CHI+MED: Multidisciplinary Computer-Human Interaction research for the design and safe use of interactive medical devices

病人的安全是一个主要的问题。对交互式医疗设备的依赖正在增长，无论是在临床环境中，还是对没有直接临床监督的患者来说都是如此。这类设备的可用性和可靠性至关重要。例如，小数点是众所周知的错误来源(例如，0.5毫克被误读为5毫克)，但很少有设备检测到小数键控错误。考虑到更广泛的使用背景，熟悉一种输液泵的护士可能会心不在焉地在类似的输液泵上使用相同的设置程序，导致不正确的剂量。这些和其他用户编程错误会导致患者死亡。即使设备编程正确，交互困难也会增加工作量和压力，增加整个系统的脆弱性。例如，临床医生关闭和打开泵以重置状态是很常见的，但患者数据可能会在此过程中丢失，需要重新输入。更好的交互设计是CHI+MED的重点，它将通过科学的方法来理解和设计潜在的错误，从而提高安全性。它将产生非常广泛的影响，因为互动系统正在医疗保健领域无处不在。CHI+MED是对人体工程学和安全设备工程的其他倡议的补充。CHI+MED是多学科的。将综合运用人机界面、计算机科学、心理学和社会科学等学科的经验方法。经验结果将建立在精确的计算表示和推理的基础上，并受到精确计算表示和推理的挑战。这将支持跨视角的整合和对研究结果的概括，以及在分析的所有方面执行独特的严谨性。CHI+MED方法将促进和改变用户与设备交互的科学和交互式医疗设备的设计。我们将从安全和可用性的角度调查哪些设备属性最重要(涉及是否会发生不良事件，设备在类似条件下的行为是否存在不安全的不一致等)，以及哪些系统描述最能支持有关它们的推理。我们将研究在与设备交互时产生错误的原因，以及更好的错误科学如何改进设计。这将包括影响失误的因素，如压力、注意力、任务结构以及线索和反馈的设计。我们还将研究引发或缓解交互错误的更广泛的情景因素(打断可能会引发错误；同事检查可能会缓解错误，等等)。CHI+MED将更好地理解交互设计以及相关的认知和情景因素、支持设计和评估的新工具、基础更知情的标准和事件调查以及更具弹性的实践。除了解决医疗领域以外的新科学问题外，CHI+MED还将与利益相关者展开对话，提高对交互设计在医疗差错中作用的认识，并开发基于证据的医疗器械设计技术，以减少潜在错误，同时适应利益相关者群体的文化和流程。它将借鉴公共参与和知识转让方面的研究，并探索不同方法在不同情况下的适当性和有效性。我们将研究知情原则和工具如何帮助开发人员设计更可靠和更可用的设备，确定影响设计和采购决策的因素，并探索如何更好地向利益相关者了解交互设计。CHI+MED涉及并整合了三个领导小组，解决单个重点问题。它将促进英国在多学科、严格的人机界面研究方面的国际领先地位，并为患者安全设计的国际议程做出重大和知情的贡献。

Patient safety is a major concern. Reliance on interactive medical devices is growing, both in clinical settings and, increasingly, for patients without direct clinical supervision. The usability and reliability of such devices is critical. For example, decimal points are a well-known source of error (e.g., .5mg misread as 5mg), yet few devices detect decimal keying errors. Considering the broader context of use, a nurse familiar with one kind of infusion pump may absent-mindedly use the same set-up procedure on a similar one, leading to incorrect dosage. These and other user programming errors cause patient deaths. Even when devices are programmed correctly, interaction difficulties raise workload and stress, increasing overall system vulnerability. For example, it is common for clinicians to turn pumps off and on to reset the state, but patient data may be lost in the process and need to be re-entered. Better interaction design, the focus of CHI+MED, will improve safety by a scientific approach to understanding and designing out latent errors. It will have very broad impact because interactive systems are encroaching everywhere in healthcare. CHI+MED complements other initiatives on the ergonomics and engineering of safer devices.CHI+MED is multidisciplinary. A combination of empirical approaches, drawn from the disciplines of HCI, computer science, psychology and the social sciences, will be applied. Empirical findings will build on, be subjected to, and be challenged by precise computational representation and reasoning. This will support integration across perspectives and generalisation of findings, as well as enforcing a distinctive rigour in all aspects of analysis. The CHI+MED approach will advance, and transform, the science of user-device interactions and the design of interactive medical devices.We will investigate which device properties are most important from safety and usability perspectives (relating to whether adverse incidents can occur, whether there are unsafe inconsistencies between device behaviours under similar conditions, etc.), and which system descriptions best support reasoning about them. We will study the causes of errors when interacting with devices and how a better science of error can improve design. This will include factors affecting slips such as stress, attention, task structure and the design of cues and feedback. We will also study the broader situational factors that provoke or mitigate interaction errors (interruptions may provoke errors; colleagues checking may mitigate them, etc.). CHI+MED will deliver a significantly better understanding of interaction design and associated cognitive and situational factors, new tools to support design and evaluation, underlying better informed standards and incident investigations, and more resilient practices.As well as addressing new scientific questions that generalise beyond the medical domain, CHI+MED will develop a dialogue with stakeholders, to raise awareness of the role of interaction design in medical errors and to develop evidence-based techniques for designing medical devices that mitigate potential errors while accommodating the cultures and processes of stakeholder groups. It will draw on research in Public Engagement and Knowledge Transfer, and explore the appropriateness and effectiveness of different approaches for different contexts. We will investigate how informed principles and tools can help developers to design more reliable and usable devices, identify factors that influence design and procurement decisions, and explore how stakeholders can be better informed about interaction design.CHI+MED involves and integrates three leading groups on a single, focused problem. It will contribute to the UK's status as an international leader in research in multidisciplinary, rigorous HCI, and make significant and informed contributions to the international agenda on design for patient safety.