Mirage events & driver haptic steering alerts in a motion-base driving simulator: A method for selecting an optimal HMI.

This paper describes a new method, a 'mirage scenario,' to support formative evaluation of driver alerting or warning displays for manual and automated driving. This method provides driving contexts (e.g., various Times-To-Collision (TTCs) to a lead vehicle) briefly presented and then removed. In the present study, during each mirage event, a haptic steering display was evaluated. This haptic display indicated a steering response may be initiated to drive around an obstacle ahead. A motion-base simulator was used in a 32-participant study to present vehicle motion cues similar to the actual application. Surprise was neither present nor of concern, as it would be for a summative evaluation of a forward collision warning system. Furthermore, no collision avoidance maneuvers were performed, thereby reducing the risk of simulator sickness. This paper illustrates the mirage scenario procedures, the rating methods and definitions used with the mirage scenario, and analysis of the ratings obtained, together with a multi-attribute utility theory (MAUT) approach to evaluate and select among alternative designs for future summative evaluation.

Impact of compliance to oral hypoglycemic agents on short-term disability costs in an employer population.

This study evaluated the relationships between compliance with oral hypoglycemic agents and health care/short-term disability costs in a large manufacturing company. The retrospective analysis used an observational cohort drawn from active employees of Ford Motor Company. The study population consisted of 4978 individuals who were continuously eligible for 3 years (between 2001-2007) and who received a prescription for an oral hypoglycemic agent during that time. Medical, pharmacy, and short-term disability claims data were obtained from the University of Michigan Health Management Research Center data warehouse. Pharmacy claims/refill data were used to calculate the proportion of days covered (PDC); an individual was classified as compliant if his/her PDC was ≥80%. Model covariates included age, sex, work type, and Charlson comorbidity scores. The impact of compliance on disability and health care costs was measured by comparing the costs of the compliant with those of the noncompliant during a 1-year follow-up. Among these employees, compliant patients had lower medical, higher pharmacy, and lower short-term disability costs than did the noncompliant. After adjusting for demographics and comorbidity, noncompliance was associated with statistically higher short-term disability costs ($1840 vs. $1161, P<0.0001), longer short-term disability duration, and an increase in short-term disability incidence (21.5% of the noncompliant had a claim compared to 16.0% of the compliant, P<0.0001). These results suggest that medication compliance may be important in curtailing the rise of health care/disability costs in the workplace. Employers concerned with the total costs associated with diabetes should not overlook the impact of compliance on short-term disability.

Partnerships between health care organizations and medical schools in a rapidly changing environment: a view from the delivery system.

BACKGROUND AND OBJECTIVES: The Undergraduate Medical Education for the 21st Century (UME-21) project encouraged the formation or enhancement of partnerships between medical schools and health care organizations distinct from the traditional teaching hospitals. The purpose was to prepare medical students in nine content areas that were components of the UME-21 project. Despite their importance today to medical schools, such partnerships with health care organizations are a challenge to develop and maintain in the midst of a rapidly changing health care environment. This article categorizes the partnerships formed and discusses the benefits and the barriers encountered in such collaborations. METHODS: Information about the partnerships was abstracted from written reports from each of the UME-21 partner schools. Additional information was obtained from personal communications with external project representatives and from a post-project survey presented to all UME-21 partner schools. RESULTS: The eight partner schools established or enhanced 32 educational partnerships with external organizations. External partner organizations contributed to curriculum planning and implementation, course development and presentation, and provision of clinical sites and preceptors. Twenty-seven of 32 initial affiliations continued in some form beyond the contract period. CONCLUSIONS: Partnerships formed as part of the UME-21 project improved medical students' exposure to the health care system and their knowledge and skills for effective practice in the 21st century health system. Barriers encountered included financial pressures, changes in leadership, different organizational missions and priorities, and preexisting prejudices against new relationships. Factors associated with successful partnerships include the presence of a health care organization and an academic "champion" dedicated to the project, strong individual relationships, and a medical school commitment to involve external partners.