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Interaction DesignEnhance the Usability of Touch Screen forIntensive Care Ventilators
Chong You Lechongyoule@gmail.comInteraction Design Programme - MA1Autumn Term
You Le, Chong Interaction Design Programme - MA1
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Table of Content 1. Project Overview �
�. Approaches and Methodology 3
3. Chaotic Environment in Intensive Care Unit 4
4. Problem Identification 5
5. Interation Between Human and Machines 6
6. Physical Interfaces and Vitual Interfaces Analysis 7
7. Design Solutions 11
8. Summary 15
9. Acknowledgements 15
10. References 16
ProjectOverview
My aim with this project is to enhance the usability of ventilators touch screen display through problem solving approaches.
I utilize human sensory systems into my studies and designs which are inspired by the Sensorial Quality Assessment Method (SEQUAM)(L. Bonapace, 2002.) The sensory systems are vision, hearing, somatic sensation (touch), taste and olfaction (smell) as feedback or response to the users. On the other hand, I also explore the functional potential of a ventilators touch screen display beyond its existing functions especially for the used in the Intensive Care Units.
The proposed design is focusing on the primary users, the medical personnel who operate the ventilators in the Intensive Care Unit yet taking into consideration of the comfort of the secondary users who are the patients and the family members. Ultimately, this could help to draw a closer the relationship between the primary and secondary users rather than being separated by the machine.
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Approaches and Methodology
This project had been divided into 2 major session. In the first phase of the project, the project approaches were to obtain a deeper understanding of an Intensive Care Ventilator and the man-machine interaction in it. On the second part of the projects, each individual selected their own focus and dive in to another research phase, which is Research 0�.
Research 01Collect InformationAnalysis
Identify ProjectScopeAnalysis
Final DesignDesign Refinement
Research 02Collect InformationAnalysis
Initial DesignIdeationUser Testing
In the first part of the project, to obtain a deeper understanding of an Intensive Care Ventilators, we had gone through some brochures from Maquet, browsing through internet about other existing ventilators, and also trying out a few ventilators in the hospital. We had implemented the Heuristic Evaluation in our analysis.
On the other hand, we had visited the Noorlands Universitisjukhus, Intensive Care Units and interviewed a few nurses there to get an overview of the working environment in Intensive Care Units. Observations are also carried out in the same time.
In this project, emphasis is also put on the users themselves. There are more than one user involved in this product. There are primary user, who operated the machines and the secondary users who are the patients and the family members. A few interviews had been carried out to obtain the users experience with the products.
In the second phase of the research, each of us had selected a certain area to zoom in and I had decided to approache this project through enhancing the usability of touch screen in ventilator. In my studies, I had utilised the Sensorial Quality Assesement Methods (SEQUAM), by L. Bonapace 2002 to analyse the feedback of physical interfaces and virtual interfaces.
I had carried out a few observations on users manipulating physical interfaces and virtual interfaces in different products and situations. Through these studies, I had manage to identify the pros and cons about touch screens. A few users testing had been carried out to verify the usability of touch screens too.
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ChaoticEnvironmentIn IntensiveCare Unit
Intensive Care Medicine or critical care medicine is a branch of medicine concerned with the provision of life support or organ support systems in patients who are critically ill who usually also require intensive monitoring. It Is a �4 hours operating environment. Some ICUs allow family members to visit �4 hours a day and some do not. The operating system in each ICU depends on each hospital organisation.
Family members who visited the ICU usually were terrified by the atmosphere. They are exposed to information which they are not familiar with and accepting the fact that, their loved one are in danger. Instead of giving the family members or friends a peaceful and quiet environment, ICU often seems chaotic with lots of medical personnel, machines, equipments, tubes, cables and other patients.
Most patients in ICU are separated with curtains due to space constrained and the medical personnel often need to tidy up or create a space for the family members and the patient.
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There are various problems that were identified during our studies. From this point, I have decided to focus in the following areas:
1. Primary Users – the trust of using touch screen a. Touch Screen Limitations i. Lack of sensitivity and accuracy ii. Slow reaction iii. No feedback iv. Not as good as the physical button especially the knob
�. Chaotic Environment In Intensive Care Unit The relationship between Medical personnel, Family members, Patients , and Machines i. Alarms and discussions disturb the patients and family members ii. Crowded ICU
ProblemIdentification
no obvious grouping
spacing in between all displayed info & settings
some data areway too small
Display
too much information need to be displayed in the same time
Settings
touchscreenfeedbacks are too mild
no obvious feedback
no clear display
lack of sensitivityon touchscreen
Screens & Displays
Transportation
Hard tomanouver
too heavy* needed � people to
move the ventilators around
Environment
Scarymachines
ICU looks scary with allthe machine surrounding
the patients
The cables & tubesare hanging all over the patients
and lie on the floor of the ICU
messy
limited space & crowded
family members & friendsneeded some private time with
the patient
task needed to be done by the nurses, be-fore allowing the patient into the ICU
1. Clear the patients room�. Put some chairs for them
3. Close the curtains
too many machines
Users
Medicalpersonnel
different usergroups
professionalor beginner
technology ornot technology
refering to both patient and the screen while do-
ing medical check up
no instructions
semantic looks of the machine - rather show
recovering but show how serious the patient are
alarms of the machine disturbing the patients
semantic looks of the machine - rather show
recovering but show how serious the patient are
some felt uncomfortable with the machine around them or their loved onesnot knowing how the ma-
chine works can be scary
Patient
Family &friends
ProblemIdentification
Problem Identification
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The second part of the research approache is inspired and influenced by Sensorial Quality Assessment Method (SEQUAM), by L. Bonapace 2002. In her studies, she mentioned about human perceptions in products design and I have adopted the same thinking and implemented into my studies.
The five senses that I am referring to are hearing, touching, seeing, tasting, and smelling. In this part of the studies, I try to identify the differences in both physical and virtual (touch screen) interfaces and how users perceived them while using them. The most frequent senses that are perceived in user interfaces are touch, vision and hearing. Touch Sensory is one of the important senses, users experience more than just tactile senses, but also biomechanics strength and thermal senses through it.
For example:
InteractionBetweenMan and Machine
the user hears the mechanical “tak” sound generated by the button when it was pressed.
the finger felt the travel distance when the but-ton is pressed.
the button lights upindicating the machine is working
the sound ofboiling water
fingers feeling thebuttons
the smell ofcoffee
Interaction between Man - Machine
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Action EffectThe knob is turning with the pointer
Feel the knob turning
Heater Knob
When it reaches maximum temperature, it cannot be turned.
Mobile Phone Keypad
The keypad looks like it is depressed and released
Feel the button depressed andreleased
Hear both mechanical and keytone from the phone
The screen displayed and highlight selected items accordingly
Kettle
The toggle switch was push downwards
The displacement of fingers before and after switching On
When the switch hit on the toggle, it stop and generated a “TAK” sound.
When the power On the switch lights up
Laptop wireless switch
The On/Off switch seems depressed and released
Feel the switch depressed andreleased
Hear both mechanical sound from the buttons
The Wireless Icon LED lights up
Stove
The knob turn accordingly following the hand motion
Feel the knob rotating accordingly and the frictions against it
Hear some mechanical sound
The LED lights up
PhysicalInterfacesAnalysis
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Significant differences between Physical Buttons and Touch Screen:
1. Biomechanics Strength Feedbacks • The need of apply pressure onto a physical buttons. • Newton’s Third Law of Motion - For every action there is an equal and opposite reaction.
�. Tactile Feedbacks • The friction between the user’s finger and the button (e.g. laptop touch pad)
3. Speed of Feedbacks • The immediate feedbacks in terms of visual and auditory. • There is no delay compare to Touch Screen
4. Three (3) senses feedbacks on every event • Visual feedback • Auditory feedback • Tactile or Biomechanics Feedbacks
Visual feedback • Physical buttons (e.g. depress and release) • Indicators lights (e.g. Power On LED) • LCD display (e.g. Highlighted selected items)
Auditory Feedback • The mechanical sound from the buttons when the user clicks • The artificial sound from the speaker to indicate the confirmation of clicking (e.g. mobile phone dialing keypad)
Tactile or Biomechanics Feedbacks • The travel distance before and after the button was pressed. (e.g. depress and release) • The friction between the finger and the surface (e.g. touchpad) • The force to push the button down • The bounce back reactions from the buttons • The feeling of turning the knob.
Physical InterfacesFeedbacks
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VirtualInterfacesAnalysis
Touch Screens are widely used in various products as Input devices to replace physical buttons. It can be operated directly using fingers or with a stylus.
During DoneThe virtual keyboard seems depressed and released
No feedback
No feedback
TouchScreen KeyboardAlphabets appeared accordingly on the screen
SelectionThe button highlighted
No feedback
No feedback
Key in Number
The button highlighted
The phone vibrates each time the user key in a new digit
Hear keytone each time the user key in a new digit
Numbers appeared accordingly on the screen
Key in using Stylus
The keyboard is highlighted when the user press on it.
No feedback
No feedback
Alphabets appeared accordingly on the screen
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Advantanges
Studies had shown that touch screens had very significant advantages and disadvantages
• Programmable interface allows for greater diversity • Utilizes natural abilities of user • Requires no additional desk space• Durability • Direct manipulation of objects or cursor • Cost efficiency
Disadvantanges • Slower alphanumeric data entry • Less accuracy (more errors) • Finger may obstruct view of object on screen • Fatigue • Sitting/Standing position: The user has to sit/stand close to the screen. • Dirt: The screen gets dirty from finger prints. • Screen coverage: The user’s hand, the finger or the pen may obscure parts of the screen. • Activation: Usually direct activation of the selected function, when the screen is touched; there is no special “activation” button as with a light pen or a mouse.
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DesignSolutions
Servo-Tablet, a detachable and portable Touch Screen display for Intensive Care Ventilator. It allows users to move freely and yet keep track on their responsibilities. Built-in Bluetooth™ allowed Servo-Tablets to be cloned into multiple screens and enhance information sharing among different users.
Servo-Tablet
New Technology By incorporating the Immersion and 3M MicroTouch Capacitive TouchSense System (Tactile Feedback Enhancement System) into the product and implementing the SEQUAM design approaches, Servo-tablets went beyond ordinary tablets, and successfully increased the reliability and trust of touch screens in every user.
Immersion and 3M introduced the MicroTouch Capacitive TouchSense System with Tactile Feedback using integrated with 4 actuators on the screen.
When the user touches the screen, a signal is sent to the touchscreen controller, which supplies information on the precise screen location where contact was made. This locationinformation is sent to the host application, which commands the TouchSense controller to play a specified tactile effect.
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The TouchSense® system can be integrated into most touchscreen designs to provide tactile feedback using these elements: • Electromagnetic actuators, which are attached to the touchscreen carrier during assembly • Touchscreen carrier design guidelines, to ensure maximum energy transfer from the actuators • Tactile feedback controller, with serial or USB communications • Software development kit, for fast integration of tactile feedback into your application software
References : http://solutions.3m.com/wps/portal/3M/en_US/
3MTouchSystems/TS/News-Events/PressReleases/?PC_7_0_3R53_assetId=1114310734448
(14.11.2006)
Status Indicators LightPower OffPower OnAlarm/ AlertLight Sensor
Display & Touch Screeen Active Area Speakers
Front View Back View
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40 cmH2O
70 l/min
-70 l/min
700 ml
15RR (b/min)
30
5
39O2 (%)
I:E 1:2:0
45
35
450
7.0MVe (l/min)
40.0
5.0
VTi(ml)
465VTe(ml)
24Ppeak (cmH20)
Pmean(cmH20)
40
11PEEP(cmH20) 5
Mode Of Ventilation Automode Nebulizer StatusAdmitPatient
Additionalsettings
PEEP
5cmH2O
Resp. Rate
30b/min
O2 Conc
39%
Tidal Volume
5ml
15RR (b/min)
30
5
39O2 (%)
I:E 1:2:0
45
35
450
7.0MVe (l/min)
40.0
5.0
VTi(ml)
465VTe(ml)
24Ppeak (cmH20)
Pmean(cmH20)
40
11PEEP(cmH20) 5
Nebulizer StatusAdmitPatient
O2 Conc
39%
Tidal Volume
5ml
AP
Design Considerations
1. Same colours usage in graphs, figures and buttons indicate relativity between them.�. Contrast Colours for better viewing.3. “Dim off” inactive buttons to avoid confusions4. High Contrast in line thickness, font sizes, and colours are for better viewing.5. Using the Knob to insert the value.6. Giving signals and alerts in terms of visual and auditory feed- back on limits settings and error.7. All buttons design simulate physical buttons being press down and also incorporating auditory feedbacks and tactile enhancement system to better usability.
Servo TabletUser Interface
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DesignSolution(Scenarios)
The screen can be placed regularly like the existing ventilators, but this time, with a 17” touch screen that is integrated with the
built-in Touch Sense System .
The screen can be detached from the ventilators for easy viewing. With this function, the medical personnel can view at both patients and the screen in the same time.
When the patients’ family members or friends visited them, they would had their own private place, with the curtain closed.Now, with this portable screen, the medical personnel can still monitor the patients’ through the Bluetooth paired screen.
The Touch Screens also function as a portable module that can be used among medical personnel to view all functioning machines, by selecting the patient name and the data to be viewed. By doing so, most discussion can be carried outside the room or away from the patient.
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Working with 5 senses in usability design had given me a brand new perspective in interfaces design. I’ve learn not only how each users perceived through their senses but also learn that, by mimicking the physical interfaces feedbacks help to im-proved the usabilty.
Since users can experience product in their true senses, it opened out more opportunities for us to improve the usability of virtual interfaces. Maybe, feedbacks on virtual interfaces can go beyond the 3 senses, but also through smell and taste.
This approach might also help to enhance usability for the handicaps who had lost some of their senses. But, when, where and what are the appropriate feedbacks to be implemented still need lots of explorations and studies.
Summary
I would like to thank Maquet for providing us this golden op-portunities to carry out this project. Special thanks for Karin Blomquist, Kent Lindberg, Johan Bergvall, Nils Eric, Niklas Ander-son, Mike Scott, Annelise Muller and the other technical person-nel from MTI who had given myself and the class such a won-derful tutoring and guidance.
Nevertheless, I would like to give a special mention to all my coursemates and the student of umea who had participated during the project giving constant feedbacks and making this project a very enjoyable experience.
Acknowledgements
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Videoshttp://www.youtube.com/watch?v=FQIVv4b2jOI (10.11.2006)http://www.youtube.com/watch?v=rFU2Z3k9w0Q (10.11.2006)http://www.youtube.com/watch?v=qQjPEslrR0E (10.11.2006)
BooksPleasure with Products: Beyond Usability by William s. Green and Patrick W. Jordan 2002, Chapter 15, Sensorial Quality Assessment Method (SEQUAM) (L. Bonapace �00�)
Webpageshttp://psychology.wichita.edu/surl/usabilitynews/�w/touchscreen.htmhttp://www.sapdesignguild.org/resources/TSDesignGL/Index.htmhttp://solutions.3m.com/wps/portal/3M/en_US/3MTouchSystems/TS/News-Events/PressReleases/?PC_7_0_3R53_assetId=1114310734448 (14.11.2006)http://solutions.3m.com/wps/portal/3M/en_US/3MTouchSystems/TS/News-Events/PressReleases/?PC_7_0_3R53_assetId=1114310734448 (14.11.2006)
Pictureshttp://www.whitememorial.com/content/images/rebuilding/move/ICU-transfer.jpghttp://www.hidakagh.gobo.wakayama.jp/kangobu/ICU-11.jpgwww.nabcoentrances.com/pricu2_092005.cfmhttp://www.whitememorial.com/content/rebuilding/move_photos.asphttp://healthlawblog.blogspot.com/uploaded_images/icu-736088.jpghttp://www.o6u.edu.eg/hospital/my%20webs/oct/Hospital%20images/icu.jpghttp://www.asada-hp.or.jp/byouin/setsubi/image/ICU.jpghttp://www.nankodo.co.jp/yomimono/kenshui/kabeya/icu.JPGhttp://www.mcg.edu/sah/pt/philosophy.htmlhttp://www.med.kyushu-u.ac.jp/ericu/index.php?plugin=ref&page=TOP&src=%B2%E8%C1%FC-ICU%B6%E1%C0%DC2.JPGhttp://www.russmed.com/icu.jpghttp://www.pref.saitama.lg.jp/A80/BA01/scrc/comedical/nurse/icu.htmhttp://www.nabcoentrances.com/pricu2_092005.cfmhttp://www.infocroatia.com/blog/wp-content/images/ICU-doctors.jpghttp://www.ncvc.go.jp/hsp/kango/icu/images/icu_00�.jpg
References