ČeskévysokéučenítechnickévPraze–ČVUT

CzechTechnicalUniversityinPrague–CTUinPrague

Hospital waiting room management system for visually impaired people Master’s thesis

Albert Vilalta Riera

Thesis submitted to obtain

the degree of Master in Electrical Engineering

CTU in Prague supervisor

Ing. Miroslav Macík

UPC BarcelonaTech supervisor Ing. Antoni Elias, Ph.D.

AcademicYear2015-2016

ii

CzechTechnicalUniversityinPrague�FacultyofElectricalEngineering

©2016AlbertVilalta.Allrightsreserved.�� This thesis is schoolwork as defined by Copyright Act of the Czech Republic. It has been

submittedatCzechTechnicalUniversity inPrague,FacultyofElectricalEngineering.Without

writtenpermissionofthesupervisor(s)andtheauthor(s)itisforbiddentoreproduceoradapt

inany formorbyanymeansanypartof thispublication.Requests forobtaining theright to

reproduceorutilizepartsofthispublicationshouldbeaddressedtoCzechTechnicalUniversity

in Prague, Faculty of Electrical Engineering –Technicka 2, 16627Praha6 –Dejvice, Prague

(CzechRepublic).

A written permission of the supervisor(s) is also required to use the methods, products,

schematics and programs described in this work for industrial or commercial use, and for

submittingthispublicationinscientificcontests.

Citationofthisthesis:

Vilalta,Albert.Hospitalwaitingroommanagementsystemforvisuallyimpairedpeople.Master’s

thesis.CzechTechnicalUniversityinPrague,FacultyofElectricalEngineering,2016.

iii

Declaration

IherebydeclarethatthepresentedthesisismyownworkandthatIhavecitedallsourcesof

information in accordance with the Guideline for adhering to ethical principles when

elaboratinganacademicfinalthesis.

IacknowledgethatmythesisissubjecttotherightsandobligationsstipulatedbytheActNo.

121/2000Coll.,theCopyrightAct,asamended,inparticularthattheCzechTechnicalUniversity

inPraguehastherighttoconcludealicenseagreementontheutilizationofthisthesisasschool

workundertheprovisionsofArticle60(1)oftheAct.

InPragueon6thofMay2016

iv

Foreword

Iwould like to thankmyCTUsupervisor Ing.MiroslavMacık forhisusefulandalwaysready

advice,hishelpwiththe interviews,hispatienceandforthetimespentduringconsultations

andmeetings.

I alsowould like to thankmyUPC supervisor, Ing.AntoniElias, PhD. forhishelp andadvice

duringmystayabroad.

Finally,Iwouldliketothankmycolleaguesinthisproject,Mrs.EvaLorencovaandMr.Tomas

Flek, for theirpatienceandhelpwithmy lackofCzech languageknowledgeandtheiralways

goodmannersduringtheteamworksessions.

AlbertVilaltaRiera

v

TableofContents

Declaration iiiForeword ivTableofContents vAbstract viiiResum ixListoffigures xiListofabbreviationsandsymbols xiiChapter1:Introduction 1Motivationandgoals 2Structureofthethesis 3

PartI:Analysis 4Chapter2:Hospitalnavigationsystem 52.1Stateoftheart 52.1.1Navigationsystems 52.1.2Authenticationtechnologies 12

2.2In-hospitalnavigationsystem 132.2.1Webapplicationforvisitpreparation 132.2.2Mainentrancekiosk 142.2.4Interactivehapticmap 142.2.4Simplenavigationterminal 14

2.3Conclusions 15Chapter3:Userresearch 163.1Hospitalfieldstudyreport:FakultnıNemocniceMotol 163.1.1FNMotol’sdescription 163.1.2Navigationthroughhospital 16

3.2Userinterviews 213.2.1Proposedquestionstotheparticipants 21

3.3Otheruserresearch 223.4Statisticaldata 243.5Persona 243.5.1Profileanddescription 25

3.6Userneeds 263.6.1VIPneeds 263.6.2Hospitalstaffneeds 26

vi

3.7Conclusions 26PartII:Design 27Chapter4:ScenariosandHTA 284.1Scenarios 284.1.1Scenario1:Terezafeelslost 284.1.2Scenario2:Terezadoesn’tarrivewithintheexpectedtime 294.1.3Scenario3:Terezagoestothewrongwaitingroom 304.1.4Scenario4:Terezawantstoleave 304.1.5Scenario5:Terezagoestothecorrectwaitingroom 30

4.2Hierarchicaltaskanalysis 324.3Conclusions 33

Chapter5:Solutiondesign 345.1Requirements 345.1.1Functionalrequirements 345.1.2Non-functionalrequirements 35

5.2Initialdesign(low-fidelityprototype) 355.2.1Waitingroomkiosk 365.2.2Waitingroomseats 495.2.3Directionalkiosks 495.2.4Hospitalstaffdevice 49

5.3Conclusions 50PartIII:Implementation 51Chapter6:Solutionimplementation 526.1Firstimplementation(high-fidelityprototype) 526.1.1Goaloftheprototype 526.1.2Usedtechnologies 526.1.3Implementation 53

6.2Conclusions 54PartIV:Evaluation 55Chapter7:Usabilitytesting 567.1Tasks 577.1.1Task1:tofindafreeseat 577.1.2Task2:togototheexit 577.1.3Task3:togotoanotherwaitingroom 587.1.4Task4:torequestassistance 587.1.5Task5:tochangethelanguage 58

7.2Lowfidelityprototypeevaluation 58

vii

7.2.1Participants 587.2.2Procedure 597.2.3Findings 59

7.3Highfidelityprototypeevaluation 607.3.1Participants 607.3.2Procedure 607.3.3Findings 61

7.4Redesignsuggestions 627.5Conclusions 63

Chapter8:Conclusions 64Futurework 66

Appendices 67AppendixA:Userresearchinterviews 68A.1InterviewtoparticipantI 68A.2InterviewtoparticipantII 70A.3InterviewtoparticipantIII 71

AppendixB:Evaluationtasksofthelowfidelityprototype 72B.1ParticipantI 72B.2ParticipantII 73B.3ParticipantIII 74

AppendixC:Evaluationtasksofthehighfidelityprototype 75C.1ParticipantI 75C.2ParticipantII 76C.3ParticipantIII 77C.4ParticipantIV 78C.5ParticipantV 79C.6ParticipantVI 80C.7ParticipantVII 81

Bibliography 82

viii

Abstract

Navigatinginsidelargebuildingssuchasgovernmentofficesorhospitalsisoftenconfusing

evenforpeoplewithnoorientationdifficulties.Imaginehowhardcanitbeforvisuallyimpaired

people:thelackofadaptedpresentationofinformationandthefrequentobstaclesontheway

are true challenges for them. In a hospital environment, where stress and unpleasant

circumstancesappear,navigationcanbeevenmorechallenging.

Theaimofthisthesisistostudyvisuallyimpairedpeople’sneedswithinthatenvironment,

concretely regarding hospital waiting rooms, and design a management system for it. The

designedsystemwillbepartofacomplexin-hospitalnavigationsystemthatexpectstosatisfy

peoplewithorientationdifficulties’needs.Themethodologywefollowisthecommononefor

anyengineeringprocess:studytheneeds,designaprototypeandevaluateit.

Thisthesisreachesitsendaftertheevaluationofthehighfidelityprototypeiscompleted.The

proposedprototype is able toperform likea realwaiting roomkiosk fromavisual impaired

person’sperspective: it informspatientsout loudabout their turnnumber,waiting timeand

doctor’soffice.Italsohelpsthemtofindafreeseatinthewaitingroom,tonavigatetospecific

locations such as toilet or cafeteria and to ask for assistance if needed. Participants of the

evaluation session are able to use the prototype for their purposes successfully and the

proposedsolutioncanbeeasilyassimilatedbythecomplexin-hospitalnavigationsystem.

Keywords

Hospital, in-hospital navigation system, navigation, orientationdifficulties, visually impaired,

waitingroom.

ix

Resum

Lanavegaciodinsd'edificisgrans,comaraoficinesdel’Administracioohospitals, essovint

confusa fins i tot per a persones sense problemes d'orientacio. Imagineu com de difıcil pot

arribar a ser per a persones amb discapacitat visual: la manca d’informacio adaptada i els

frequentsobstaclesenelcamısonveritablesdesafiamentsperaells.Enunentornhospitalari,

onlescircumstanciesnoacostumenaseragradablesionapareixl’estres,lanavegaciopotser

unatascaencaramescomplicada.

L'objectiud'aquestatesi esestudiar lesnecessitatsde lespersonesambdiscapacitatvisual

dins d'aquest entorn, concretament pel que fa a les sales d'espera d’hospital, i dissenyar un

sistemaperagestionar-les.Elsistemadissenyatformarapartd'unsistemadenavegaciodins

d’hospitals complexques'esperaquesatisfaci lesnecessitatsde lespersonesambdificultats

d'orientacio.Lametodologiaqueseguimesl’habitualenqualsevolprocesd'enginyeria:estudi

delesnecessitats,dissenyd'unprototipiavaluaciodelprototip.

L’abast d’aquesta tesi es, per tant, l’avaluacio d’un prototip d'alta fidelitat. El prototip que

finalment es proposa es capaç de funcionar realment com el quiosc d’una sala d'espera

d’hospitaldesdelaperspectivad'unapersonaambdiscapacitatvisual:informaelspacientsen

veualtasobreelseunumerodetorn,eltempsd'esperaisobrequinaeslaconsultadelseumetge.

Tambeelsajudaatrobarunseientlliure,adesplaçar-sefinsaindretsespecıfics,comaralavabos

ocafeteria,iademanarajudasical.Elsparticipantsdelasessiod'avaluaciosoncapaçosdefer

servirelprototipperalsseuspropositsambexitilasolucioproposadaesfacilmentintegrable

enelcomplexsistemadenavegaciodinsd’hospitals.

Paraulesclau

Hospital,sistemadenavegaciodinsd’hospitals,navegacio,dificultatsd'orientacio,discapacitat

visual,salad'espera.

x

xi

Listoffigures

Figure1:Panasonicwirelesspager,from[3] 6Figure2:3DCommunicationNaviSystem,from[4] 6Figure3:LogicJunctionkiosk,from[5] 7Figure4:AliceHospital’s3DNavigationSystem,from[7] 8Figure5:ConceptualdesignoftheKUHNavigationSystem,from[8] 8Figure6:MayoClinicPatientsApp,from[9] 9Figure7:Spreo’sNavigationApp,from[10] 10Figure8:Navigationprocedurewithproposedsystem,from[14] 13Figure9:Simplenavigationterminalprototype 15Figure10:InteractionprocedurewithS.N.T.,from[14] 15Figure11:MainentrancemapatFNMotol 17Figure12:GuidelinesatFNMotol 17Figure13:ManualdoorsatFNMotol 18Figure14:KioskandsignsatFNMotol 19Figure15:LiftbuttonsandsignsatFNMotol 19Figure16:LiftbuttonswithbraillelabelsatFNMotol 20Figure17:Motol’swaitingroomscreen 20Figure18:Experiencemapsection 22Figure19:Scenariosdiagram 31Figure20:HTAdiagram 32Figure21:Sketchofwaitingroomkiosk 36Figure22:WRkiosk,Buttonpad 37Figure23:WRkiosk,Standbyscreen 38Figure24:WRkiosk,loadingscreen 39Figure25:WRkiosk,Mainmenuscreen 40Figure26:WRkiosk,Findafreeseatscreen 40Figure27:WRkiosk,Acousticbeaconactivatedpop-up 41Figure28:WRkiosk,WhereamI?screen 42Figure29:WRkiosk,Navigatetoanewdestinationscreen 42Figure30:WRkiosk,Predeterminednewdestinationscreen 43Figure31:WRkiosk,Onyourwayscreen 44Figure32:WRkiosk,Scheduledvisitsscreen 44Figure33:WRkiosk,Chooselanguagescreen 45Figure34:WRkiosk,Languagechangedpop-up(inCzech) 45Figure35:WRkiosk,ChooselanguagescreeninCzech 46Figure36:WRkiosk,Requireassistancescreen 46Figure37:WRkiosk,Assistancerequiredpop-up 47Figure38:WRkiosk,WrongWRscreen 48Figure39:Hospitalstaffdevice,Alertnotificationscreen 49Figure40:Hospitalstaffdevice,Alertstatusscreen 50Figure41:Thethreepartsoftheusertestingenvironment 61

xii

Listofabbreviationsandsymbols

VIVisualimpairmentVIPVisuallyimpairedpersonSPSeniorpersonWRWaitingroomFRFunctionalrequirementNFRNon-functionalrequirementCTUCzechTechnicalUniversityinPrague

1

Chapter1:Introduction

Visiting a hospital is usually a stressful experience.Often, reasons for going to a

hospitalareconnectedtonegativeevents.Inadditiontothat,itisquitecommontoget

confusedwiththedirectionsandsigns.Ifweaddlongwaitingtimesandtheusuallack

ofproperinformationaboutthemtothis, frustrationamongpatientsandvisitors is

perfectlyunderstandable.

Clearly,oneoftheusergroupsthatarechallengedthemostalltheseissuesarethe

visuallyimpairedpeople.Theyhaveadditionalproblemswithorientationandtheyare

speciallychallengedwiththelackofadaptedpresentationofinformation.

According toGroteetal. [1], “Patientsandphysiciansaremoreandmore likely to

base their choice of hospital on nonclinical aspects of a visit –like convenience and

amenities”.Nevertheless,“fewhospitalsactsystematicallytounderstandwhatpatients

valueinthenonclinicalaspectsoftheirhospitalvisitsorhowandwhenhospitalsshould

invest tomeet theirexpectations.Mosthospitalexecutivesbelieve that it isenoughto

address the experience of patients by measuring and raising their satisfaction and

resolvingtheircomplaints.Hospitalsneedtodomore.”

Inthiscontext,thisworkattemptstoimprovethehospitalvisitingexperiencewhile

paying special attention to people with orientation difficulties such as visually

impaired people or seniors. This general objective is too complex and indistinct to

addressitassubjectofasingleMaster’sthesis.Oureffortsarejoiningabiggerproject

whose goal is to design a complex hospital navigation system for people with

orientationdifficulties.Intheparticularcaseofthepresentwork,weputthefocuson

thewaitingroomexperiencewhenitconcernstovisuallyimpairedpeople.Wewant

thisuser group tobeable tovisit ahospitalwith complete independenceand self-

confidence.

2

Motivationandgoals

Imaginethatavisuallyimpairedpatientisvisitingthehospital.Heorshemighthave

severalorientationproblems.Firstly, thepaththroughout thehospitalcanbereally

confusing. Secondly, once in awaiting roomwith aqueuemanagement system, the

patientmightbeunable to read thescreenandknowwhenhisorher turnarrives.

Thirdly,thepatientmighthavesomeproblemsinordertofindafreeseattowaitfor

hisorherturn.Andlastly,thehospitalstaffmighthavesometroubleswhiletryingto

identifythosepatientswithspecialneeds.Oursystemisgoingtosolvethesekindof

problems by installing navigation kiosks with facial recognition all around the

hospital.

Inordertoachieveourgoals, it isneededtoestablishasetofobjectivesthatwill

guideourpaththroughoutthesearchofasolutiontotheproblem.Theseestablished

objectivescanbelistedasfollows:

1. Tostudyandunderstandthestateoftheartinhospitalnavigationsystems.2. Toanalysetheuserneeds.3. Tostatethesystemrequirementsaccordingtotheseneeds.4. Toproposeadesignfulfillingthestatedrequirements.5. Toimplementandevaluateahigh-fidelityprototypeofthesolution.6. Tostatefuturedeveloperdocumentation.

Thesegoalsaretheessentiallythesameforanyengineeringprocessandtheyare

importantinordertofollowascientificmethodology.Butweneedtostategoalsmore

closelyrelatedtoourparticularsubjectifwewanttodefinethepurposeofthisthesis:

7. To help visually impaired people to understand information displayed in ahospitalwaitingroom.

8. Toimprovevisuallyimpairedpeople’sexperienceinahospitalwaitingroomby,for example, helping them to find a free seat or navigating them to specific

locationssuchastoiletorcafeteria.

9. Tomakevisuallyimpairedpeopleindependentfromotherpeoplewhiletheyareintheirwaytothewaitingroomandinthere.

10. Todesignawaitingroommanagementsolution integrated in thecomplex in-hospitalnavigationsystem.

3

Structureofthethesis

Thisthesisisformedbyfourpartsthatrepresentthefourstagesofanyengineering

process.

Thefirstpartistheanalysis,inwhichtheproblemanditsenvironmentisdefinedin

ordertostatetheneedsthatoursolutionwilltrytosatisfy.Itisformedbytwochapters

calledHospitalnavigationsystemandUserresearch.Thefirstoneincludesanoverview

of thestateof theart innavigationsystems(goal1)andacontextualisationof this

thesis intheframeworkofacomplexsystem.Thesecondoneisastudyofouruser

group formed by field studywith interviews, statistical data and the creation of a

personathatcomesupwiththestatementoftheuserneeds(goal2).

Thesecondpartofthethesisisthedesign,wherethesolutionisproposed.Thispart

isformedbytwomorechapters.ScenariosandHTAisthefirstoneandexposesallthe

situationsausermayface.Thesecondone,calledSolutiondesign,startsbystatingthe

requirementsof thesystem(goal3)andcontinuesbyproposingthe initialsolution

thatexpectstosatisfytherequirements(goal4).

Thethirdpartistheimplementation.Thisthirdpartisformedbyonlyonechapter

calledSolutionimplementation.There,thesystempreviouslydesignedinthesecond

part is now implemented in a high-fidelity prototype capable of representing the

solutioninarealistictestingenvironment(goal5).

The fourthand finalpart is the evaluativeone, inwhich thedesigned solution is

testedwithrealusersinordertocheckitsfunctionalityandimproveit.Thispartis

formedbyasinglechaptercalledUsabilitytesting,whichiscarriedoutwithrealusers

(goal6).

Afterthesefourmainparts,thethesisendswiththehabitualsections:conclusions

andfuturework(goal7),appendicesandbibliography.

4

PartI:Analysis

Thefirstpartofthisthesisfocusesontheanalysis.Asforotherengineeringprojects,

it isnecessarytocarefullyanalyseexternal factorsthatmight influenceaparticular

solution that is being proposed. In case of this thesis, we will primarily focus on

analysisofthetargetenvironmentandanalysisofneedsandpreferencesofthetarget

useraudience.Onthebasisofcomplexanalysisdescribedinthispartwewereableto

proposeauseablesolutionthatmeetsneedsandrequirementsofourtargetusers.

Inordertoachievethisgoal,thefirstpartisdividedintwochapters.Thefirstone

studiestheexistingsolutionsofhospitalnavigationissuesandexplainstheroleofthis

thesisintheframeworkofthecomplexnavigationsystemthatisgoingtobedesigned

(seesection2.2).Thesecondonecontainstheuserresearchcarriedoutinorderto

understandtheproblemsandidentifytheuserneeds.

5

Chapter2:Hospitalnavigationsystem

This chapter starts with an overview of the state of the art related to hospital

navigationproblems.Afterthat,itbrieflyintroducesthesolutioncurrentlydeveloped

at the CTU to address issues of current navigation systems: In-hospital navigation

systemforindividualswithspecificnavigationandorientationneeds.

2.1Stateoftheart

This section is a quick look to the related technologies applied to deal with

navigationissuesinhospitals.

2.1.1Navigationsystems

Navigating inside a big building like a hospital can be really confusing even for

peoplewith no impairments, aswe seewhenwe visit themain hospital in Prague

(section3.1).Therefore,itisunderstandablethatmanyprojectsbeforethisveryone

havebeenfocusedinsolvingthoseproblems.Mostofthecollectionofthefollowing

technologieswasmadebyK.Fixova[2].

I.PanasonicIn-hospitalNavigationSystemforOutpatients Panasonic proposed its so-called In-hospital Navigation System for Outpatients,

whereeveryoutpatientisgivenawirelesspager(Figure1).AccordingtoPanasonic

[3],thesystem“deliverstheexaminationroomdetailsandtimetopatients(…)through

handheldpagingreceivers.Andithasachievedreductionofthecomplaintsfrompatients

duetolongwaitingtimeaswellasincreasesprivacy.”Panasonicalsopointsoutthat“as

well as the benefits for outpatients, the system will take over the receptionists'

paperwork toregister foroutpatients, tell themthe timeand locationofexamination

roomaswellaswhentopayfortheirmedicalfees.”

This means that hospitals can significantly decrease noise distractions such as

verbalannouncementsand,atthesametime,adapttheenvironmentbymakingfull

useofwaitingrooms.

ThemainissuethatarisefromthePanasonicsolutionisbasicallythatthosepagers

areexpensiveandliabletobestolenordamagedbytheusers.

6

Figure1:Panasonicwirelesspager,from[3]

II.3DCommunicationNaviSystem TheJapans’KanazawaMedicalUniversityHospitalisusinganavigationsystemin

which the routes are displayed in 3D [4]. It uses a 3D visualisation of the hospital

layout, connected to a touchscreen monitor (Figure 2). The creators of the 3D

CommunicationNaviSystem(AbleseedandMetabirds)explainthat“avirtualversion

is easier thanassembling video footage for everypossiblePointA-to-PointB request.

Using 3D digital world, we can create navigation to any place when we want. A 3D

simulationiseasierto‘read’thanrealworldvideoofthesamelocation,sincethevirtual

versioncanbevisuallystreamlinedtoshowonlythemostessentialaspects.”

Themainproblemwiththisverysolutionisthat3Dvisualisationoftherouteisnot

anoptionforuserswithlimitedorientationcapabilitiesorvisuallyimpairedpeople.

Figure2:3DCommunicationNaviSystem,from[4]

7

III.LogicJunction Logic Junction [5] is anavigation system theyhave in someUShospitals like the

ClevelandClinic,rankedasoneofthebesthospitalsintheworld[6],whichprovides

staff-assisted and self-service way finding. Self-service touch-controlled kiosks

(Figure3)arelocatedatentriesand,asitsnamesuggests,atjunctionsthatmightbe

confusing.Byinteractingwiththosekiosks,visitorscanobtainaprintedmaporsend

ittotheirmobilephone(partofthesystemisalsoamobileapplication,whichallows

userstogetdirectionsbyscanningQRcodes).Moreover, thesystemprovidesaudio

descriptionsifrequested.

This solution is closer to fulfil our needs than the previous ones, but the almost

imperativeuseofmobilephonesandprintedpapers is far fromour ideaof a good

solution.

Figure3:LogicJunctionkiosk,from[5]

IV.3DnavigationsystemforbuildingsintheAliceHospitalinDarmstadt AliceHospitalinDarmstadt(Germany)providesa3Dnavigationsystemthatcanbe

usedfromanylocationviainternetaccess[7].Patientscanselectastartingpointand

anenddestination.Then,thesystemhighlightsthetargetbuildingina3Dmodeland

startsthenavigationpresentationwithanarrowmovingthroughthehospital(Figure

4).

Themainproblemofthissolutionisthatthesystemdoesnotknowwheretheuser

is, so it can be confusing for people who have orientation difficulties or problems

rememberingtheroute.Inadditiontothat,thissolutionrequirespermanentInternet

connection.

8

Figure4:AliceHospital’s3DNavigationSystem,from[7]

V.KyotoUniversityHospitalNavigationSystem The Kyoto University Hospital introduced a navigation system [8] in which all

patients have their own Bluetooth terminal with a proximity sensor (Figure 5).

Furthermore,allpatient’spositionsaretrackedbythesystemandthesystemhelps

them to go to any waiting room at the appropriate time. This means a significant

reductionofthewaitingtimeandpreventspatientsanddoctorsfromtimewasting.

Themain issue this solution has is similar to the one arisen from the Panasonic

solution: those terminals are expensive considering that they can be stolen or

damagedbytheusers.

Figure5:ConceptualdesignoftheKUHospitalNavigationSystem,from[8]

9

VI.MayoClinicPatientApplication TheprestigiousMayoClinic inMinnesota (USA), developeda smartphoneapp in

2012calledMayoClinicPatientApplicationthathelpsuserstonavigatethroughthe

hospital.MikePlotnick[9],fromtheHealthcareFacilitiesToday,explainsthat“Mayo

developedthetoolin-house,usingexistingresources.They(theITteam)workedclosely

withthefacilitiesteamtoconceiveandbuildtheapplication,whichalsoincludessecure

access to personalmedical records,messaging capabilities, hospital news and videos

aboutthefacilities.”(Figure6).

TheappusessophisticatedinteriormappingdevelopedbyGoogletoprovidestep-

by-step navigation in the patient’s smartphone. Furthermore, beyond way finding

within the clinic, the apps also help visitors to find accommodations in the

surroundings.Thissolutionisveryinterestingfromabudgetpointofviewbecauseit

usesexistingtechnologyandpatients’devices.Itsmainissueis,obviously,thatnotall

hospitalvisitorshaveasmartphone,especiallyoldandvisuallyimpairedpeople.

Figure6:MayoClinicPatientsApp,from[9]VII.Spreo’sWayfinding,Navigation&MappingsolutionsforHospitals Spreo is a company that provides indoor location solutions. According to their

website [10], their mobile wayfinding technology uses Bluetooth, Wi-Fi, GPS,

gyroscope, accelerometer, and compass sensors on any smartphone to identify the

locationof a user.Although theybase their technologyon smartphones (Figure7),

they have also the so-called Self-Service Interactive Digital Displays & Kiosks.

According toSpreo’swebsite “utilizing the interactivemapsanddirectories found in

SPREO’sCloudCMS,thekiosksprovideanintuitiveself-servicetouchscreenexperience

onhigh-techyetsurprisinglyaffordablehardware.(…)Eachkiosk featuresaneasyto

usetouchscreeninterfacethatemulatestheAndroidversionofthemobileapp.Withjust

10

afewtaps,avisitorcanlocatetheirdestinationonthemapandviewthecompletestep-

by-stepdirectionsandapproximatewalkingtimetoanylocationinthevenue.”

Thissolutionisveryinterestingandfitsmanyofourneeds,butitisstillnotvisually

impaireduser-friendlymainlybecauseofthetouchscreens.

Figure7:Spreo’sNavigationApp,from[10]

11

Conclusions Inordertogathertogetherandcomparetheexposedsolutions,weareputtingthem

allinatabletodiscusstheprosandconsofthemfromourpointofview:

System Pros ConsPanasonicIn-hospital

NavigationSystem

forOutpatients

- Deliversexaminationroomdetailsandtime.- Increasesprivacy.- Reducesnoise.- Reducespaperworktoregisteroutpatients.

- Wirelesspagerneeded.

3DCommunication

NaviSystem

- Providesnavigationdirections.

- Touchscreenmonitor.- 3Dvisualisationoftheroute.

LogicJunction - Providesstaff-assistedandself-serviceway

finding.

- Providesaudiodescriptionoftheroute.

- Providesamap(printedoronthemobilephone).

- UserscangetdirectionsbyscanningQRcodes.

- Touch-controlledkiosks.- Worksbetterwithsmartphones.

3Dnavigationsystem

forbuildingsinthe

AliceHospitalin

Darmstadt

- Provides3Dnavigationmodelthatcanbeused

fromanylocationvia

internetaccess.

- Locationoftheusernottracked.- Internetconnectionneeded.

KyotoUniversity

HospitalNavigation

System

- Locationoftheusertracked.- Reducestimewasting.

- Bluetoothterminalwithaproximitysensorneeded.

MayoClinicPatient

Application

- Usesexistingresources.- Includessecureaccesstopersonalmedicalrecords,

messagingcapabilities,

hospitalnewsandvideos

aboutthefacilities.

- Smartphoneneeded.

Spreo’sWayfinding,

Navigation&

Mappingsolutions

forHospitals

- Locationoftheusertracked.- Intuitiveself-serviceexperience.

- Providescompletestep-by-stepdirectionsand

approximatewalkingtime

toanylocation.

- Touchscreenorsmartphoneneeded.

Table1:Prosandconsoftheexistingnavigationtechnologies

12

Thestudiedsolutionsaregoodapproachestoin-hospitalnavigationissuesformost

ofthevisitorsahospitalreceives.Wecantakesomegoodideasfromthem:usersneed

tobetrackedduringtheirway,thesystemmustbeintuitiveandprovidestep-by-step

audiodescriptionoftherouteanditcanincludeotherfeaturesrelatedtohospital’s

surroundingsand facilities.Thisanalysis also remindsus some important topics to

take into account when we design our solution, such as users’ privacy and noise

pollution. Nevertheless, none of the existing solutions is visually impaired user-

friendlyduetotheuseofspecialdevices,touchscreensorsmartphones.

2.1.2Authenticationtechnologies

Inordertoidentifythepatientsinaneasywaywhilerespectingtheirprivacy,we

think about a biometric authentication method. Jain et al. [11] define biometric

recognition,orsimplybiometrics,as“thescienceofestablishingtheidentityofaperson

basedonphysicalorbehavioralattributes.”TheBiometricsResearchGroupfromthe

MichiganStateUniversity[12]addsthat“Theword‘biometrics’isalsousedtodenote

biometricrecognitionmethods.Forexample,fingerprint,face,oririsbiometricfeatures

aresometimesdescribedassinglebiometrics.Biometrictechnologycanpreventfraud,

enhancesecurity,andcurtailidentitytheft.”

Therefore,biometricauthentication isabetterandsaferwayof identifyingusers

than passwords or personal cards. The question is: what biometric way of

authenticationisthebestoneforourdesign?

Pruthietal. [13] list thebiometricsolutionsdistinguishingbetweenphysicaland

behaviouralonesasfollows:

“Physicalbiometrics

a)Fingerprintscan

b)Facialrecognition

c)Irisscan

d)Handgeometry

e)Retinascan

f)DNAanalysis

g)Vascularpatternsrecognition

Behavioralbiometrics

a)Speaker/voicerecognition

b)Keystrokepatterning

c)Handwriting/signatureanalysis”

Considering a hospital environment,we candismiss someof theseoptions:DNA

analysisandvascularpatternsrecognitionare toocomplexandexpensivemethods.

Voicerecognitionmightbeimpreciseinnoisyareas.Fingerprintscan,handgeometry

andkeystrokepatterningareinsanitarymethodsinahospital.Moreover,considering

ourtargetgroup,wecandismisssomemoreoptionssuchasirisandretinascanand

the handwriting analysis. In conclusion, and by a process of elimination, the best

biometric solution would be facial recognition. Pruthi et al. emphasize that, even

though this technology is cheapandnon-intrusive, themajordrawbackof it is that

13

peopledochangetheirfaceovertime.Thatistruebut,inoursystem,thefacewillbe

recognizedeverytimetheusersarrivetothehospitalandusedonlyduringthatsingle

visit.

2.2In-hospitalnavigationsystem

Asweexplainedbefore,thecurrentworkispartofacomplexprojectthatintentsto

satisfy our target group’s needs throughout their visit to the hospital. The system

shouldsupportvisitors’activitiesfromthepreparationofthevisituntiltheyleavethe

facilitiesafterit.Obviously,thewholeextentofthetopicisfartoocomplextoaddress

itdirectlywithonesingle thesis.This is thereasonwhy thenavigationsystemwas

dividedintoseveraldifferentpartsandprojects.Currently,therearebeingdeveloped

the following components: aweb application to prepare the visit, amain entrance

kiosktologinthesystemandstartthenavigationprocessandawaitingroomkiosk

tomanagethewaitingtimeandtheusersthatwaitinthere(Figure8).Theprimary

aimofthisthesisisdevelopmentofthewaitingroommanagementkiosk,but,inorder

to contextualize it, it is important to briefly summarize the purpose of other

componentsofthesystem.

Figure8:Navigationprocedurewithproposedsystem,from[14]

2.2.1Webapplicationforvisitpreparation

CTU student Flek, T. is developing theweb application1 that allows the users to

preparetheirvisitstothehospital.Whenaskedabouthisdesignaftertheusertesting,

heexplainsthat,throughthewebapplication:

• Userscanreadorlistenanoverviewofthefunctionalityofthesystemandthey

aretoldaboutthefacerecognition.

• Userscanmakeanappointmentwithadoctororforaspecificexamination.

1 A functional prototype of the website is available (only in Czech) at http://hospital-

flektoma.rhcloud.com/,retrievedApril24,2016.

14

• Users can also prepare navigation to a specific ward, to a doctor, to the

cafeteria,etc.withthepossibilitytosearchforconnectionsfromhometothe

hospital(usingidos.czandnaviterier.czforvisuallyimpairedpeople).

• Thesystemaskstheusersabouttheirpersonaldata(name,surname,dateof

birth, insurance company, phone number and optional email address) and

needs(levelofvisual,motororhearingimpairment).Forthoseuserswhodo

notwant to fill inpersonaldata to theiraccount, thesystemallowsthemto

accesstheirappointmentviaphonenumber(whichisauniqueidentifier)and

SMScode.

• Users have the option to add tasks and notes to an appointment (e.g. “take

results of the blood examwithme” or “don’t forget the insurance company

card”).

Flekalsoexplainsthat, inthefuture,he isplanningto implementasimpleforum

whereuserscouldwritetipsandtricksaboutthesystemandthehospitalitself.

2.2.2Mainentrancekiosk

CTU studentLorencova, E. isdeveloping themainentrancekiosk that allows the

userstosign inthesystemwhentheyarrivetothehospital.Whenaskedabouther

designaftertheusertesting,sheexplainsthat:

• Themainentrancekioskissituatedinthehallway,nexttothemainentrance.• Users are identified by using their insurance card. Data is read via OCR andcomparedtothepersonaldataretrievedonthewebsiteoronthemedicalhistory

isimportant.

• Userscanselecttheirdestinationatthekioskifitwasnotdefinedpreviouslyonthewebsiteapplication.

• Ifthevisitwasscheduledandtheuserisidentified,thesystemprovidesdirectlythelistofscheduledvisits.

• User face is recognized in order that the step-by-step navigation by the simplenavigationterminalscanstart.

2.2.4Interactivehapticmap

CTUteamcomposedbyMaciketal. [14]designedan Interactive tactilemap that

“providestopologicalinformationaboutlargepartsofthehospital.”Userscanexplore

themapinavisualwayorinahapticway:“Theactualrouteisvisuallyhighlighted.For

the visually-impaired, there are touch sensors that help them to follow their planned

routeonthetactilemap.”

2.2.4Simplenavigationterminal

Macik et al. [14] define the Simple navigation terminal (Figure 9) as “the basic

building block of our navigation system. The primary aim of it is to provide simple

directional instructionsat thecorridor junctions.”The interactionprocedure (Figure

10)beginsbydetectingthemotionofauser.Afterthat,“afastfacedetectionalgorithm

15

isperformedonthecapturedimage.Ifafaceispresentintheimage,theframeissentto

theserverthatperformsadvancedfacerecognition,resultingintheidentificationofa

particular person. After successful user recognition, personalized navigation

instructionsareprovided.However,thevisualformisnon-intrusiveandisadequatefor

most users. Instructions for visually-impaired users are provided in the formof voice

instructions.”

Figure9:Simplenavigationterminalprototype

Figure10:InteractionprocedurewithSimpleNavigationTerminal,from[14]

2.3Conclusions

This chapter has beenuseful to have awhole picture of the state of the art and,

particularly,of theplaceoursystem isgoing toadopt in it.Althoughwe tooksome

ideasfromthem,wedismissedtheexistingsolutionsbecausetheyarenotsatisfying

entirelywhatweneedthemto.Afterthat,weconsideredthedifferenttechnological

ways of identifying people and we decided that facial recognition is the best

authenticationsolutionforahospitalenvironment.Thelastsectionhasbeenusefulto

contextualiseandunderstandtheunifiedpartsofthecomplexsystem.

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Chapter3:Userresearch

This chapter gathers together all the user research done in order to analyse the

problemandstatetheuserneeds.Onlyafterlisteningtotheusersinsuchastudy,one

canthinkaboutthestartdesigntoprovideapropersolutiontotheproblem.

Theuserresearchstartswithareportofthecurrentsituationofthemainhospital

in Prague focusing on navigation issues. It continues with three interviews with

potential users (from this point on called “participants”). After that, the chapter

introducesa teamworkexperiencemapanalysisof the resultsandstates statistical

data.Theuserresearchcontinueswiththecreationofapersonawhichbringstogether

themaincharacteristicsoftheparticipantsandallowsustogetabetterpictureofthe

situationstheyface.Finally,thechapterendsbystatingtheuserneedsoursolution

mustfulfil.

3.1Hospitalfieldstudyreport:FakultníNemocnice2Motol

When designing a solution to navigation problems that visually impaired people

mayhaveinsideahospital,tovisitandanalyseabighospitalseemsagoodstartpoint.

3.1.1FNMotol’sdescription

FNMotolisthebiggesthospitalintheCzechRepublic.Accordingtoitswebsite[15],

thehospital:

• “Providesbasic,specializedandsuperspecializedhealthcareandservicesinmedicalfields in form of outpatient and in-patient care for children, adults and elderly

patients.

• ThebiggesthealthcarefacilityintheCzechRepublic.• Is built in two single blocks that are connected together as well as few separate

pavilions–has2,410beds.

• Morethan860,000peopleperyeararetreatedasoutpatients.• Morethan70,000peoplearetreatedasinpatients.• Hasmorethan5,000employees.”

3.1.2Navigationthroughhospital

OurvisittoFNMotolstartsgettingoffthemetro.Althoughthemetrostationwas

recentlybuilt, it hasno guidelines on the floor. Itmight be confusing for a visually

impairedpersontogettothehospitalmainentrance.

2“Nemocnice”istheCzechwordfor“hospital”.

17

Onceatthemainentrance,thefirstmapyoucanfindhasseveralproblems(Figure

11):ithasnobrailleindications,itisupsidedownfromtheobserver’spointofview

(thisisbecausethemapisorientatedfollowingthecardinalpointswhiletheobserver

istowardstheSouth),ithasnoEnglishtranslations,thelettersA-Earenotexplained

in the legend and the legend lines are not following the alphabetical order.

Furthermore, some buildings are extremely difficult to find following the map,

according toourownexperience and somenursesweasked forhelp (e.g. building

number16).

Figure11:MainentrancemapatFNMotol

Inside a particular building of the hospital, you are supposed to follow coloured

lines on the floor to find yourway. These guidelines can be helpful if you are not

visually impaired, but they have some confusing problems such as finishing

unexpectedlyorchangingitscoloursuddenly(Figure12).

Figure12:GuidelinesatFNMotol

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Mostofthedoorsaretrueobstaclesforvisuallyimpairedpeople3.Sincetheyarenot

automaticandthecolouredguidelineshavenorelief,itisnoteasytodistinguishsuch

kindofdoorsfromawallwhenusingawhitecane(Figure13).

Figure13:ManualdoorsatFNMotol

Theyusedtohavesomekindofinformationkiosk,butitisnotworkinganymore.

Inadditiontothat,thelackofhomogeneityintheusedfontsofsomesignsisconfusing

(Figure14).

3Fromthefirstquestionoftheinterviewtothefirstparticipant(appendixA.1).

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Figure14:KioskandsignsatFNMotol

Thealternationbetween “-P” and “SP” todefine the floor immediatelyunder the

groundfloorisconfusing(Figure15andFigure16).

Figure15:LiftbuttonsandsignsatFNMotol

Someliftshavenobraillesignsnoraudioindications.Furthermore,insomecases

inwhichtheyputbraillesigns,thelabelsdisappeared(Figure16).

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Figure16:LiftbuttonswithbraillelabelsatFNMotol

Thewaitingroomscreenisusefultoknowwhenyourturnisorwheretogo,butit

iscompletelyuselessforvisuallyimpairedpeople,sincetherearenovoiceindications

(Figure17).

Figure17:Motol’swaitingroomscreen

Inconclusion,wecanstatethatthehospitalhasmanyorientationproblems,even

forpeoplewithnovisual impairment,and that it isnot friendlyatallwithvisually

impairedpeople.

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3.2Userinterviews

NewmanandLamming[16]statethat“todesignaneffectiveinteractivesystem,we

mustidentifythepeopleitistosupport-theusers-andgainsomefamiliaritywiththeir

activities.”Thereareseveralmethodstoconductuserstudies.Themostcommonones

areinterviews,questionnairesandobservation.NewmanandLammingalsodefinethe

interviewsasa“particularlyrapidandcongenialwayofgatheringdata”and,compared

to other methods, “the data are available immediately after the interview”.

Nevertheless, interviews “can backfire or givemisleading results. (…) This makes it

imperativetotakecareintheirpreparationandconduct.”

In our user study, we decide to carry out interviews. Specifically, three semi-

structured interviews are held. The questions are planned beforehand and all the

interviews follow the same structure. They can be found in appendix A. The three

participantsaretwomalesandonefemalewithanaverageageof46.7yearsoldanda

standarddeviationof18.6years.Adetaileddescriptionoftheirprofilescanbefound

alsoinappendixA.Inordertocharacterizeuserswhilerespectingtheirprivacy,the

profilewasdefinedusingfourimportantparameterssuchasage,gender,categoryof

visualimpairment(from1to5where1isthelowestimpairmentand5thehighest,

meaningtotalblindness)andtime(distinguishingbetweenL“laterimpairment”and

C“congeniallyimpairment”).

Findingsfromtheinterviewsarereflectedbyourpersona(see3.5).

3.2.1Proposedquestionstotheparticipants

Thefollowingproposedquestionswerethoughtinordertorespectsomebasicrules

such as to avoid binary answers, to avoid forced opinions and to respect the

participants’privacyassuggestedbyNewmanandLamming[16].

Q1Howdoyouorientateyourselfinahospital?Q2Onceyouareinthewaitingroom,howareyouinformedallthetime?Whatwouldyouliketoknow?

Q3Howdoyoutofindafreeseatinthewaitingroom?Q4 How do you think that the hospital staff is prepared to help visually impairedpeople?

Q5Howwouldyouliketoreceivetheinformation?Q6Afterthevisittothedoctor,howwouldyouliketosetthenextappointment?Q7Afterthevisittothedoctor,wouldyouliketobeguidedtogototheentrancepoint,pharmacy or public transport? Would you like to be guided throughout a free-

obstacles(maybelonger)route?

Q8Anyadditionalideatoimproveyourvisitstothehospital?

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3.3Otheruserresearch

In a brainstorming session held by some of the students who take part in the

navigation system design, all the user research done was gathered together in an

experiencemap[17](Figure18).Theconclusionsweredividedintothreelists:“what

weknow”,“whatweneedtoprove”and“whatwedon’tknow”.

Figure18:Experiencemapsection

Whatweknow

1. Participantsmakeanappointmentbeforegoingto thehospitalorvisitingthedoctor.

2. Mostoftheparticipantsusethephonetomakeanappointment.3. The most common reasons to visit a hospital are surgery on-boarding,

examinationorvisitinganotherpatient.

4. Visually impaired participants (VIP) prepare their visit to the hospitalbeforehand.

5. ThoseVIPwhoareusedtouseacomputerdosearchtheroutetothehospitalontheinternetbeforehand.

6. ThoseVIPwhoarenotusedtouseacomputerdoaskforadescriptionoftheroutetoafriend,arelativeoranassistant.

7. SPandVIPpreferphoneswithbuttons.8. MostVIPhaveexperiencewithtouchscreensbutpreferphoneswithbuttons.9. VIPusewhitecaneandtransmitterforvisuallyimpairedpeople.10. SPandVIPaskforhelpatthereceptionortopassers-by,ifneeded.

23

11. MostofthehospitalstaffmembersdonotknowhowtoorientatethoseVIPwhoaskforhelp.

12. VIP have problems with navigation when the hospital consists of severalbuildings.

13. ThereisnosupportforVIPinhospitals.14. VIPhavegoodexperienceswithotherpeoplewhenasking them forhelpand

orientation.

15. VIPexpect someusualproblems in theirway through thehospital.Themostcommononesarehangingobjectsandcloseddoors.

16. MostoftheVIPfeelreallyworriedwhentheygetlost.17. ManyVIParenotsureabouthowtoinformthenursewhentheyarrivetothe

waitingroom.

18. VIParenotabletoreadelectronicwaitinglists.19. MostVIPdonothaveproblemsinaskingforafreeseatinthewaitingroom.20. WhenVIParesenttovisitanotherdoctorinthesamebuilding,thereisalways

someonewhoaccompaniesthem.

21. When VIP and SP are sent to another doctor, they ask for a description, theaddressandthename.

22. Manyvisitorswant touseotherhospital servicesbesides thedoctor, like thecafeteriaorthepharmacy.

23. Manypatientshavetocarrysomedocumentswhengoingtothehospital.24. VIPusecomputersmorelikelythanSP.

Whatweneedtoprove25. SomeVIPaskfordirectionsatthemainentrancereception.26. SomeVIPareworriedaboutovertakingsomeone’sturnorbeingovertakenby

someoneinthewaitingroom.

27. Where and for how long do patients wait before they are admitted(hospitalized).

Whatwedon’tknow

28. VIPsearchforinformationaboutthehospitalonitswebsite.29. TheamountofVIPwhouseacomputerorasmartphoneregularly.30. VIP (andmaybe even SP) areworried about the hygiene of touchingpads or

brailletexts.

31. VIPsufferingfromseverediabetescannotreadbraille.32. TheamountofVIPwhouseaguidedogandhow.33. StatisticsaboutVIPusageofsmartphonesvs.featurephones.34. VIPneedhelpwithelectronicwaitinglists.

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3.4Statisticaldata

Thedefinitionsofblindnessandpartialsightvary fromoneEuropeancountry to

another.TheEuropeanBlindUnion(EBU)adoptsthedefinitionsusedbytheWorld

HealthOrganisation(WHO)forvisualimpairedandpartialsight[18]:“theterm‘visual

impaired' is used to indicate blind plus partially sighted people together. Partially

sightedandlowvisionareusedasequalindicationoflimitedsight.”

AccordingtotheEBU:

• “There are estimated to be over 30 million blind and partially sighted persons in

geographicalEurope.

• Anaverageof1in30Europeansexperiencesightloss.

• Therearefourtimesasmanypartiallysightedpersonsasblindpersons.

• Womenaremoreatriskofbecomingblindorpartiallysightedthanmen.

• Sightlossiscloselyrelatedtooldage:oneinthreeseniorcitizensover65facessight

loss.90percentofvisuallyimpairedpersonsisovertheageof65.

• TheWHOestimates,infiguresdatingfrom2010,thatinEuropethereare2,550,000

blindpeopleand23,800,000lowvisionpeople,givingatotalof26,350,000visually

impairedindividuals.”

Consideringthesefigures,wecanstatethatvisualimpairmentisaglobalproblem

inoursociety.Wecannotforgetthiswhenwedesignbuildingsorthinksolutionsto

satisfyneeds:itisamajorproblemthathastobetakenintoaccountineverystepwe

takeasengineersanddesigners.

3.5Persona

According to Adlin and Pruitt [19], “Personas are fictitious, specific, concrete

representationsoftargetusers.Personasputafaceontheuser.”

Personasareamethodologytodescribeandgathercharacteristicsofatargetgroup.

Theyrepresentrealpeopleandtheyareusedalongthedesignprocesstomakeusers

morereal.Whendesigning,designersoftenbasescenariosandsituationsonpeople

similartothemselves.Thecreationofthesepersonasallowsthedesignerstokeepthe

distanceandbemoreobjective.

AdlinandPruittdescribesomespecificrulesabouthowtocreateandusepersonas

duringadesigningprocess:

• “Buildingpersonasfromassumptions isgood;buildingpersonasfromdataismuch,muchbetter.�

• Personasarenotdocuments.Theyareeffectiveonlyiftheyseemtobealive.��• Personasareahighlymemorable, inherentlyusablecommunicationtool if theyare

communicatedwell.”

Thefindingsfromtheuserresearchdescribedinsections3.1,3.2and3.3arereflected

byourpersona(seebelow).

25

3.5.1Profileanddescription

• Name:Tereza• Age:46• Gender:Female• Categoryofvisualimpairment(1-5):5• Time:L(Laterblindness)• Address:Prague

Tereza isa46yearsold ladywhoworksasauniversityprofessor.She is living in

Prague,where shemovedwhen she started losing her sight since there is amuch

greatersupportforblindpeopleinbigcitiesthaninsmalltowns.

Terezalovesgoingtothelibraryand,iftheweatherisnice,shelikestogoforawalk.

Normally, she does not travel with assistant, because she feels better when she is

independentofotherpeople(P1-Q1)4.Sheusesawhitecanetohelpherselfmoving

around and, if needed, she does notmind to ask passers-by for help (P1/2/3-Q1).

Whenshetriesawayforthefirsttime,sheplansitcarefully:firstly,shesearchesthe

nearestbusstoptoherdestinationandthenshefindstheappropriatebusconnection

ontheinternet(P2-Q1).Usuallyshearrangessomebodytodescribeherthewayusing

GoogleStreetView(P2-Q1).Oncesheisonherwaysheusesorientationpointsand

guidelinestoorientateherself.Themostcommonguidelinesarewallsorcurbs.Open

spacesarechallengingforherduetothelackoftheseorientationguidelines(P1-Q7).

Whengoinganywhere,shealwaystakesherspecialtransmitterforblindpeoplewith

her(P1-Q1).Ithelpshertofindoutthenumberoftramorbusthatarrived,toopen

the doors of public transport vehicles, to activate acoustic beacons and get some

informationfrompublicbuildings,etc.

LastweekTerezawenttothedoctor,whotoldherthatshemustgotothehospital

foranexamination.Whengoingtothehospital,Terezaalwaysneedstoasksomebody

toaccompanyher(P1/2/3-Q1).Shewouldprefergoingalone,butitistoochallenging

forher to remembersuchacomplicatedway inside thebuilding.Furthermore, this

problemismoreseriousinverylargehospitalcomplexconsistingofseveralbuildings.

Terezahadtovisitthehospitalaloneonce.Shehadtoaskthehospitalstaffforhelp.

Unfortunately, theydidn’t know reallywell how to orientate or guideherproperly.

Whenshefinallyreachedthewaitingroom,sheaskedsomeotherpatienttofindafree

seatforherandtoletherknowwhenherturnwas.Aftervisitingthedoctor,Tereza

setthenextappointmentwiththenurse.Terezaalsoaskedthenursethetoguideher

outofthehospitalbuilding.

4“P1-Q1”meansthatthischaracteristicisbasedontheanswerthefirstparticipantgavetothe

firstquestion(appendixA).

26

3.6Userneeds

Accordingtothefindings,ourpersonaandthesituationsshemayexperience,we

arereadytolistthoseuserneedsthatcanbetechnologicallysolved.

3.6.1VIPneeds

1. Toknowthewaitingtimeandwhentheirturnis.(P1/2/3-Q2)52. Tofindafreeseatinthewaitingroom.(P3-Q3)3. Toaskfordirections.(P2-Q8)4. Toaskforassistance.5. Tochooseamongdifferentlanguages.6. Tochoosehowtheinformationisdisplayed.(P1/2/3-Q5)

3.6.2Hospitalstaffneeds

7. ToknowthataVIParrivedtothewaitingroom.(P1-Q8,Whatweknow#17)68. ToknowthataVIPislostandtofindthem.(Whatweknow#16)9. ToknowthataVIPneedshelp.10. ToknowthataVIPhasbeenattended.

3.7Conclusions

Thegoalofthischapterwastogatheralltheuserresearchinordertoanalysethe

problemandbeabletostatetheuserneeds.WestartedbyanalysingthemainPrague’s

hospitalandweunderstoodthatishasseveralnavigationissuesevenfornotVIusers.

ThemainfindingthereisthatwaitingroomsaregenerallynotVIuser-friendlyatall

duetoitslackofanadaptedpresentationofinformation.Afterthat,weinterviewed

threeusersandwefoundouthowVIfeelwhentheyvisitahospital.Wediscovered

thattheynormallyneedsomebodytoaccompanythemeventhoughtheydon’tlikethis

dependency.Theyarespeciallyconcernedaboutwhattodowhentheyarrivetothe

waitingroombecausethereisnotadefinedprotocol.Theseandsomemorefindings

weresharedwithtwootherresearcherswhohavehelduserresearch.Andfinally,all

thisknowledgeaddedtosomestatisticaldatawasput together into thecreationof

Tereza,ourpersona,andthesubsequentuserneedsdetermination. In thisway, the

user research concludes and we are ready to start the designing process in the

followingchapters.

5“P1/2/3-Q2”meansthatthisuserneedisbasedontheanswerallthreeparticipantsgaveto

thesecondquestion(appendixA).

6“Whatweknow#17”meansthatthisuserneedisbasedontheknowledgearisenfromthe

Experiencemapsession(section3.3).

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PartII:Design

Thesecondpartofourprojectisthedesign.Thisisthecreativepartofthework,in

whichtheengineerhastothinkaboutasolutionabletofulfiltheneedsoftheusers.

Wehavetostartby imaginingall thepossiblesituationsausercan face inorder to

statetheirneeds.Afterthat,wearegoingtoproposeapropersolutiontotheminorder

tobetestedafterwards.Thispartisdividedintwochapters.Thefirstonedefinesand

analyses the different scenarios that a user can experience. The second chapter is

abouttheconceptualsolutionweproposetosatisfytherequirementsarosefromthe

userneeds.

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Chapter4:ScenariosandHTA

Inthepreviouschapter,westudiedtheusersfromourtargetgroupanddefineda

persona(Tereza)whogathersthemaincharacteristicsoftheparticipants.Theaimof

thischapteristoputTerezainallthepossiblesituationsshemightfacewhenvisiting

thehospitaland,fromthat,understandherneeds.

4.1Scenarios

According to Hsia et al. [20] “scenario analysis is the process of understanding,

analyzing, and describing system behavior in tens of particular ways the system is

expected to be used.”Wedefine scenarios in order to picture all the situations that

couldhappeninthestudiedenvironment.Ourpersona,Tereza,willbeplacedinthe

describedscenariostofindoutthenecessitiesoursystemcansatisfy.Allthescenarios

haveacommonstartpointwhichisexplainedbelowandascenariosdiagramcanbe

foundattheendofthissection(Figure19).

Today,Terezahasanappointmentwitha specialist at thehospital.Normally, she

goestothehospitalwithherbrother,buttodayhecouldn'taccompanyher.

Beforehervisit,Terezapreparesitusingthewebsiteapplicationofthehospital.On

it, she can make an appointment so the system will know when and where her

scheduledvisitis.Afterarriving,shechecks-inusingherinsurancecardatthemain

entrancekiosk.Thesystemscansherfaceandlinksherfacetoherprofile.Thanksto

thewebsiteapplication,thesystemknowsherneedsandherscheduledvisits,sothe

navigationprocesstothewaitingroomcanstart.SincethesystemknowsthatTereza

isblind,itwilldisplaytheinformationthroughthespeakers.

4.1.1Scenario1:Terezafeelslost

Terezafeelsconfusedbecausesheisnotabletorememberthedirectionsshewas

following. At this moment, she is not sure whether she has to turn left or right.

Luckily,sheremembersthatanykioskinawaitingroomofthehospitalcanhelpher

tofindherway.Usingherwhitecane,Terezaisabletofollowthefloorguidelinesto

thenearestwaitingroomkiosk.Thesystemrecognizesherimmediatelyandshecan

askfordirectionsagain(S1.1)orassistance(S1.2).

29

Sub-scenario1.1:Terezaasksfordirections Tereza feelshelpedenoughbyhearing thedirectionsoncemore, so sheasks the

system to recalculate her way and provide the new directions. After hearing the

instructionsagain,Terezafeelscomfortableenoughtokeepongoingand, following

thedirections,shearrivestothewaitingroom(S5). Sub-scenario1.2:Terezarequiresassistance Tereza needs assistance, so the system informs the hospital staff about Tereza's

situationandherlocation.Afterreceivingthealert,oneoftheavailablemembersof

thehospitalstaffmarksitas"alertattended"andgoestofindandhelpTereza.After

helpinghertofindthewaitingroom(S5),thememberofthehospitalstaffmarksthealertas“solved”.

4.1.2Scenario2:Terezadoesn’tarrivewithintheexpectedtime

Afterapre-settimeout,thesystemdetectsthatTerezadidn’tarrivetothenextkiosk

orthewaitingroomwhenexpected.Then,italertsthehospitalstaffand,byusingthe

systemcameras,amemberofthestaffcanlookforTerezaaroundherlastconfirmed

location. If needed, someone can be sent to this last position inwhich Terezawas

detectedbyfacialrecognition.

Sub-scenario2.1:Terezaisdelayed WhileTerezawasfollowingthedirections,shereceivesaphonecall.Shestopsand

picksupthephone.Sincesheknowsthatitisquiteearlyforherscheduledvisit,she

hastimetoanswerandtalkcalmlywiththefriendwhoiscallingher.Usingthesystem

cameras,amemberofthestafflooksforTerezaaroundherlastlocationandchecks

outthatsheisthere,usingherphonenormally.Therefore,thenursemarksthealert

as“solved”.Lately,whenTerezafinishesthecall,shecontinuesherwaynormallyto

thewaitingroom(S5). Sub-scenario2.2:Tereza“disappeared” Terezafeltabitsickonherwaytothewaitingroomandshedecidedtogotothe

toilet.Althoughthememberofthehospitalstafflooksforherusingthecameras,they

are not able to find Tereza. Therefore, a member of the staff is sent to her last

confirmedpositiontostartthesearchthere,alwaysguidedbyastaffmemberbehind

thecameras.Aftera fewminutes, theyassumethatTerezamustbe intherestroom

becauseshehasn’tappearedanywhereelsedetectedbythefacialrecognitioncameras.

After a fewmoreminutes, they decide to go inside the restroom and askwhether

Terezaneedsassistance.TheyfindTerezaabitdizzy,standingnexttothewall.They

offertheirhelpandaccompanyhertotheemergencyroominordertobetreated.Sub-scenario2.3:Terezaleftunexpectedly WhileTerezawasfollowingthedirections,shereceivesaphonecall.Shestopsand

picksupthephone.Herbrotheriscallingherbecauseofanunexpectedemergency.

Terezamustleavethehospitalandgotofindhim.Shedoesn'tevenhavetimetocheck

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outatthemainentrancekiosk,sosheleavesthehospitalwithoutinformingabouther

departure.Thehospitalstaffisnotabletofindherusingthecameras,sotheycallher

tohermobilephonetoaskwhethersheleftdefinitelyornot.Terezafeelsbetterbeing

askedandsheishappytoexplainthatsheleftbecauseofanemergency.Furthermore,

shecanrescheduleherappointmentwiththedoctor.

4.1.3Scenario3:Terezagoestothewrongwaitingroom

WhenTerezaisfollowingthedirections,shemisunderstandsoneoftheindications

andgoestothewrongfloor.Finally,shearrivestoawaitingroomwhichisnottheone

thatsheneeded.Followingtheguidelinesonthefloor,sheisabletoplaceherselfin

frontofthewaitingroomkiosk.Thesystemdetectsthatsheisinthewrongplaceand

alertsherwithanaudiowarning.Then,Terezahastheoptiontogetnewdirections(S3.1)tothecorrectdestinationortocallsomeonefromthehospitalstaffandaskforhelp(S3.2).

Sub-scenario3.1:Terezarequiresassistance Sameassub-scenario1.2.

Sub-scenario3.2:Terezaasksfordirections Sameassub-scenario1.1.

4.1.4Scenario4:Terezawantstoleave

Sameassub-scenario5.2.

4.1.5Scenario5:Terezagoestothecorrectwaitingroom

Tereza follows the directions provided by the system and arrives to thewaiting

roomnormally.Thenshegoestothewaitingroomkioskandthesystemdetectsthat

shearrivedtotherightplace.Thesystemtellshertheestimatedwaitingtime.Italso

informsthenursethatavisualimpairedpersonarrivedtothewaitingroom.Afterthat,

thesystemasksTerezawhethersheneedsassistancetofindafreeseatornot.Since

thereisnobodynearbyandthewaitingtimeisa lot,Terezadecidestoaskforhelp.

Thesystemactivatesanaudiobeaconfromthesetofreservedseatsinordertoguide

Terezatothe freeseat.Tereza followsthebeaconalarmandfindstheseatreadyto

wait.WhenTereza'sturnarrives,thesysteminformsaboutitoutloud,notonlyonthe

screens.

Afterthevisit,Terezaexitsthedoctor’sofficeandfollowstheguidelinesuntilthe

kiosk in the waiting room. Then, the system offers to guide her to some specificlocations such as the hospital pharmacy (sub-scenario 5.1) or to the exit (sub-scenario5.2).

Sub-scenario5.1:Terezawantstogosomewhereelse Sincethedoctorprescribedhersomemedicines,Terezadecidestovisitthehospital

pharmacybeforeleaving.Shechoosesthisspecificoptionfromthelistandthesystem

31

startsguidingher to thepharmacy.She followsthedirectionsuntilherdestination,

buysthemedicinessheneeds,andleavesthepharmacy(sub-scenario5.2).

Sub-scenario5.2:Terezaleavesthehospitalafterthevisit Terezawantstoleavethehospitalandgohome,soshechoosesthisoptionfromthe

listandfollowsdirectionsuntiltheexit.Afterpassingbythemainentrancekiosk,the

systemdetectsthatsheleftandstopstrackingher.

Figure19:Scenariosdiagram

32

4.2Hierarchicaltaskanalysis

Hierarchicaltaskanalysis(HTA)isataskdescriptionmethod.AccordingtoStanton

etal.[21],“HTAisusedtoproduceanexhaustivedescriptionoftasksinahierarchical

structureofgoals,sub-goals,operationsandplans”.

Inourcase, themaingoalof theHTA(Figure20) is toprovideaqualityhospital

experience. Particularly, we have to focus on the waiting room part of the visit.

Nevertheless,itisquiteusefultohaveawholepictureoftheprocess.

Figure20:HTAdiagram

ByfollowingthedifferentverticalpathsoftheHTAdiagram,wecandetermine

thesetofindividualactions(calledplans)thatthesystemshouldperforminorderto

achievespecificgoals.

33

4.3Conclusions

Thegoalofthischapterwastofigureoutandunderstandtherangeofsituationsin

which thesystemhas tooperate.Tereza,ourpersona,hasbeen imagined inawide

varietyofscenariosinordertodeterminetheexactfeaturesthesolutionshouldhave.

Thiscouldbeconsideredthefirstdesignstepofthesolution:itisawell-definedand

justifiedcollectionofstepsthatthesystemhastobeabletoaccomplish inorderto

fulfilouruser’sneeds.Basically,aswecanreadintheHTAdiagram,thesystemweare

designing shouldperform threemain actions: keepVIPs informedabout their turn

numberandwaitingtime,informthenurseabouttheirarrivaltothewaitingroomand

helpthemtonavigatetonewdestinationsifrequired.Theseactionscanbesplitinto

severalsmallerstepsthat,whentakenintoaccount,willdefineentirelythesystem:

thenextchapterwillstartbystatingtherequirementsarisenfromthesescenariosand

thesubsequentHTAdiagram.

34

Chapter5:Solutiondesign

Thepreviouschapters2and3formedtheanalyticalpartoftheengineeringprocess.

Theyallowustodiagnosetheproblemandunderstandtheneedsoursystemshould

satisfy.Inthischapter,theaimistoproposeasuitabletechnologicalsolutionforthe

diagnosedproblem.Thesolutionhastofulfilsomerequirementswhichwereobtained

fromtheuserstudy.Aftertheserequirementsaredefined,thedesigningprocesscan

start.

5.1Requirements

The requirements of a system are those characteristics the systemmust fulfil in

ordertoperformproperly.Theserequirementscanbedividedintofunctionalandnon-

functionalones.

5.1.1Functionalrequirements

According to the software management multinational company ReQtest [22], “A

functional requirement describes what a system should do, that is to describe the

behaviourofthesystemasitrelatestoitsfunctionality.”

1. Waitingroomkioska) Toidentifypeople.b) ToguideaVIPuntilthekiosk.c) Toprovideinformationaboutthecalculatedaveragewaitingtime.d) Todetectwhetherapatientisinthecorrectwaitingroomornot.e) Toprovidedescriptionsofthewaytospecificlocations.f) TohelpaVIPtofindafreeseatifrequired.

g) ToinformthehospitalstaffdevicewhenaVIParrivestothewaitingroom.h) To inform thehospital staffdevicewhenaVIPdoesn’t arrive to thewaiting

roomwhenexpected.

i) ToinformthehospitalstaffdevicewhenaVIPrequiresassistance.

2. Waitingroomseatsa) Toreservesomeseatsforpatientswithspecialneeds.b) Todetectwhetheraseatisfreeornot.c) ToguideaVIPtoafreeseatifrequired.

3. Directionalkioska) ToguideaVIPuntilthewaitingroom/specificdoctor’soffice.b) Toidentifypeople.c) ToguideaVIPuntilthekiosk.d) TodetectwhenaVIPislostorinthewrongway.

35

e) ToinformthehospitalstaffdevicewhenaVIPislostorinthewrongway.f) ToinformthehospitalstaffdevicewhenaVIPrequiresassistance.

4. Hospitalstaffdevicea) Toreceivethealertsfromthekiosks.b) Toinformthehospitalstaffaboutthealerts.c) Tosendinformationtothesystem.

5.1.2Non-functionalrequirements

Ontheotherhand,ReQtest[22]statesthat“anon-functionalrequirementdescribes

howthesystemwilldowhatitissupposedtodo.”

1. Waitingroomkioska) Tousefacialrecognitiontoidentifyaperson.b) Toprovidetheinformationindifferentlanguages.c) Toprovideaudioinformation.d) Toprovidehygienicinteraction.e) ToactivateabeaconinordertoguideaVIPuntilthekiosk.

2. Waitingroomseatsa) ToactivateabeaconinordertoguideaVIPuntilafreeseat,ifrequired.

3. Directionalkioska) Tousefacialrecognitiontoidentifyaperson.

4. HospitalstaffdeviceTherearenonon-functionalrequirementsforthehospitalstaffdevicesinceitis

nottheaimofthisthesistoexplainhowshoulditbedesignedandimplemented.

5.2Initialdesign(low-fidelityprototype)

The initialdesign is,as itsnameindicates, the firststep inthedesigningprocess.

Thelow-fidelity(lo-fi)prototypesareagoodwaytobeginwiththisprocess.According

to Egger [23], they are characterised by “a quick and easy translation of high-level

design concepts into tangible and testable artefacts.” Egger also states that “A clear

advantage of lo-fi prototyping is its extremely low cost and the fact that non-

programmerscanactivelybepartoftheidea-crystallisationprocess.”Therefore,alow-

fiprototypepermitsbasicideastobestudiedinasimple,quickandcheapway.Thus,

thedesigner isable toeasily test theprototype throughout theprocessandchange

thosefeaturesthatmustbeimproved.

BalsamiqMockupsisaprogramthatsubstitutespaperandpencilwhenitcomesto

drawschematicallythelo-fiprototypes.Anditisalsothetoolwechosetopresentthe

differentscreenshotsofthekiosk.

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5.2.1Waitingroomkiosk

ThemainfunctionsofthewaitingroomkioskaretodetecttheVIP’sarrivalandkeep

theminformedaboutthewaitingtimeandtheturnnumber.Ithasacamerathatscans

theVIP’sfaceandlinksittothetemporaryprofilecreatedaftertheircheck-inatthe

mainentrancekiosk.Inthisway,thesystemknowsthattheVIParrivedtothewaiting

roomandinformsthehospitalstaffaboutit.

Figure21:Sketchofwaitingroomkiosk

Parts:Camera

Function:facialrecognitionandobservingareasifneeded.Description:thecamerahastoscanthepatient’sfaceinordertoidentifythem.Itislocatedonthetopofthekiosk.Inadditiontothismainuse,thecamerasofthe

kioskscanbeusedbyspecialisedmembersfromthehospitalstaffinorderto,for

example,searchforlostpatients.

Buttonpad

Function:informationinput.

Speakers

Camera

Screen

Buttonspad

Guidelines

Headphonesjack

37

Description: the buttons are the only information input source of the kiosk(Figure 22). It is similar to a phone button pad, formed by ten keys with the

numbersfrom1to9andthreespecialkeysnamedTime(whichreadsoutloudthe

current time),Repeat (which repeats the options displayed on the screen) and

Emergency (which alerts somebody from thehospital staff). All thebuttons are

labelled with a braille sign. Hygiene of this pad is a matter of concern, but

alternatives like voice input are not realistic in a hospital environment. The

hospitalcleaningstaffhastobetrainedtobecomeespeciallyconsciousaboutthe

hygienicconditionsofthekiosk.

Figure22:WRkiosk,Buttonpad

Screen

Function:informationoutput.Description: the screen is the main interaction device of the kiosk. It has toprovidevisual informationaboutthewholerangeofoptionsthepatienthas.All

theoptionsmustbelinkedtooneofthebuttonsofthepad(Figure22)inorderto

beselected.

The systemknows that thepatient is aVIP since their registration at themain

entrancekiosk.Therefore,ifthepatientisaVIP,theoptionsonthescreenareread

outloutthroughthespeakersandrepeatedafteradefinedtimeout.

Inorder toprevent thesystemtobeabandoned ina specific screenoption, the

system goes back to theMain menu screen (Figure 25) after another defined

timeout.

Adetaileddescriptionofall theoptionsandpathsausercanfindonthescreen

can be found below. The design of thesemenus takes into account all the user

38

researchdoneandtheconsideredscenarios.Itisworthsayingthatthefollowing

screenshotsarenottheveryfirstversionofthedesign:sincethis isaniterative

process,the“initial”designincludessomeofthemainfindingsfromtheevaluation

sessionofthelo-fiprototype(section7.2).

Thestandbystateofthekioskisascreenthatinformsaboutthedepartmentand

askstheuserstoplacetheirfaceproperlyinfrontofthekioskinordertoproceed

withthefacialrecognition(Figure23).

Figure23:WRkiosk,Standbyscreen

When the user faces the kiosk camera, the face recognition starts. While the

processisbeingdone,thesystemshowsaloadingscreen(Figure24).

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Figure24:WRkiosk,loadingscreen

Oncethefacerecognitioniscompleted,thesystemshowstheMainmenuscreen

(Figure25).Ontheleftuppersideofthisscreen,informationaboutthelocationof

thekioskcanberead.Here,theusersarewelcomedandinformedabouttheirturn

number,anestimatedwaitingtimeandtheofficeanddoctorthattheyhavetovisit.

Afterthis informationistransmitted, thesystemnotifiestheusersthattheyare

goingtobeinformedwhentheirturnarrives.InthecaseoftheVIP,thisinforming

process is done by saying the turn number out loud and activating an acoustic

beacononthetopoftheassignedoffice’sdoor.

Finally,theusercansimplyleavetothewaitingroomseatsorchooseamongsix

options:1.Repeatinformation,2.Findafreeseat,3.WhereamI?,4.Navigatetoa

newdestination,5.Changethelanguageand6.Requireassistance.

TheRepeatoptionsbuttonisacommonoptionthroughoutallthescreens.Itmakes

thesystemtoreadagainalltheoptionsfromthemenuthroughthespeakers.

The1.Repeatinformationoptionmakesthesystemtoreadagaintheinformation

displayedonthescreenthroughthespeakers.

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Figure25:WRkiosk,Mainmenuscreen

The 2. Find a free seat option helps the user to find a free seat, and it is only

availableiftheuserisaVIP.Asexplainedinthenextsection(5.2.2Waitingroom

seats),thesolutionincludeskeepingsomereservedseatsofthewaitingroomfor

thosepatientswhomayneedthem.ThesystemaskstheVIPswhethertheywant

helpinordertofindafreeseatornot(Figure26).

Figure26:WRkiosk,Findafreeseatscreen

If the user confirms the help request, a pop-up alert informs them about the

activation of the acoustic beacon on the reserved seats (Figure 27). If the user

41

cancels,presses the3.Mainmenuoptionor thepredefined timeoutexpires, the

systemgoesbacktotheMainmenuscreen(Figure25).

Figure27:WRkiosk,Acousticbeaconactivatedpop-upThe3.WhereamI?optionofthemainmenuexplainsthelocationofthekioskto

the user (Figure 28). It shows a hospitalmap and a detailed description of the

location.Theoptionsmenuprovidesthreealternatives:1.Repeatinformation,to

makethesystemtoreadagainthelocationthroughthespeakers;2.Mainmenu,to

gobacktotheMainmenuscreen(Figure25);2.andRepeatoptions tomakethe

system to read again all the options. As explained before, this last button is

commoninallthescreenswhentheuserisaVIP.

42

Figure28:WRkiosk,WhereamI?screen

The4.Navigatetoanewdestinationoptionofthemainmenuallowstheuserto

askfordirectionstoanotherplaceofthehospitalsuchastheexit,thepharmacy,

the cafeteria and others (Figure 29). It also allows the user to select another

doctor’sofficeifthevisitisscheduledbeforehand.Inadditiontothat,thisscreen

allowstheusertogobacktotheMainmenuscreen(Figure25)ortolistenagain

totheoptions,asusual.

Figure29:WRkiosk,Navigatetoanewdestinationscreen

Whentheuserselectsapredeterminedoption(exit,pharmacy,cafeteria,etc.),the

system shows detailed information about the chosen destination and asks for

43

confirmation to start the guiding process (Figure 30). It also provides the 4.

General route audio description option to listen to a general description of the

selectedrouteandthe5.Detailedaudiodescriptiontonextkioskoptiontolistento

adetaileddescriptionofthewaytothenextkioskoftheroute.Inadditiontothat,

theuserhastheusualoptionstogobacktotheMainmenuscreen(Figure25)and

tolistenagaintoallthealternatives.

If the chosen destination is cancelled, the system goes back to the Get new

directionsscreen(Figure29).

Ontheotherhand,iftheuseracceptsthechosendestination,thesystemshowsa

screen with information about this destination and the location of the next

directionalkioskontheirway.Itstilloffersthepossibilitytocanceltherouteand

listentotheaudiodescriptionofitagain.Afterapredefinedtimeout,thesystem

goesbacktotheStandbyscreen(Figure23).

Figure30:WRkiosk,Predeterminednewdestinationscreen

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Figure31:WRkiosk,Onyourwayscreen

Whentheuserchosestheoption4.OtherscheduledvisitsfromtheNavigatetoa

newdestinationscreen(Figure29),thesystemshowsalistofalltheappointments

theuserhasforthepresentday(Figure32).Weassumethattheuserwillnothave

morethan8appointments,sothe9thbuttonisreservedforgoingbacktotheMain

menuscreen(Figure25)andtherepeatbuttonisreservedtolistentotheoptions

again,asusual.Whentheusersselectoneofthevisits,thesystemshowsthemthe

Onyourwayscreenasiftheyhadselectedacommondestinationlikethepharmacy

orthecafeteria(Figure31).

Figure32:WRkiosk,Scheduledvisitsscreen

45

The5.Change language optionof themainmenuallows theuser tochange the

languageofthesystem(Figure33).Asusual,itprovidesthealternativestogoback

totheMainmenuscreen(Figure25)ortolistentotheoptionsagain.

Figure33:WRkiosk,Chooselanguagescreen

Assoonas theuserselectsa language, thesystemshowsapop-upalertingthat

“the language has been changed”. This message is already written in the new

selected languageand theuserhas theoption toconfirmordismiss thechange

(Figure34).

Figure34:WRkiosk,Languagechangedpop-up(inCzech)

46

If thechangeisconfirmed,the languageofthewholesystemischanged(Figure

35).

Figure35:WRkiosk,ChooselanguagescreeninCzech

The 6. Require assistance option of the main menu alerts someone from the

hospitalstaff.Beforelaunchingthealert,thesystemasksforconfirmation(Figure

36). As usual, it provides the alternatives to go back to theMain menu screen

(Figure25)ortolistentotheoptionsagain.

Figure36:WRkiosk,Requireassistancescreen

Iftheusercancelsthealert,thesystemgoesbacktotheMainmenuscreen(Figure

25). On the other hand, if the user confirms the assistance request, the system

47

alertssomeonefromthehospitalstaffandaskstheusertowaitforitwithapop-

up(Figure37).

Figure37:WRkiosk,Assistancerequiredpop-up

Wemustconsiderthatthepatientmightarrivetothewrongwaitingroom.Ifthis

happens,theMainmenuscreen(Figure25)isslightlydifferent(Figure38).Allthe

optionsarethesame,buttheyaremovedbecauseoftheinclusionofthe2.IamOK

option.This optionexists to ensure that thehuman judgement ismore reliable

thanthesystem’sone:thesystemmaysaythattheusersareatthewrongwaiting

room when they are not because of an error or an unexpected change in the

hospital’sorganization.

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Figure38:WRkiosk,WrongWRscreen

Speakers

Function:informationoutput.Description: the speakers are the way whereby the kiosk communicatesinformationtotheVIP.Alltheoptionsfromthescreenarereadoutloudthrough

thespeakers.Inordertopreventawronguseofthem,speciallyinahospital,the

volumeisnotadjustablebyauserwithoutheadphones.Besidereadingtheoptions

and the information from the screen, the speakers can be used as an acoustic

beaconthatmayhelpaVIPtofindthekiosk.Thisbeaconisactivatedbythedevice

that many VIP use to activate such acoustic beacons when approaching traffic

lightsorusingpublictransport.Thethirduseofthespeakersistoinformoutloud

abouttheturnnumberdisplayedontheLEDsscreenthatinformsvisuallyabout

it.ThislastfunctionisonlyactivatedwhentheturnnumberbelongstoaVIP.

Computer

Function:systemcontrol.Description: to describe the computer specifications is not the aim of a startdesign section, but itmust be a computer able to perform satisfactorily all the

requestedfunctions.

Framework

Function:protectionandstructure.Description:theexternalstructureofthekioskmustbetallenoughtoplacethecamerainanaveragehumanheightandhardenoughtoprotectalltheelements

insideit.Ifthehospitalbuildings’organizationisfollowingacolourpattern,the

kioskframeworkshouldbepaintedaccordingtoit.

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5.2.2Waitingroomseats

Theproposedsolutionincludesthereservationofsomeseatsofthewaitingroom.

Theexactamountofreservedseatsandtheirlocationmaybedifferentdependingon

thehospitalcharacteristics.Anacousticbeaconisplacedintheareawheretheseseats

are.ThisacousticbeaconisactivatedbytheoptionsoftheWRkiosk(Figure27).In

additiontothis,thereservedseatsmustbeeasilyidentifiablebyaspecialcolourand

writtensignsinformingaboutit.

5.2.3Directionalkiosks

Itisnotanaimofthisprojecttodesignthedirectionalkiosks.Anyway,inorderto

preserve the coherence of thewhole system, they should be similar to thewaiting

roomkiosksbutsimpler.

5.2.4Hospitalstaffdevice

Thehospitalstaffmembershaveadevicewhichisabletoreceiveandsendalerts.

In order to save money, this device can be an app in the member’s personal

smartphone connected to the Wi-Fi network of the hospital. The system sends a

notificationtotheclosestdevicesandthemembersfromthehospitalstaffwhoreceive

it canattendor refuse thealert (Figure39). In the “Details”box, some information

aboutthealertsuchasthelocationortheproblemthepatienthasisexposed.

Figure39:Hospitalstaffdevice,Alertnotificationscreen

When the alert is accepted, the system tracks the status of the alert. During this

process,thehospitalstaffmemberhasthreeoptions:indicatethatthealerthasbeen

solved, ask for help from the cameras or declare an emergency (Figure 40). If the

hospitalstaffmemberasksforhelpfromthecameras,theappcallsanoperatorwith

accesstothecamerasofthehospitalforassistance.

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Figure40:Hospitalstaffdevice,Alertstatusscreen

It is not the aim of this thesis to go further into the hospital staff device design

because we do not have the option of testing it with real hospital staff members.

Furthermore, the needs of these users may change from one hospital to another,

accordingtotheirtrainingandtechnologicalpossibilities.

5.3Conclusions

The aim of this chapterwas to propose a suitable technological solution for the

diagnosed problem. After the requirements were defined, the proper designing

process started.Theproposed solution takes into account those requirements and,

therefore,we expect it to satisfy theuserneeds.The evaluationof this low-fidelity

prototypecanbefoundinsection7.2.Findingsarisenfromthisevaluationareadded

to the initial requirements in order to implement the high-fidelity prototype that

follows(chapter6).

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PartIII:Implementation

Thefirstpartofthecurrentworkwasabouttostudytheusersandtheenvironment

oftheproblem.Thesecondpartwasabouttoproposeasolutionthatsolvesproperly

theneedsof theusers foundon the firstpart.Therefore, this thirdpart isabout to

implement a prototype of the designed solution in order to test it with real users

afterwards.

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Chapter6:Solutionimplementation

Thischapterbringstheinitialdesignintoarealprototype.Thelo-fiprototypewas

justthedesignofthemenusofthekiosk.Thenextlogicalstepistodevelopausable

implementationofthosescreenshotsandoptions.

6.1Firstimplementation(high-fidelityprototype)

Egger[23]defineshigh-fidelity(hi-fi)prototypesasa“high-techrepresentationof

thedesignconcepts,resultinginpartialtocompletefunctionality.”Itsmainadvantage

isthat“userscantrulyinteractwiththesystem,asopposedtothesometimesawkward

facilitator-drivensimulationsfoundinlo-fiprototyping.”Hi-fi,however,“implieshigher

costs(…)andnecessitatesgoodprogrammingskillstoimplementtheprototype.”

Thissectionbrieflyexplainsthedevelopmentofthehi-fiprototype,thetechnologies

usedandtheimplementationprocess.

6.1.1Goaloftheprototype

It isimportanttokeepinmindthegoaloftheprototypeduringtheprocess.Only

thiswaywecanpreventourselvesfromspendingtoomuchtimeandresourcesonit.

Themaingoaloftheprototypeistosimulatethesystemoperationinordertobetested

byVIPs.Therefore,theimplementationofavisualuserinterfaceisunnecessary;itis

bettertofocusonthetext-to-speechissue.Moreover,sincethesolutionisapartofa

whole thatwillmerge different fragments into a homogenous complex system, the

programminglanguageandeventhecodearenotamatterofdeepconcern:theymay

bechangedtoadaptthemtothewholesystemandthehospitalneedsandcapabilities.

Iftheprototypeisabletoperformproperlywhenusersgothroughmenusandoptions

withaudiodescription,itwillaccomplishitsmissionandwewillbereadytoevaluate

it.

6.1.2Usedtechnologies

Althoughwejustexplainedwhytheusedtechnologiesshouldnotconcernusvery

much,itisimportanttoexplainwhichoneswechoseandwhywetookthemasafirst

choice.Twomaindecisionsaregoingtobemadeinthissection:thefirstoneisabout

the programming language and environment; the second one is about the text-to-

speechtechnology.

Programminglanguage Only twoprogramming languageswere considered as options since they are the

onesthatwearemoreusedto:C++andJava.Betweenthem,Javaseemedthebestone

consideringtheinteractivegoaloftheprototype.

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Text-to-speechtechnology There are many text-to-speech technologies, but most of them are either web

applicationswithnoeasyintegrationtoaprogrammedcodeornot-freeones.Thefirst

option considered was FreeTTS [24] a speech synthesizer in Java by the Speech

IntegrationGroupofSunMicrosystemsLaboratories.Themainproblemithasisthat

itdoesnotprovideaCzechlanguageoption(neededtotesttheprototypewithreal

CzechVIusers).UsingMBROLA[25]aprojectinitiatedbytheTCTSLaboftheFaculte

PolytechniquedeMons(Belgium)toobtainasetofspeechsynthesizersforasmany

languagesaspossible,thislanguageissuewouldbesolved.Theproblemnowisthat

MBROLA isa10-yearsoldprojectwithnocompatibilitywith thecurrentoperative

systemofourcomputers.Thesecondoptionconsideredwasthedefinitiveone:MacOS

X’s text-to-speech feature. The code only needs to call the terminal and its “say”

command. Even though this technology certainly has a compatibility problemwith

otheroperativesystems,itisveryeasytoimplementandithasabigrangeofdifferent

languageswithanaccuratepronunciation.

6.1.3Implementation

This is a technical section that explains the most relevant methods of the

programmedJavacode.Themainideabehindthecodeissimple:thecodereadstext

from a set of files that contain the differentmenus and options texts, it shows the

contentonthescreenanditreadsitoutloudbycallingthe“say”command.

ShowContent(file_path,language) Thismethodshowsonscreensomecontentfromatextfilespecifiedbyitspath.The

language variable affects directly the path name: the path can be

/Users/user/KioskScreens/eng/file.txt for the English version or

/Users/user/KioskScreens/cz/file.txt for the Czech version. This way, when a newlanguagewants tobeadded to the system, it is enough to createa folderwith that

versionoftextfilesandchangethevariablelanguage.

WhatToSay(file_path,language) Thismethodtellstheterminalhowandwhattosayoutloudfromatextfilespecified

by its path. The language variable affects the path name like in the ShowContentfunction.The“say”commandhastwooptionalfeaturesthatweuse:

-vname_of_the_vocie:voiceusedtoread.Inourcase,VictoriafortheEnglishversion

andZuzanafortheCzechone.

-ffile_path:filecontainingthetexttoread.

Say(file_path,process,language) Thismethodlaunchesaprocessthatstartsthecommand“say”andusesWhatToSay

inorder tochoosewhat isgoing tobereadout loud. It isworth toexplain that the

method destroys previous processes in order to prevent the program from

overlappingaudiomessageswhen theuser selectsanoptionbefore themessage is

completelyread.

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6.2Conclusions

Thegoalofthis implementationwastoperformlikearealsystemwhenusersgo

through menus and options. Even though the code is clearly improvable and its

efficiencyisnotthebestwecouldachieve,simplicityandaccuratepronunciationare

theremarkablefeaturesoftheprototype.Whentestedbytheprogrammersimulating

scenarios,itperformsproperlyandwithnoincidents:thisisagoodstartpointbefore

theprototypeistestedbyrealVIusers.

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PartIV:Evaluation

Theevaluationisacrucialpartoftheengineeringprocess.Westartedbystudying

the users and the environment, after that we designed a solution and finally we

implemented it. This part focuses on evaluation of the implemented solution.

Concretely,wefocusonusabilityandaccessibilityevaluationwithrealusersdescribed

inchapter7.Asfarastheintendedresultwasahighfidelityprototype,thesourcecode

oftheimplementationwasnotformallyevaluatedyet.

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Chapter7:Usabilitytesting

Theusabilitytestingisthemainpartoftheevaluationprocess.Itsmaingoalisto

finddesignproblems.AccordingtoNielsen[26],“Itisimportanttorealisethatusability

is not a single, one-dimensional property of a user interface. Usability has multiple

complimentsanditistraditionallyassociatedwiththesefiveusabilityattributes:

• Learnability:Thesystemshouldbeeasytolearnsothattheusercanrapidlystartgettingsomeworkdonewiththesystem.

• Efficiency:Thesystemshouldbeefficienttouse,sothatoncetheuserhaslearnedthesystem,ahighlevelofproductivityispossible.

• Memorability:Thesystemshouldbeeasy toremember,so that thecasualuser isabletoreturntothesystemaftersomeperiodofnothavingusedit,withouthaving

tolearneverythingalloveragain.

• Errors: The system should have a low error rate, so that usersmake few errorsduringtheuseof thesystem,andso that if theydomakeerrors theycaneasily

recoverfromthem.Further,catastrophicerrorsmustnotoccur.

• Satisfaction:The systemshouldbepleasant touse, so thatusersare subjectivelysatisfiedwhenusingit;theylikeit.

Onlybydefiningtheabstractconceptofusabilityintermsofthesemorepreciseand

measurablecomponentscanwearriveatanengineeringdisciplinewhereusabilityis

notjustarguedaboutbutissystematicallyapproached,improved,andevaluated.”

Therearemanymethodologiestotesttheusabilityandevaluatethevalidityofthe

prototype. The third lecture of the CTU’s Department of Computer Graphics and

Interactionsubject“Testovanıwebovehorozhranı(WebInterfaceTesting)”[27]lists

threedifferentuser-basedmethods:

• User surveys: Questionnaires with open-ended questions oriented towardsexpectedusabilityproblems.Theprosofthismethodarethatitisinexpensiveand

itcanbedoneremotely.Theconsarethatitreliesonlyonthedataprovidedbythe

usersandrecruitingtherightpeopleisaproblemduetoself-selectionbias.

• Ethnographic observations: Observing users in their environment, without anyintervention.Theobserverstayswiththeusersandwatchesthemhowtheyuse

thesystem.Theprosofthismethodisthatitistrulybasedonthereality.Onthe

otherhand,theconsarethatitneedsathoroughpreparation,itisanotinteractive

method,itcouldhavesomeethicalproblemsanditisexpensive.

• Usability engineering: Observing the users using the system in a simulatedenvironment where aspects of the real world are feigned. Users work on

predefined,butrealistictaskswhiletheyareobserved.Theprosandtheconsof

thismethodaretwofacesofthesamecoin:ifwellprepared,theresultsofsucha

testarecomparabletotheresultsobtainedfromthe“real-worldobservation”.If

not, since users are not in their natural environment, the results can be totally

away fromreality.Therefore, it is important tocreate lifelike tasks inarealistic

environmentand,ifpossible,touserealtargetusersofthesystem.

57

Afterconsideringallthreeuser-basedmethodsandfollowingtherecommendations

ofthementionedsubjectlecture,wedecidetocarryoutausabilityengineeringtest.

Thegoalsofthetestingare:

• Tofinderrorsandminormistakesinthedesignedprototype.

• Toobservewhethertheuserscompletetheassignedtasksornot.

• Tolistentotheusers’feedback.

7.1Tasks

Alltheusersareaskedtocompletefivetasksthatcoverthemainsituationsthatthe

systemisgoingtoface.Therefore,thesystemistestedinalmostrealconditionsandit

canbeimprovedwiththefeedbackfromtheusers.

Thereisacommonstart(below)forallthetasksandthenaspecificdescriptionfor

eachsituation.Theusershearthedescriptionfromtheinterviewerandthentheyuse

theprototypeinordertocompletethetask.

Thecommonstartgoes like follows: imagine thatyouarrive to thewaitingroom

afterfollowingthedirectionsprovidedbythesystem.Youfollowtheguidelinesonthe

floor(oractivatethekioskbeaconwithyourdevice)andplaceyourselfinfrontofthe

waitingroomkiosk.Afterafewseconds,yourfaceisrecognizedandthekioskstarts

talking.

7.1.1Task1:tofindafreeseat

Inthistask,theusersareaskedtoimaginethattheyaregoingtovisitDoctorJan

Prazak,fromtheCardiologyDepartmentoftheFNMotolhospital.Theywanttoknow

whentheirturnisand,afterthat,tofindafreeseatinordertowaitforit.

The expected resolution of this task is to listen to the message automatically

displayedatthebeginning(afterthefacerecognition)andthenselectthe“findafree

seat”optionfromthemenu.

Whenthetaskiscompleted,theusersaretoldthat,inarealscenario,theywould

followthesoundofthebeaconandfindtheseat.Afterafewminutes,whentheirturn

arrives,thesystemwouldinformthemaboutitoutloudandabeaconatthedoctor’s

officedoorwouldbeactivated.

7.1.2Task2:togototheexit

In the second task, the users are asked to imagine that the doctor had some

problemswithpreviousvisitsandeverythingislate.Thewaitingtimethesystemtells

totheusersisfivehours,sotheywouldliketogohome(thismeansfindingtheexit)

andcomebackinawhile.

The expected resolution of this task is to listen to the message, then select the

“navigate to a new destination” option from themenu and finally select the “exit”

option.

58

7.1.3Task3:togotoanotherwaitingroom

In the third task, the users are asked to imagine that they had two different

scheduledvisits for todayand theywent firstly to theone that is later.Thewaiting

timethesystemwilltellthemisfivehours,sotheywouldliketosolveitbygoingfirst

totheotherscheduledvisit.

The expected resolution of this task is to listen to the message, then select the

“navigate to a newdestination” option from themenu and finally select the “other

scheduledvisits”option.Then,itwillbethesameresolutionastheprevioustask.

7.1.4Task4:torequestassistance

In the forth task, theusers are asked to imagine that theymadeamistakewhile

followingthedirectionsandtheyarrivedtoawrongwaitingroom:theywouldheara

differentwelcomemessageatthebeginning.Then,theusersaretoldtoimaginethat

theyareinahurrybecausetheywillbelatefortheirscheduledvisit.Therefore,they

wouldliketobeassisted.

Thistaskcanbesolvedbypressingthealarmbuttondirectlyfromthekeypadorby

selectingthecorrectoptionfromthemenu.

7.1.5Task5:tochangethelanguage

Inthelasttask,theusersareaskedtoimaginethattheywanttochangethelanguage

ofthesystemintoEnglish.

Thetaskissolvedwhentheychangethelanguageandthereisnoneedtogothrough

thetaskagaininthenewlanguage.

7.2Lowfidelityprototypeevaluation

Thelowfidelityprototypeiscomposedofsimplythemenuofthekiosk.Inthisfirst

evaluation,participantswillbeaskedtocompletethetasksinordertocheckwhether

theoptions fulfil their expectationsornot.This evaluation isnot about the correct

operationofthesystembecauseitisthetesterwhoperformsthroughthemenuslike

thesystemwould.

7.2.1Participants

Three visually impaired participants take part in this evaluation session: two

femalesandonemale,allofthemfromPragueandpresentingdifferenttypesofvisual

impairment. The average age of the participants is 53 years old with a standard

deviation of 14.1 years. A detailed description of their profiles can be found in

appendixB.

59

7.2.2Procedure

Thetestingwithrealusers isheld ina testingroomof theElectricalEngineering

FacultyattheCTU.Theusersareaskedtocompleteatestshorterthanhalfanhour.

Thetestsimulatesarealenvironmentinwheretheusershavetogothroughthemenus

ofthekiosk.Thetesterreadstheoptionsoutloudandsimulatestheresponseofthe

systemwhentheuserinteractswiththekeypad.

7.2.3Findings

Sincethedesignprocessisiterative,mostofthefindingsarisenfromthisevaluation

session are already included in the initial design (section 5.2). Findings can be

distinguished between positive and negative ones. Positive findings are those that

praisethesystemandallowustoseethatthedesignedprototypeisworkingproperly.

Ontheotherhand,negativefindingsarethosethatshouldbetakenintoaccountina

re-designprocess.

Positivefindings• Overall,menusandoptionsareunderstandable.• Overall,participantsexpresssatisfactionwiththeinformationdisplayedwhentheyarrivetothekiosk.

NegativefindingsPriority1:

• The alternation of the words “accept” and “confirm” for the same action isconfusingandshouldbehomogenised.(P1-T3)7

Priority2:

• Oneparticipant feels confusedaboutwhen to leave thekioskafterhearing theroutedescription.(P3-T2)

Priority3:

• Oneparticipantfeelsuncomfortablewiththenumericpad.(P1-T1)• Oneparticipantexpectstheoption“navigatetotheexit”tobeindependentfromothernavigationoptionsandaccessiblefromthemainmenu.(P2-T2)

Otherconcerns• Howwillusersfindthecorrectdoctor’sofficeafterhearingtheirturnnumber?(P2-

T1)

• Thespeakerscanbebotheringforotherpatientsinthewaitingroom.(P3-T1)

7“P1-T3”meansthatthisfindingcomesfromhowthefirstparticipantperformedthethirdtask

oftheevaluationsession(appendixB).

60

7.3Highfidelityprototypeevaluation

ThehighfidelityprototypeiscomposedoftheJavaimplementation,theMackintosh

TexttoSpeechfeatureandanumerickeypad.Theaimofthisevaluationisnottotest

how the code performs but to verify that menus and options are understandable,

intuitiveandvisuallyimpaireduser-friendly.

7.3.1Participants

Sevenvisuallyimpairedparticipantstakepartinthisevaluationsession.Allofthem

are from Prague and present different types of visual impairment. A complete

descriptionoftheirprofilescanbefoundinappendixC.

Seven visually impaired participants take part in this evaluation session: five

femalesandtwomales,allofthemfromPragueandpresentingdifferenttypesofvisual

impairment. The average age of the participants is 38.3 years oldwith a standard

deviation of 13.7 years. A detailed description of their profiles can be found in

appendixC.

7.3.2Procedure

Thetestingwithrealusers isheld ina testingroomof theElectricalEngineering

FacultyattheCTU.Theusersareaskedtocompletethreetestsinarow,eachshorter

thanhalfanhour.Thisthreetestssimulatethethreepartsofthenavigationsystemin

order:thewebapplication,themainentrancekioskandthewaitingroomkiosk.

Thewebapplicationisthefirstparttobetested.Thetestingenvironmentisformed

byaWindowslaptopandanormalkeyboard.Thesecondparttobetestedisthemain

entrancekiosk,simulatedbyatabletintoa3Dprintedframework.Thethirdandlast

parttobetestedisthewaitingroomkiosk,thatisthepurposeofthecurrentthesis,

which is formedby aMacBookAir laptop running the Java source code, itsText to

Speechfeatureandanormalnumerickeypad(Figure41).

61

Figure41:Thethreepartsoftheusertestingenvironment

ThecompletesetoftestingsessionscanbefoundinappendixC.

7.3.3Findings

ApartfromminorspellingorCzechtranslationmistakesthatwereinstantlyfixed,

themainfindingsof thetestingsessionscanbedistinguishedbetweenpositiveand

negative findings, aswealreadydiscussed (section7.2.3).Thepositive findingsare

thosethatpraisethesystemandallowustoseethatthedesignedprototypeisworking

properly.Ontheotherhand,thenegativefindingsarethosethatshouldbetakeninto

account inare-designprocess.Negative findingsareclassified indifferent levelsof

priority depending on the urgency with which they must be fixed. Obviously, the

negative findingsaremuchmore interesting inandengineeringprocess.Therefore,

wearegoingtofocusonthem.

Positivefindings• Overall,theprototypeisunderstandableandworksproperly.• Twoparticipantsthinkthattheideaofusinganacousticbeacononthewaitingroomseatsisagreatidea.(P4/5-T1)8

• Sixparticipantsusedtheemergencybutton.(P1/2/3/4/5/6-T4)• Overall,participantsexpresssatisfactionwiththeinformationdisplayedwhentheyarrivetothekiosk.

NegativefindingsPriority1:

• Thekioskdoesn’thaveavolumecontrolforheadphones.(P7-T1)

8 “P4/5-T1” means that this finding comes from how the forth and the fifth participant

performedthefirsttaskoftheevaluationsession(appendixC).

62

• VIusersaremoreusedtofindthe“0”buttonofthekeypadratherthana“repeat”button.(P7-T1)

• The “change the language” section is not well designed when consideringmonolingualusers.(P7-T5)

Priority2:

• Threeparticipantswouldnotusetheacousticbeaconfeatureandwouldaskforhelpinstead.(P3/6/7-T1)

• Threeparticipantsareconfusedaboutwhentoleavethekioskafterselectingthe“navigatetoanewdestination”option.(P3-T3,P4/5-T2)

Priority3:

• Theword“next”mightbeconfusingreferredonlytotheimmediatelynextkioskoftherouteandnottherestofit.(P3-T3)

• Oneparticipantthinksthatthe“navigatetotheexit”optionshouldn’tbehiddeninsideanotheroption.(P4-T2)

• Oneparticipantexpectsmoredirectordersintheroutedescriptions.(P5-T3)

Otherconcerns• Howwillthewaitingroomseatsbereserved?(P1-T1)• Thesuggestedroutesmustbefree-obstaclesroutes.(P1-T2)• HowwouldthesysteminformVIuserswhenadelayonthewaitingtimeisproducedwhiletheyarealreadywaiting?(P7-T2)

7.4Redesignsuggestions

Afterdrawingthefindingsfromtheusabilitytesting,wecansuggestsomesolutions

tothesolvablenegativeonesinordertoimprovethesystem.

Priority1:

• Toaddavolumecontrolforheadphonestothekiosk,withbuttons“+”and“-”.ThebuttonsmustbereadablebyVIusers,sothesymbolsmusthaverelief.

• Tochangethe“repeat”buttonforthe“0”buttononthekeypad.• Toreconsiderthe“changethelanguage”sectiontakingintoaccountmonolingualusers.Eachlanguageoptionhastobewritten(andread)inthesamelanguagethe

optionis.

Priority2:

• Todisplaythesentence“now,youcandepart”beforetheoptionsinordertomakeclearthattheusercanleave.

Priority3:

• To reconsider whether the word “next” referred only to the immediately nextkioskoftherouteshouldbereplacedby“first”ornot:“Detailedaudiodescription

tothenextkiosk”vs.“Detailedaudiodescriptiontothefirstkiosk”.

• Toreconsiderwhether the “navigate to theexit”optionshouldbe independentfromthe“navigatetoanewdestination”ornot.

• Totakeintoaccountthattheaudiodescriptionoftheroutemustbeclearandeasytofollowandremember.

63

7.5Conclusions

Theaimofthischapterwastoevaluatethehi-fiprototypeinaprocessthatshould

be iterativewith thedesignone.Themore iterationsyou canafford, thebetter the

solutionwillfulfilrequirementsanduserneeds.Thishi-fiprototypecouldandshould

beimprovedafterthisiteration,asweexposedinthere-designsuggestions(section

7.4).GoingthroughNielsen’s[26]fiveusabilityattributesaftertheevaluation,wecan

state that our system’s strengths are learnability, satisfaction and a low error rate

whilethemainweaknessisefficiency.Memorabilityisadifficultattributetoevaluate

withsuchafewtestingsessions.Overall,wecanstatethattheproposedsolutionisa

verygoodstartpointthatsetsthebasisforthedefinitivesolution.

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Chapter8:Conclusions

Theaimofthischapter istoconcludethisthesisandproposethepossiblefuture

work. Firstly, the extend of achievement regarding particular thesis objectives is

described.

1. Tostudyandunderstandthestateoftheartinhospitalnavigationsystems.

Chapter 2 provided us a detailed study of seven existing solutions for in-hospital

navigationissues.Noneofthemapproachedtheproblemasourtargetgroup(VI)needs

it to be approached.: most of them consider the use of special devices such as

touchscreensorsmartphones.Nevertheless,thestudywasusefulinordertotakesome

ideasanditremindedussomeimportanttopicstotakeintoaccountlikeusers’privacy

or noise pollution. In addition to that, we explained the complex system which our

waitingroommanagementsystemisgoingtobeapartof.

2. Toanalysetheuserneeds.

User needs were analysed after an exhausting user research in chapter 3. Research

startedwithavisittothemainhospitalinPraguethatshowedmanynavigationissues,

even forpeoplewithnovisual impairment. It continuedwith three interviews toVIP

which were useful to understand better our target group and, from there, create a

personawithrealisticcharacteristics:Tereza.Aftertheinterviews,inchapter3westated

the findings from the experiencemap arisen from a brainstorming session heldwith

otherresearchers.Someofthosefindingswereusefultodefineuserneedsattheendof

thechapter,namely:toknowthewaitingtimeandwhentheirturnis,tofindafreeseat

inthewaitingroom,toaskfordirections,toaskforassistance,tochooseamongdifferent

languagesandtochoosehowtheinformationisdisplayed.

3. Tostatethesystemrequirementsaccordingtotheseneeds.

Requirementsarestatedinsection5.1.

4. Toproposeadesignfulfillingthestatedrequirements.

Afterdefiningtherequirements,theproperdesigningprocessstarted.Theinitialdesign

is a low fidelity prototype description (see section 5.2) of the different parts of the

system: waiting room kiosk, waiting room seats, directional kiosk and hospital staff

device.We focused on theWR kiosk and defined every screenshot of themenus and

optionsfollowingthescenarioanalysisofchapter4.Thelo-fiprototypewasevaluated

insection7.2and,aftersomeredesignsteps,itprovedtobeperformingasusersneed.

5. Toimplementandevaluateahigh-fidelityprototypeofthesolution.

Inchapter6,weprovidedanimplementationthatwasabletoperformlikearealsystem

whenusersgothroughmenusandoptions.Eventhoughtheefficiencyoftheproposed

programedcodeisclearlyimprovable,thehi-fiprototypeworksproperlythroughoutthe

differentevaluationtasks.

65

6. Tostatefuturedeveloperdocumentation.

Afterthisobjectivesandachievementsanalysis,afutureworksectioncanbefound.

7. To help visually impaired people to understand information displayed in a hospital

waitingroom.

The proposed solution keeps VIPs informed by telling them out loud an estimated

waitingtimeandturnnumberwhentheyarrive.Moreover,itwarnsthemwhenthat

turnnumbercomes.

8. To improve visually impaired people’s experience in a hospitalwaiting roomby, for

example,helpingthemtofindafreeseatornavigatingthemtospecificlocationssuch

astoiletorcafeteria.

TheproposedsolutionallowsVIPs toask forhelp inorder to finda freeseat in the

waitingroombyusinganacousticbeacon.Italsohelpsthemtobenavigatedtoother

destinationswithinthehospital:exit,toilet,cafeteria,pharmacy,otherwaitingrooms…

9. Tomakevisuallyimpairedpeopleindependentfromotherpeoplewhiletheyareintheir

waytothewaitingroomandinthere.

Thewholesystemisdesignedtoavoidasmuchdependenceaspossible.Italwaysminds

thatVIPisaloneandalltheinformationinput/outputisaccessible,butitkeepssome

external help available for emergencies such as the help button and the “request

assistance”option.

10. To design a waiting roommanagement solution integrated in the complex in-hospitalnavigationsystem.

Thedesignedsolutiontakes intoaccountandevenassumestherestof thecomplex

system.VIPspreparetheirvisitonthewebapplication,thengotothehospitalandget

signedinbythemainentrancekiosk,followdirectionsprovidedbysimplenavigation

terminalsandfinallyarrivetothewaitingroom.Butitisworthtopointoutthatwedo

notbelievethatarrivingtoawaitingroomistheendofnavigationprocess:aftertheir

visit, VIPs can be navigated to the exit and leave the hospital or they can ask for

directionstoanyotherplacewithinthehospitalandstarttheprocessagain.Therefore,

waitingroomkioskmustperformverysimilartomainentrancekiosk.

Itseemsfairtostatethatthesefourmaingoalswereaccomplishedbyfollowinga

formalengineeringprocess.Nevertheless,somestepscouldhavebeenimprovedifthe

meanshadallowedustodoso:awiderrangeof interviewswouldhaveprovideda

morereliableuserresearchorhavingahospitalavailabletotesttheprototypesand

havingallpartsofthecomplexsystemworkingtogetherwouldhavecontributedtoa

morerealisticevaluation.Itwouldhavealsobeeninterestingtoaskhospitalstaffand

propose a solution for their device. Unfortunately, resources of a single thesis are

limited.Thisiswhydescribingtheexpectedfutureworkissoimportant.

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Futurework

Thisthesisisjustafirststepthatopensthedoortoanyoneinterestedinhospital

navigationsystems.Itisthesubjectoffutureworktoaddressissuesdiscoveredduring

evaluationofourfinalprototype(seesection7.4).Nextprototypeshouldassimilate

thoseredesignsuggestionsandeventuallybeperfectlyintegratedwiththerestofthe

complexsysteminordertobetestedinarealenvironment.Designingadeviceforthe

hospital’sstaffisalsoamatteroffutureapproachestothisissue.

Goingfurtherinthefuture,theidealcomplexsystemshouldbeasmallpartofan

evenmorecomplexhospitalsystemthatwillmanageallkindofvisitorsandneeds.

This system should provide assistance to different kind of peoplewith orientation

difficulties,butalsofreenursesandadministrativestafffrompaperwork.

Furtherapproachestothisissuehavetotakeintoaccountthefinancialfaceofthe

problem: hospitals need to know the costs of implementing such a system in their

facilities.Anotherconcerntobeconsideredinthefutureisusers’privacy.Ifthesystem

ismanaging confidential data and electronic health records, it has to be protected

againstattacksanderrors.

67

Appendices

68

AppendixA:Userresearchinterviews

This appendix contains the three interviews carried out in order to collect

informationfortheuserresearch.

A.1InterviewtoparticipantI

ProfileAge:38

Gender:M

Categoryofvisualimpairment(1-5):5

Time:L

Address:Prague

Q1Howdoyouorientateyourselfinahospital? Heusesawhitecanetoorientatehimselfand,althoughhepreferstobeindependent

fromotherpeople,henormallygoestothehospitalwitharelativeorafriendwhocan

helphim.Theparticipantpointsoutthattheworstorientationproblemhefaceswhen

visiting a hospital are closed doorswithout guidelines: they are undistinguishable

fromwallswhen youuse awhite cane.While traveling to the hospital, he uses his

transmitterforblindpeople,whichinteractswithbeaconsallaroundthecity,specially

whilecrossingthestreetorwhenusingthepublictransport.

Q2Onceyouareinthewaitingroom,howareyouinformedallthetime?Whatwouldyouliketoknow? Theuserthinksthat,likealltheotherpatients,heisnotinformedenough.Knowing

theamountofpeopleinfrontofhimorknowinganestimatedremainingtimewould

beuseful.

Q3Howdoyoutofindafreeseatinthewaitingroom? Theuserhasnoparticulardifficulties in findinga freeseatandhe thinks that to

reserveanamountofseatsfordisabledpeoplemakesnosenseinahospitalwaiting

roombecauseinthereeveryonehassomespecialneeds.

Q4Howdoyouthinkthatthehospitalstaffispreparedtohelpvisuallyimpairedpeople? Theuserthinksthat,ingeneral,hospitalstaffarenotkindandtheydon’tknowhow

todealwithvisuallyimpairedpeople.Maybesomespecificcourseabouthowtodeal

withthisusergroupisneeded.

Q5Howwouldyouliketoreceivetheinformation? Theuserexplainsthatnotmanyvisually impairedpeopleareabletoreadbraille

and he points out that people with diabetes may have difficulties with tactile

interaction.Accordingtohisopinion,thebestalternativeisanaudiosystem(withyour

ownheadphonesinordernottobothertheotherpatients)withnumberslike“ifyou

69

want this, press that” similar to a call centre.He recommends shortmessages and

voiceconfirmationalways.Theuseralsothinksthatthehygieneofthebuttonscanbe

aprobleminahospital.

Q6Afterthevisittothedoctor,howwouldyouliketosetthenextappointment? Thenurseusuallydoesthatanditisthebestoptionforhim.

Q7Afterthevisittothedoctor,wouldyouliketobeguidedtogototheentrancepoint,pharmacyorpublictransport?Wouldyouliketobeguidedthroughoutafree-obstacles(maybelonger)route? Yes,eventhoughtheusernormallyvisitsthehospitalwithaguide.Theuserpoints

outthatcloseddoorsarelikewallswhenusingawhitecane,andhangingobjectscan

beinvisible.Openareasareaproblemtoo.

Q8Anyadditionalideatoimproveyourvisitstothehospital? Theuser thinks that thereshouldbeaway toknowwhenhis turn isandawell-

definedprotocoltoinformthenursethattheuserarrivedandtoknowwhattodowith

thehealthinsurancecard.

70

A.2InterviewtoparticipantII

ProfileAge:68

Gender:F

Categoryofvisualimpairment(1-5):5

Time:L

Address:Prague

Q1Howdoyouorientateyourselfinahospital? Theuserusesawhitecaneandaguidedogtomovearound,butshenormallygoes

tothehospitalaccompaniedbysomerelativeor friend. Ifshe isgoingtosomenew

place,shepreparesherwaycarefullyandaskssomebodytodescribeittoherbyusing

GoogleMapsorsimilarapps.

Q2Onceyouareinthewaitingroom,howareyouinformedallthetime?Whatwouldyouliketoknow? Theuserthinksthatsheisnotinformedenough.Shewouldfindusefultoknowthe

numberofpatientsinfrontofherortheremainingwaitingtime.Sheusuallyasksthis

kindofinformationtothenurseortootherpatients.

Q3Howdoyoutofindafreeseatinthewaitingroom? Normally,otherpatientshelphertofindaplacewithoutneedtoask.

Q4Howdoyouthinkthatthehospitalstaffispreparedtohelpvisuallyimpairedpeople? Theuserthinksthatsometimesthehospitalstaffdon’tknowhowtohelpher.

Q5Howwouldyouliketoreceivetheinformation? Theuserhasnorelevantexperiencewithanytouchpad;shewouldliketoreceive

theinformationinaudioorbraille.

Q6Afterthevisittothedoctor,howwouldyouliketosetthenextappointment? Theuserexplainsthatshealwaysasksthenursetosetthenextappointment.

Q7Afterthevisittothedoctor,wouldyouliketobeguidedtogototheentrancepoint,pharmacyorpublictransport?Wouldyouliketobeguidedthroughoutafree-obstacles(maybelonger)route? Theuserwouldfindreallyusefultoheardetaileddescriptionsthatmayguideher

tospecificlocations.

Q8Anyadditionalideatoimproveyourvisitstothehospital? Theuserwouldliketofinddetaileddescriptionsofthehospitalonthewebsite.

71

A.3InterviewtoparticipantIII

ProfileAge:34

Gender:M

Categoryofvisualimpairment(1-5):5

Time:C

Address:Prague

Q1Howdoyouorientateyourselfinahospital? Theuserusesawhitecane,buthenormallygoestothehospitalwithsomebodyand

asksforhelpwhenneeded.Hefeelscomfortablewhenaskingtostrangersandhehas

nothadrelevantbadexperienceswiththat.

Q2Onceyouareinthewaitingroom,howareyouinformedallthetime?Whatwouldyouliketoknow? Theusersaysthattheinformationreceiveddependsonthewaitingroomheisin.

Normally,hekeepsaskingtootherpatientsor to thenurses.Theuserwould found

usefultoknowtheamountofpeopleinfrontofhimorthewaitingtime.Heexplains

thatwhenthepatientorderisregulatedbyanumberdisplayedonascreen,itisabig

problemthatforceshimtokeepaskingallthetime.

Q3Howdoyoutofindafreeseatinthewaitingroom? Somebodyhelpshimto find the freeseat,normally thepersonwhoaccompanies

himcandothat.

Q4Howdoyouthinkthatthehospitalstaffispreparedtohelpvisuallyimpairedpeople? Theuserthinksthatnursesanddoctorsarenormallypreparedenoughtohelphim.

Ontheotherhand,theotherhospitalstaffsuchasadministrationpersonnelisnotable

tohelpvisuallyimpairedpeople.

Q5Howwouldyouliketoreceivetheinformation? Theuserisfamiliarizedwithsmartphonesandheusesakeypadfortheinformation

inputs and audio descriptions for the outputs. He feels also comfortable reading

braille.

Q6Afterthevisittothedoctor,howwouldyouliketosetthenextappointment? Theuserexplainsthathealwaysasksthenursetosetthenextappointment.

Q7Afterthevisittothedoctor,wouldyouliketobeguidedtogototheentrancepoint,pharmacyorpublictransport?Wouldyouliketobeguidedthroughoutafree-obstacles(maybelonger)route? Theusernormallyasks thehospital staff fordirections, andhewould find really

usefultoheardetaileddescriptionsthatmayguidehimtospecificlocations.

Q8Anyadditionalideatoimproveyourvisitstothehospital? Theuserwould like to knowwhenhis turn is. Andhewould finduseful to hear

detaileddescriptionsofthehospitalonthewebsite.

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AppendixB:Evaluationtasksofthelowfidelityprototype

This appendix contains the three tests carried out in order to evaluate the low

fidelityprototype.

B.1ParticipantI

ProfileAge:40

Gender:F

Categoryofvisualimpairment(1-5):4

Time:L

Braille:No

Address:Prague

Task1:tofindafreeseat Thetaskiscompletednormally,buttheparticipantpreferstousethenumberson

thekeyboardratherthanthenumerickeypad.

Task2:togototheexit Thetaskiscompletednormally.

Task3:togotoanotherwaitingroom Thetaskiscompletednormally,buttheparticipantpointsoutthatthealternation

ofthewords“accept”and“confirm”isconfusing.

Task4:torequestassistance Thetaskiscompletednormallybyusingtheemergencybutton.

Task5:tochangethelanguage Thetaskiscompletednormally.

73

B.2ParticipantII

ProfileAge:68

Gender:F

Categoryofvisualimpairment(1-5):5

Time:L

Braille:Yes

Address:Prague

Task1:tofindafreeseat Thetaskiscompletednormally,buttheparticipantwondershowshewouldfindthe

doorafterhearinghername.

Task2:togototheexit Theparticipantisunabletocompletethetaskwithouthelp.Sheexpectedtofindthe

option“gototheexit”inthemainmenu.

Task3:togotoanotherwaitingroom Thetaskiscompletednormally.

Task4:torequestassistance Thetaskiscompletednormallybyusingtheemergencybutton.

Task5:tochangethelanguage Thetaskiscompletednormally.

74

B.3ParticipantIII

ProfileAge:51

Gender:M

Categoryofvisualimpairment(1-5):5

Time:C

Braille:Yes

Address:Prague

Task1:tofindafreeseat The task is completed normally, but the participant thinks that this feature is

unnecessaryandmaybebotheringforotherpatients.

Task2:togototheexit Thetaskiscompletednormally,buttheparticipantisunsureabouttheendofit.

Task3:togotoanotherwaitingroom Thetaskiscompletednormally.

Task4:torequestassistance Thetaskiscompletednormallybyusingtheemergencybutton.

Task5:tochangethelanguage Thetaskiscompletednormally.

75

AppendixC:Evaluationtasksofthehighfidelityprototype

This appendix contains the seven tests carried out in order to evaluate the high

fidelityprototype.

C.1ParticipantI

ProfileAge:41

Gender:M

Categoryofvisualimpairment(1-5):4

Time:C

Braille:Yes

Address:Prague

Task1:tofindafreeseat Thetaskiscompletednormally,buttheparticipantwondershowwillthefreeseats

bereservedandpreservedfromotherpeopletositinthem.

Task2:togototheexit Thetaskiscompletednormally,buttheparticipantpointsoutthattheroutetothe

exitmustbewithoutstairsandproperlydetailed.

Task3:togotoanotherwaitingroom Thetaskiscompletednormally.

Task4:torequestassistance Thetaskiscompletednormallybyusingtheemergencybutton.

Task5:tochangethelanguage Thetaskiscompletednormally.

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C.2ParticipantII

ProfileAge:40

Gender:F

Categoryofvisualimpairment(1-5):5

Time:C

Braille:Yes

Address:Prague

Task1:tofindafreeseat Thetaskiscompletednormally.

Task2:togototheexit Thetaskiscompletednormally.

Task3:togotoanotherwaitingroom Thetaskiscompletednormally.

Task4:torequestassistance Thetaskiscompletednormallybyusingtheemergencybutton.

Task5:tochangethelanguage Thetaskiscompletednormally.

77

C.3ParticipantIII

ProfileAge:66

Gender:F

Categoryofvisualimpairment(1-5):4

Time:L

Braille:No

Address:Prague

Task1:tofindafreeseat Theparticipantpressesthehelpbuttoninsteadofselectingthe2.Findafreeseat

optionfromthemenu.Sheexplainsthatshewouldaskforhelptofindafreeseatto

someonearoundherbecauseshedoesnotwant tobotheranyonewith thebeacon.

Shealsofeelsconfusedaboutthe3.Findoutwhereyouareoptionofthemenubecause

shealreadyknowswheresheis.

Task2:togototheexit The task is completednormallybut theparticipanthas some trouble inorder to

makethesystemrepeatthemainmenuinfo.

Task3:togotoanotherwaitingroom Theparticipantisconfusedabouttheendofthetask,butshecompletesitnormally.

Inaddition to that, shepointsout that theword “next” is confusing referred to the

kiosks because one would expect the option of hearing one after the other when

pressingthe5.Detailedrouteaudiodescriptiontonextkioskoptionmorethanonce.

Task4:torequestassistance Thetaskiscompletednormally.

Task5:tochangethelanguage Thetaskiscompletednormally.

78

C.4ParticipantIV

ProfileAge:28

Gender:F

Categoryofvisualimpairment(1-5):5

Time:C

Braille:Yes

Address:Prague

Task1:tofindafreeseat Thetaskiscompletednormallyandshethinksthatthebeaconontheseatisagreat

idea.

Task2:togototheexit Theparticipantisconfusedabouttheendofthetask.Shealsopointsoutthat,inher

opinion, the “exit” option should not be hidden inside the 4. Navigate to a new

destinationoptionbutindependentandaccessiblefromthemainmenu.

Task3:togotoanotherwaitingroom Thetaskiscompletednormally.

Task4:torequestassistance Thetaskiscompletednormallybyusingtheemergencybutton.

Task5:tochangethelanguage Thetaskiscompletednormally.

79

C.5ParticipantV

ProfileAge:30

Gender:F

Categoryofvisualimpairment(1-5):4

Time:C

Braille:Yes

Address:Prague

Task1:tofindafreeseat Thetaskiscompletednormally.Theuserthinksthatthebeaconontheseatisagreat

ideabutsheisconcernedaboutbotheringtheotherpeopleinthewaitingroom.And

shewoulddefinitelyuseheadphones.

Task2:togototheexit Thetaskiscompletednormally,butshefeelsconfusedabouttheendofthetask.She

wouldexpectthe“youcandepart”justaftertheinformationisdisplayed.

Task3:togotoanotherwaitingroom Thetaskiscompletednormallybutshewouldexpectmoredirectorderslike“turn

left”.

Task4:torequestassistance Thetaskiscompletednormallybyusingtheemergencybutton.

Task5:tochangethelanguage Thetaskiscompletednormally.

80

C.6ParticipantVI

ProfileAge:25

Gender:F

Categoryofvisualimpairment(1-5):5

Time:C

Braille:Yes

Address:Prague

Task1:tofindafreeseat Thetaskiscompletednormally,buttheparticipantopinesthattheacousticbeacon

is a sci-fi and too expensive solution: it is easier to ask someone forhelp. She also

explainsthatknowingtheturnnumberisveryuseful.

Task2:togototheexit Thetaskiscompletednormallyandshethinksthatthisisaveryusefulfeature.Task3:togotoanotherwaitingroom Thetaskiscompletednormally.

Task4:torequestassistance Thetaskiscompletednormallybyusingtheemergencybutton.

Task5:tochangethelanguage Thetaskiscompletednormally.

81

C.7ParticipantVII

ProfileAge:38

Gender:M

Categoryofvisualimpairment(1-5):5

Time:L

Braille:Yes

Address:Prague

Task1:tofindafreeseat Thetaskiscompletednormally,buttheparticipantthinksthathewouldaskforhelp

to someone in thewaiting roomwithoutusing thebeacon.He suggests a coupleof

changes:the2.Findafreeseatoptionshouldbe“askforhelptofindafreeseat”and

the“repeat”buttonshouldbethe“0”onthebuttonspadbecausevisually impaired

people is completely used to find it on the pad. In addition to that, the participant

expresseshisconcernaboutthelackofavolumecontrol.

Task2:togototheexit The task is completed normally, but the participant is concerned about how he

wouldbeinformedifthedelayoccurswhileheisalreadywaitinginthewaitingroom.

Task3:togotoanotherwaitingroom Thetaskiscompletednormally.

Task4:torequestassistance Thetaskiscompletednormally,buttheparticipantexplainsthehewouldn’tusethis

featureofthesystem:incaseofanemergency,hewouldshoutorcallsomebody.

Task5:tochangethelanguage Thetaskiscompletednormally,buttheparticipantsuggeststhateachlanguageon

thelistshouldbewrittenandreadinthesamelanguagetheoptionoffers.

82

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