The technology acceptance model and beyond: factors influencing physicians' intention to use teleconsultations

Background/Aims: The COVID-19 pandemic accelerated the implementation of telehealth and virtual care services. Clinicians must be comfortable using this technology in order for it to be developed effectively and implemented consistently. This study evaluated the influence of various factors, including those theorised in the technology acceptance model, on physicians' intention to use teleconsultations in their clinical practice in Chennai, India. Methods: A snowball sampling method was used to distribute an online survey to physicians in Chennai, India. The survey measured respondents' intention to use teleconsultations (dependent variable), along seven independent variables relating to this technology (perceived usefulness, perceived ease of use, physicians' attitudes, social influences, facilitating conditions, perceived compatibility with the clinical area and trust). A total of 165 responses were collected. Results were analysed using descriptive and correlational statistics, along with multiple linear regression. Results: All seven independent variables were found to be significantly associated with the dependent variable (P<0.01). Multiple linear regression analysis indicated that the independent variables accounted for 67.8% of the variance in respondents' intention to use teleconsultations. Conclusions: Physicians' intention to use teleconsultations is complex and multi-faceted. Although the factors theorised by the technology acceptance model were significantly associated with intention to use telemedicine, other factors were also found to be important, including social influences, external facilitating factors, perceived compatibility with the clinical area and personal trust in technology.

Evaluating the Feasibility and Usability of the Disposable Intubation Drape (I-Drape)

In response to the COVID-19 pandemic, several protective barrier enclosures were developed to protect healthcare providers during airway manipulation. A certified registered nurse anesthetist (CRNA) created a barrier, the disposable intubation drape (I-Drape), that addressed limitations in range of motion. A nonrandomized, quasi-experimental design with repeated measures was used to evaluate I-Drape usability. CRNAs implemented I-Drape up to three times. Multilevel modeling was used to analyze the primary outcome: time (in seconds) to successful intubation. An online survey was used to evaluate secondary outcomes of interest: users' perceptions of features such as usability, visibility, and durability. We recruited 23 CRNAs as participants for 59 trials. Overall successful intubation and first-pass success rates were 96.6% and 93.2%, respectively. Time to successful intubation did not significantly decrease (β = -9.6, P = 0.323) or differ significantly among types of laryngoscopy device and years of experience was not a significant factor. Overall, users favorably rated I-Drape with respect to usability, visibility, durability, and feature utility. This study demonstrated the functionality, success rate, and acceptability of I-Drape. I-Drape can be used safely and efficiently with any type of laryngoscopy device by providers with various experience levels.

An educator's toolkit for virtual simulation: A usability study.

BACKGROUND: The rapid change brought on by COVID-19 meant that many educators adopted virtual simulation quickly, often without having a strong background in the pedagogical principles of virtual simulation. To address this resource gap, a team of 21 Ontario virtual simulation-experienced educators created the freely available, online, interprofessional Virtual Simulation Educator's Toolkit. The Toolkit provides the theory, practical strategies and resources needed to teach effectively with virtual simulation. Because the Toolkit would include new content, resources and numerous untested design elements, the team conducted a usability test. DESIGN: A usability study, that followed a three-step process, was conducted. Participants were asked to carefully review the Toolkit, including all interactive components and complete an online survey based on the Technology Acceptance Model, to measure the ease of use and utility of the Toolkit. Lastly, participants were interviewed. PARTICIPANTS: In keeping with sampling principles for usability studies, twenty experienced virtual simulation educators from different disciplines participated in the study. METHODS: A validated survey and one-on-one interviews were used to measure educators' perceptions of the ease of use and utility of the Toolkit and their recommendations to improve it. Quantitative data were analyzed using descriptive statistics and qualitative data were coded and themes developed. CONCLUSION: The score of 90 % on the Toolkit Experience Survey indicated that participants found the Toolkit both easy to use and useful. Results from the interviews indicated that a practical, accessible professional development tool is urgently needed to support education with virtual simulation. Because the Toolkit introduces educators to different ways of implementing virtual simulation, as well as options, process considerations, and tools to enhance their teaching with virtual simulation, different disciplines and educators with different levels of simulation experience may benefit by using it.

REDCap Delivery of a Web-Based Intervention for Patients With Voice Disorders: Usability Study.

BACKGROUND: Web-based health interventions are increasingly common and are promising for patients with voice disorders because web-based participation does not require voice use. To address needs such as Health Insurance Portability and Accountability Act compliance, unique user access, the ability to send automated reminders, and a limited development budget, we used the Research Electronic Data Capture (REDCap) data management platform to deliver a patient-facing psychological intervention designed for patients with voice disorders. This was a novel use of REDCap. OBJECTIVE: We aimed to evaluate the usability of the intervention, with this intervention serving as a use case for REDCap-based patient-facing interventions. METHODS: We used REDCap survey instruments to develop the web-based voice intervention modules, then conducted usability evaluations using (1) heuristic evaluations by 2 evaluators, and (2) formal usability testing with 7 participants, consisting of predetermined tasks, a think-aloud protocol, ease-of-use measurements, a product reaction card, and a debriefing interview. RESULTS: Heuristic evaluations found strengths in visibility of system status and real-world match, and weaknesses in user control and help documentation. Based on this feedback, changes to the intervention were made before usability testing. Overall, usability testing participants found the intervention useful and easy to use, although testing revealed some concerns with design, content, and terminology. Some concerns were readily addressed, and others required adaptations within REDCap. CONCLUSIONS: The REDCap version of a complex web-based patient-facing intervention performed well in heuristic evaluation and formal usability testing. REDCap can effectively be used for patient-facing intervention delivery, particularly if the limitations of the platform are anticipated and mitigated.

Mobile Educational Applications: Remote Usability Study

The self-contained mobile educational applications support the student in the learning process combining technology and pedagogy through the use of mobile devices. The adoption of these applications is closely related to their level of usability. Generally, the usability studies of these applications are carried out through usability metrics or heuristics oriented for generic systems. In this paper, we describe in detail a usability study of two independent commercial mobile educational applications that incorporate interactivity, socialization, and adaptability. The usability study is presented with the intention of evaluating the usability of the applications in terms of the application interface, the educational support functions, and the characteristics of M-Learning. The objective of the usability study allowed us to identify the usability problems present in these types of applications. The application of the usability tests was carried out remotely due to the COVID-19 health contingency period. This usability study can serve as a reference for evaluators to identify and carry out a remote evaluation of these types of applications;as well as the test results could serve as a reference to improve the usability of mobile educational applications. © 2021 IEEE.

Poll worker security: Assessment and design of usability and performance

Election infrastructure includes socio-technical systems that are designated as United States critical infrastructure within the Government Facilities sector. Following the 2016 United States' General Election and during the 2020 Presidential Election cycle, election security and the integrity of election processes became a prevalent, national conversation. From the 2019 U.S. Senate Intelligence Committee report indicating that election systems in all 50 states had been targeted by foreign adversaries to the more recent broadened use of, and concern about, mail-based voting during the COVID-19 pandemic, election integrity is increasingly important. Furthermore, poll workers play a crucial role in elections and election equipment, as they are one of the first lines of defense in systems security. This paper contributes to improving the security of election infrastructure through intentional, targeted, cyber, physical, and insider threat training for poll workers. Specifically, this paper details the engineering design, including pedagogical approach, and deployment of online, election-specific, threat training modules. Results of a System Usability Scale assessment from 44 poll workers indicate the content and online platform are easy to interact with and use. Further, the developed modules were piloted and then deployed in a mid-Atlantic state;participating counties include over 1,900 poll workers who serve nearly 750,000 voters. © 2021 IISE Annual Conference and Expo 2021. All rights reserved.

Usability-In-Place-Remote Usability Testing Methods for Homebound Older Adults: Rapid Literature Review.

BACKGROUND: Technology can benefit older adults in many ways, including by facilitating remote access to services, communication, and socialization for convenience or out of necessity when individuals are homebound. As people, especially older adults, self-quarantined and sheltered in place during the COVID-19 pandemic, the importance of usability-in-place became clear. To understand the remote use of technology in an ecologically valid manner, researchers and others must be able to test usability remotely. OBJECTIVE: Our objective was to review practical approaches for and findings about remote usability testing, particularly remote usability testing with older adults. METHODS: We performed a rapid review of the literature and reported on available methods, their advantages and disadvantages, and practical recommendations. This review also reported recommendations for usability testing with older adults from the literature. RESULTS: Critically, we identified a gap in the literature-a lack of remote usability testing methods, tools, and strategies for older adults, despite this population's increased remote technology use and needs (eg, due to disability or technology experience). We summarized existing remote usability methods that were found in the literature as well as guidelines that are available for conducting in-person usability testing with older adults. CONCLUSIONS: We call on the human factors research and practice community to address this gap to better support older adults and other homebound or mobility-restricted individuals.

Usability of an At-Home Anterior Nares SARS-CoV-2 RT-PCR Sample Collection Kit: Human Factors Feasibility Study.

BACKGROUND: Readily available testing for SARS-CoV-2 is necessary to mitigate COVID-19 disease outbreaks. At-home collection kits, in which samples are self-collected without requiring a laboratory or clinic visit and sent to an external laboratory for testing, can provide convenient testing to those with barriers to access. They can prevent unnecessary exposure between patient and clinical staff, increase access for patients with disabilities or remote workers, and decrease burdens on health care resources, such as provider time and personal protective equipment. Exact Sciences developed an at-home collection kit for samples to be tested to detect SARS-CoV-2 that includes an Instructions for Use (IFU) document, which guides people without prior experience on collecting a nasal swab sample. Demonstrating successful sample collection and usability is critical to ensure that these samples meet the same high-quality sample collection standards as samples collected in clinics. OBJECTIVE: The aim of this study was to determine the usability of a SARS-CoV-2 at-home nasal swab sample collection kit. METHODS: A human factors usability study was conducted with 30 subjects without prior medical, laboratory, or health care training and without COVID-19 sample self-collection experience. Subjects were observed while they followed the IFU for the at-home sample collection portion of the SARS-CoV-2 test in a setting that simulated a home environment. IFU usability was further evaluated by requiring the subjects to complete a survey, answer comprehension questions, provide written feedback, and respond to questions from the observer about problems during use. RESULTS: All 30 subjects successfully completed the sample collection process, and all 30 samples were determined by reverse transcription-polymerase chain reaction (RT-PCR) testing to meet quality standards for SARS-CoV-2 testing. The subjects' written feedback and comments revealed several recommendations to improve the IFU. CONCLUSIONS: The study demonstrated the overall usability of an at-home SARS-CoV-2 collection kit. Various feedback mechanisms provided opportunities to improve the wording and graphics for some critical tasks, including placing the label correctly on the tube. A modified IFU was prepared based on study outcomes.

The WOMEN-UP Solution, a Patient-Centered Innovative e-Health Tool for Pelvic Floor Muscle Training: Qualitative and Usability Study during Early-Stage Development.

e-Health may enhance self-management of pelvic floor muscle training (PFMT) to treat stress urinary incontinence (SUI). It is crucial to involve patients in planning, developing and monitoring the optimal e-Health solution. This research aims to describe patient-centered innovation in an early developmental stage of the WOMEN-UP solution. We conducted a qualitative study through a self-developed questionnaire in 22 women with SUI, to define system requirements from a patient's perspective. The first prototype of the WOMEN-UP solution was developed. It was tested by 9 patients in a usability study (think-aloud protocol and retrospective interviews). Patient preferences regarding the possible use of an e-Health solution with serious games for PFMT were: (1) to receive feedback about PFMT; (2) convenient home-use; (3) increasing motivation; (4) available in medical centers. Identified usability aids (31) reassured our design-development plan, which considered the biofeedback and serious games as key factors. Patient's perspective detected some unexpected issues related to the calibration and serious games, involving a change in the ongoing development to get an improved WOMEN-UP solution; the value of patient-centered innovation during the development of an e-Health solution for PFMT (WOMEN-UP solution). To identify patients' unmet needs, we proposed a longitudinal approach for the future eHealth-related patient-centered innovations.

Is a cloud-based platform useful for diabetes management in Colombia? The Tidepool experience.

BACKGROUND: There are several medical devices used in Colombia for diabetes management, most of which have an associated telemedicine platform to access the data. In this work, we present the results of a pilot study evaluating the use of the Tidepool telemedicine platform for providing remote diabetes health services in Colombia across multiple devices. METHOD: Individuals with Type 1 and Type 2 diabetes using multiple diabetes devices were recruited to evaluate the user experience with Tidepool over three months. Two endocrinologists used the Tidepool software to maintain a weekly communication with participants reviewing the devices data remotely. Demographic, clinical, psychological and usability data were collected at several stages of the study. RESULTS: Six participants, from ten at the baseline (five MDI and five CSII), completed this pilot study. Three different diabetes devices were employed by the participants: a glucose meter (Abbot), an intermittently-scanned glucose monitor (Abbot), and an insulin pump (Medtronic). A score of 81.3 in the system usability scale revealed that overall, most participants found the system easy to use, especially the web interface. The system also compared highly favourably against the proprietary platforms. The ability to upload and share data and communicate remotely with the clinicians was raised consistently by participants. Clinicians cited the lockdown imposed by the Covid-19 pandemic as a valuable test for this platform. Inability to upload data from mobile devices was identified as one of the main limitations. CONCLUSION: Tidepool has the potential to be used as a tool to facilitate remote diabetes care in Colombia. Users, both participants and clinicians, agreed to recommend the use of platforms like Tidepool to achieve better disease management and communication with the health care team. Some improvements were identified to enhance the user experience.