Summary of the impact: Our research into the Human-Computer Interaction (HCI) issues behind medical error has enabled hospitals to procure safer devices and is strategically changing attitudes. Approximately 10% of deaths due to preventable errors in hospitals are computational errors; in absolute numbers, this is higher than road fatality rates. Corresponding increased hospital stays, etc, are estimated to cost the NHS >£600Mpa. Our formal analyses and laboratory research with clinicians show error rates can be reliably reduced dramatically by software and HCI improvements. Swansea’s research has significant international reach across decision-makers, clinicians, manufacturers, and regulators. The US Food and Drug Administration (the FDA, the leading international regulator) say research-based improvements will take decades and have therefore started to co-author papers with us to improve impact (all healthcare manufacturers watch the FDA closely).
References to the Research
- A. Cox, P. Oladimeji & H. Thimbleby, “Number Entry Interfaces and their Effects on Errors and Number Perception,” Proc IFIP Conf on Human-Computer Interaction — Interact 2011, IV:178–185, Springer Verlag, 2011. Peer-reviewed, full paper.
Unique laboratory experiments show skilled nurse drug dosing errors can be reduced by a factor of over 6 by improved design of user interfaces; also used eye tracking to support rationales for similar error reductions in other applications.
- P. Lee, H. Thimbleby & F. Thompson, “Analysis of Infusion Pump Error Logs and Their Significance for Healthcare,” British Journal of Nursing, 21(8):S12–S22, 2012. Peer-reviewed, full paper.
The largest survey and analysis of infusion pump log data (approximately 500,000 hours); shows a high proportion of staff time is wasted in user interface design problems.
- P. Masci, R. Ruksenas, P. Oladimeji, A. Cauchi, A. Gimblett, Y. Li, P. Curzon & H. Thimbleby, “The benefits of formalising design guidelines: A case study on the predictability of drug infusion pumps,” Journal of Innovations in Systems and Software Engineering. http://dx.doi.org/10.1007/s11334-013-0200-4, 2013. Peer-reviewed, full paper.
Formal analysis can completely eliminate certain classes of user error.
- H. Thimbleby, “Interaction Walkthrough: Evaluation of Safety Critical Interactive Systems,” Proc XIII International Workshop on Design, Specification and Verification of Interactive Systems — DSVIS 2006, Lecture Notes in Computer Science, 4323:52–66, Springer Verlag, 2007. http://dx.doi.org/10.1007/978-3-540-69554-7_5. Peer-reviewed, full paper.
Paper underpinning the EPSRC Programme Grant — showed there was a serious, but solvable problem in health IT.
- H. Thimbleby & P. Cairns, “Reducing Number Entry Errors: Solving a Widespread, Serious Problem,” Journal Royal Society Interface, 7(51):1429–1439, 2010. http://dx.doi.org/10.1098/rsif.2010.0112. Peer-reviewed, full paper.
Laboratory experiments and simulation show improved user interfaces can reduce out by ten errors by a factor of two.
- H. Thimbleby & D. Williams, “Using Nomograms to Reduce Harm from Clinical Calculations,” Proc IEEE International Conf on Healthcare Informatics — ICHI, 2013 [in press; publication date September 2013]. Peer-reviewed, full paper.
Alternatives to conventional calculators can reduce error rates and their relative magnitude, in our experiments completely eliminating errors out by more than 50%.