The development and evaluation of a user interface model for clinical IT systems in residential aged care

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Over the next two decades the Australian aged care system will experience increasing pressures to deliver quality care services for a rapidly ageing population. There is increasing evidence of best practice to suggest that IT systems have the potential to make significant contributions to the delivery of health services for older Australians by improving efficiency and safety of information on care. This includes the development of Clinical Information Technology (CIT) systems in aged care settings, which is generally considered to be lagging behind other industries in terms of IT adoption. With the increase of CIT systems in aged care, the care workforce will actively engage in the use of computers (many for the first time) to manage the delivery of care needs and services for residents in aged care facilities. This necessitates a detailed study on the usability requirements for the successful introduction of CIT systems in aged care and is the focus of this thesis. The study includes the development and evaluation of a user interface model, designed to support common clinical documentation tasks. It also assesses the capacity of the model to streamline key aspects of aged care documentation within a real-world context. A user-centred design approach was adopted for the study. Usability requirements were generated using a contextual inquiry process consisting of interviews with aged care nurses and survey as the method of data collection. A practical application of the user interface model was demonstrated in a 3-month field trial. The trial was conducted at a residential aged care facility in the inner-west region of Sydney, NSW. A total of 12 participants were observed during the trial. The findings indicated that, overall, the user interface model is suitable for older and less experienced computer users in performing clinical documentation tasks. At the same time a number of important issues were identified. These issues related to security, performance, and reliability factors. In many ways these issues impacted on the overall user experience. Although this study has focussed on the experiences of ill single residential aged care facility, similar studies report substantial benefits in the use of appropriate technologies in health care environments. Touch screens and mobile devices (e.g. tablet PCs, PDAs) offer innovative ways to support the management of clinical information at or near the point of care. Most interesting, is the possible application of touch screen, voice and handwriting recognition technologies to extend the proposed user interface model. The adoption of CIT systems in aged care that harness on these technologies can improve the management of information on care by streamlining clinical documentation tasks, particularly in comparison to paper-based methods.
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