0000145144.56673.59 · Cited by 609 · see citing works
Self-citation
Flagged first, then by citations
1 of the 4 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Clinical requirements of future patient monitoring in the intensive care unit: qualitative study
Poncette, A.-S., Spies, C., Mosch, L., Schieler, M., Weber-Carstens, S., Krampe, H., & Balzer, F. (2019) · JMIR Medical Informatics · doi:10.2196/13064 · Cited by 136 · see citing works
Interdisciplinary collaboration between nursing and engineering in health care: A scoping review
Zhou, Y. M., Li, Z., & Li, Y. (2021) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2021.103900 · Cited by 96 · see citing works
Wronikowska, M. W., Malycha, J., Morgan, L. J., Westgate, V., Petrinic, T., Young, J. D., & Watkinson, P. J. (2021) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.13582 · Cited by 59 · see citing works
Flohr, L., Beaudry, S., Johnson, K. T., West, N., Burns, C. M., Ansermino, J. M., Dumont, G. A., Wensley, D., Skippen, P., & Gorges, M. (2018) · IEEE Journal of Translational Engineering in Health and Medicine · doi:10.1109/jtehm.2018.2812162 · Cited by 44 · see citing works
Patient characteristics associated with false arrhythmia alarms in intensive care
Harris, P., Zègre‐Hemsey, J. K., Schindler, D. M., Bai, Y., Pelter, M. M., & Hu, X. (2017) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s126191 · Cited by 42 · see citing works
Self-citationPoncette, A.-S., Mosch, L. K., Stablo, L., Spies, C., Schieler, M., Weber‐Carstens, S., Feufel, M. A., & Balzer, F. (2021) · JMIR Human Factors · doi:10.2196/30655 · Cited by 32 · see citing works
Postoperative ward monitoring – Why and what now?
Khanna, A. K., Ahuja, S., Weller, R. S., & Harwood, T. N. (2019) · Best practice & research. Clinical anaesthesiology · doi:10.1016/j.bpa.2019.06.005 · Cited by 32 · see citing works
Kwok, Y.-T., Mah, A. P., & Pang, K. M. C. (2020) · BMC Health Services Research · doi:10.1186/s12913-020-05356-6 · Cited by 28 · see citing works
Li, B., Yue, L., Nie, H., Cao, Z., Chai, X., Peng, B., Zhang, T., & Huang, W. (2023) · International Journal of Nursing Sciences · doi:10.1016/j.ijnss.2023.12.008 · Cited by 27 · see citing works
Understanding heart rate alarm adjustment in the intensive care units through an analytical approach
Fidler, R., Pelter, M. M., Drew, B. J., Arroyo-Palacios, J., Bai, Y., Stannard, D., Aldrich, J. M., & Hu, X. (2017) · PLoS ONE · doi:10.1371/journal.pone.0187855 · Cited by 19 · see citing works
Self-citationUsability Evaluation of a Co-created Big Data Analytics Platform for Health Policy-Making
Cleland, B., Wallace, J. G., Bond, R., Muuraiskangas, S., Pajula, J., Epelde, G., Arrúe, M., Álvarez, R., Black, M. M., Mulvenna, M. D., et al. (2019) · Lecture notes in computer science · doi:10.1007/978-3-030-22660-2_13 · Cited by 15 · see citing works
Self-citationContribution of Electrocardiographic Accelerated Ventricular Rhythm Alarms to Alarm Fatigue
Suba, S., Sandoval, C. P., Zègre‐Hemsey, J. K., Hu, X., & Pelter, M. M. (2019) · American Journal of Critical Care · doi:10.4037/ajcc2019314 · Cited by 13 · see citing works
Self-citationAndrade, E., Quinlan, L. R., Harte, R., Reid-McDermott, B., Kirrane, F., Fallon, E. F., Kelly, M. A., Hall, T., Scully, M., Laffey, J. G., et al. (2023) · Applied Ergonomics · doi:10.1016/j.apergo.2023.103990 · Cited by 9 · see citing works
User Experience Study of the Patient Monitoring Systems Based on Usability Testing and Eye Tracking
Choi, H., & Jang, W. S. (2024) · Healthcare · doi:10.3390/healthcare12242573 · Cited by 8 · see citing works
Tillis, W. P., Bond, W. F., Svendsen, J. D., & Guither, S. (2017) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2016.0201 · Cited by 6 · see citing works
Rapid Review of the Application of Usability Techniques in Medical Equipment
Brandão, M. R., & Garcia, R. (2022) · World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany · doi:10.1007/978-3-030-70601-2_305 · Cited by 2 · see citing works
Fallon, C. K., Jefferson, B. A., & Andersen, E. S. (2022) · Resilience Week (RWS) · doi:10.1109/rws55399.2022.9984018 · Cited by 2 · see citing works
Pelter, M. M., Prasad, P. A., MORTARA, D. W., & Badilini, F. (2024) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2024.153777 · Cited by 1 · see citing works
Self-citationState of the Art and Future Trends in the Usability of Patient Monitors
Andrade, E., Quinlan, L. R., Harte, R., Byrne, D., Fallon, E. F., Kelly, M., O'Connor, P. E., O’Hora, D. P., Scully, M., Laffey, J. G., et al. (2018) · Advances in intelligent systems and computing · doi:10.1007/978-3-030-02053-8_52 · Cited by 1 · see citing works
Patterson, M., Bond, R., Mulvenna, M. D., Reid, C., McMahon, F., McGowan, P., McGarry, M., & Cormican, H. (2017) · Electronic workshops in computing · doi:10.14236/ewic/hci2017.22
Self-citationSex differences in intensive care unit electrocardiographic alarms
Pelter, M. M., & Hu, X. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-817728-0.00053-x
Self-citationLiu, L., Sheng, S., Xu, W., & Man, S. S. (2026) · Safety Science · doi:10.1016/j.ssci.2026.107394
- Authors
- Fidler, R., Bond, R., Finlay, D., Guldenring, D., Gallagher, A., Pelter, M., Drew, B., & Hu, X.
- Affiliations
- San Francisco VA Medical Center (US)
- University of Ulster (GB)
- University of California, San Francisco (US)
- Corresponding author
- Fidler, Richard
- ORCID
- Venue
- Journal of Electrocardiology
- Publisher
- Elsevier BV
- Published
- 2015-11
- Volume
- 48
- Issue
- 6
- Pages
- 982-987
- ISSN
- 0022-0736 (ISSN-L)
- OpenAlex
- W2117088313
- Cited by
- 23
- References
- 4
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 2 · 2017: 4
- FWCI
- 2.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Electrocardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Healthcare Technology and Patient Monitoring
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Physical Sciences › Computer Science › Human-Computer Interaction › Usability and User Interface Design
- Keywords
- physiological monitoring, user interface usability, user experience, task analysis, alarm management, false alarms, bedside monitoring, electronic health records, clinician training, human factors
- MeSH terms
- Adult, Aged, Clinical Competence, Consumer Behavior, Female, Humans, Ergonomics, Male, Man-Machine Systems, Middle Aged, Monitoring, Physiologic, Pilot Projects, United States, User-Computer Interface, Clinical Alarms
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
