Future of Health IT: Trends and Scenarios

links for 2006-10-29

• Guerrilla HCI
  Tutorial by Jakob Nielsen
  (tags: design hci usability tutorial)
• MIT course in UI Design and Development
  Open Courseware - pretty comprehensive coverage.
  (tags: design usability mit ui hci tutorial si682)
• Accessibility in the UI Design process
  nice brief tutorial showing use of scenarios. good brief explanation and lots of examples.
  (tags: hci tutorial si682)
• FROM USAGE SCENARIOS TO USER INTERFACE DESIGN IN A FEW STEPS
  Hey, the title was in caps, I just copied it. Good example of a way of doing a scenario on p. 95 (page 4-5 in the PDF).
  (tags: design hci tutorial si682)
• Task-Centered UI Design, Chapter 2: Getting to Know Users and Their Tasks
  Doesn't include any super clear examples, but does describe a great method for task analysis and creating scenarios from task analysis results.
  (tags: hci tutorial si682 design ui)
• The Art of Designing Meaningful Conversations
  Not specifically about scenarios, but a seminal paper showing in a few pages why scenarios are a good idea.
  (tags: hci si682)
• Scenario-Based Design
  Minimalist looking web page with a very nice, brief description about its topic. Also has link to oodles of scenarios contributed by others around a single topic.
  (tags: how-to usability si682 tutorial hci)
• Write Scenarios/Analyze
  Brief but perfect method description for writing scenarios, including an answer to that persistent question, how long should my scenario be?
  (tags: hci si682 tutorial)
• Writing an Online Form
  Describes a project using paper prototyping + scenarios. Not too long, easy read, good info.
  (tags: hci si682 tutorial)
• Final Scenarios
  Another good page about scenarios on usability.gov; this one talks about scenario writing for user testing in system evaluation.
  (tags: si682 hci tutorial)

links for 2006-10-27

• Wanda J. Orlikowski
  Author of "The Duality of Technology", the first paper I saw that looked at IT adoption (in particular groupware adoption) through the lens of structuration theory.
  (tags: structuration information+technology groupware research)

More EHR products get certified, and I become a convert

CCHIT recently announced the second round of Certified EHR Products, bringing the total number to 33. This is great news. I'm curious, though about the use of the word "evolve" in this excerpt from the press release:

The certification criteria have been developed to ensure that products provide a broad foundation of functionality, will evolve to deliver standards-based interoperability with other systems, and include security features to protect the privacy of personal health information.

Oops. I thought we were doing this to achieve interoperability in the first place. One of the goals in CCHIT's About page reads: "Ensure interoperability (compatibility) of HIT products ".  It turns out that is in the future, and it's not clear when interoperability standards will be delivered.

Forget all those things about being skeptical about interoperability with respect to CCHIT's efforts (for example, see CCHIT EMR Certs: The Prisoner's Dilemma Revisited). CCHIT is starting from a different Square One than I was assuming, so at least some of my complaints are off-target. My bad.

eWeek: Delivering Psychiatric Care Through Broadband

eWeek is running an article entitled Delivering Psychiatric Care Through Broadband that describes the use of two Australian Web sites to monitor and treat depression. Our Depression Center's program, called Michigan Depression Outreach and Collaborative Care (M-DOCC), has just started using a Web interface to capture patient self-reports, but the Aussies have already gone us one better. They are using their Web presence to teach and reinforce evidence-based treatment using an online version of Cognitive Behavioral Therapy (CBT), and the results sound very promising. Not bad for people who have to stand upside down all their lives!

links for 2006-10-26

• Vitamin Features » How C.R.A.P is Your Site Design?
  CRAP stands for Contrast, Repetition, Alignment, Proximity - not what you were thinking.
  (tags: design webdesign tutorial si682)

Computational biology meets family physician - the future of clinical research

In a conversation this morning with some colleagues about the future of clinical research, I had an insight about how to make sense of the rapid changes in health IT, especially in the research realm.

The IT revolution dramatically accelerated the field of systems biology by making solutions to incredibly hard problems possible - still not easy, but possible. The decoding of the human genome is an example. I am not an insider in that realm, but I have been in bar conversations where people who are insiders told me that about 30% of the decoding happened in the first eight years, and the remaining 70% in the following couple years, thanks to the power law curve created by the interaction of Moore's Law with rapid advances in the related areas of storage and retrieval technology and parallel processing. (Remember this is from bar conversations, so correct me if I'm wrong.)

Not much was happening in clinical research informatics at that time. We got better at electronic data capture, and learned a lot more about how much effort the protection of patient confidentiality really requires. No revolution occurred equivalent to the genomics world.

The recent discovery of possible inks between Vioxx and heart attacks by Kaiser-Permanente may have been the turning point. What they did wasn't rocket science, it was a matter of having a standard EMR for a large population and enough computational power to mine a huge data set. I don't know if they had the standard EMR in K-P fifteen years ago, but they certainly didn't have the MIPS-per-dollar ratio we have now. So again not being an insider in their world, I would speculate that the Vioxx affair was paradigmatic of the future of clinical research, or at least one major facet of that future.

The decoding of the human genome led to the gradual realization that genomics alone doesn't do it, we need a better understanding of proteomics and metabolomics to solve the mysteries behind cancer and the other complex ailments that beset us. The birth of genomics is the evolutionary equivalent of the first creature that grew legs and waddled out of sight of the ocean. An amazing first step, but only the beginning of a much exploration. 

The Vioxx affair may be the same kind of moment in the realm of clinical research. We've realized we can get oxygen out of the air, and don't have to stay in the water. We are now on shore and looking inland. What awaits us? No one can say for sure, but there can be no doubt that information technology is the evolutionary engine, the prime driving force at this point in history. Our real discoveries in this realm, as in basic science, have just begun.

Isaac Asimov pointed out that a sufficiently advanced technology will be indistinguishable from magic. I can safely predict that one day soon, a family physician will be doing magical things in a clinic near you.

links for 2006-10-22

• Research-Based Web Design & Usability Guidelines
  Comprehensive evidence-based guide to heuristics and guidelines primarily focused on Web usability, but easily generalized to other types of user experience. Best feature: you can sort the guidelines by title, strength of evidence, and other criteria (ht
  (tags: collaboration standards usability UserExperience Web2.0 webdesign reference research)
• Older Wiser Wired - Adults over 50 Online, Life and Living - AARP
  Info about computer use by Americans over 50. Excellent stuff here!
  (tags: reference usability webdesign ia research)
• Blog Usability: Top Ten Design Mistakes in Weblogs (Jakob Nielsen's Alertbox)
  Usability guidelines for bloggers, from the Web Usability God.
  (tags: blog usability reference research)

Spam Trojan Installs Own Anti-Virus Scanner

I just got a link to this article in eWeek entitled Spam Trojan Installs Own Anti-Virus Scanner.

Most viruses and Trojans already attempt to block anti-virus software from downloading updates by tweaking hosts file to the anti-virus update sites to the localhost address. Malicious hackers battling for control over an infected system have also removed competing malware by killing processes, removing registry keys, or setting up mutexes that fool the other malware into thinking it is already running and then exiting at start. But, as Stewart discovered during his analysis, SpamThru takes the game to a new level, actually using an anti-virus engine against potential rivals. At start-up, the Trojan requests and loads a DLL from the author's command-and-control server. This then downloads a pirated copy of Kaspersky AntiVirus for WinGate into a concealed directory on the infected system. It patches the license signature check in-memory in the Kaspersky DLL to avoid having Kaspersky refuse to run due to an invalid or expired license, Stewart said. Ten minutes after the download of the DLL, it begins to scan the system for malware, skipping files which it detects are part of its own installation. "Any other malware found on the system is then set up to be deleted by Windows at the next reboot," he added.

I don't know whether to laugh or cry.

SERENDIPITY: Older Wiser Wired

While looking at the Guidelines Sorting Tool, a cool feature of the US DHHS's usability.gov guidelines tome, I stumbled across the AARP's subsite on computer use by adults over 50 - Older Wiser Wired - Adults over 50 Online, Life and Living - AARP. 

This is a great find for those of us interested in making our Websites usable to persons other than college sophomores and baristas, who in any case spend most of their time on MySpace, YouTube, Second Life, World of Warcraft, and Google Everything rather than visiting the sites and applications we build and the blogs we write.

links for 2006-10-21

• FrontPage - MICHIPUG Wiki
  Wiki for the Michigan Python Users Group.
  (tags: annarbor python wiki)
• TurboGears: Front-to-Back Web Development
  Python aficionados (and aficionadas): If this doesn't blow your hair back, you're using too much styling mousse. Ruby on Rails-like.
  (tags: Ajax python programming tutorial Web2.0)