This project, with a team of 5 people, seeks to create a “personalized, mobile and rapid patient identification and medical record management system suited for the expected ‘paperless’ healthcare operations of the future.”  The product developed is a wireless clipboard sized computer, which relies on a micro-electronic device subcutaneously, implanted in the forehead.  This implant is scanned with a laser-equipped stylus to enter the patient’s medical information and identity into the portable computer, The computer has additional functions enabling rapid diagnosis and triage.  Provisions are made for these functions to be available in the event that the patient does not have the implanted device.

The system is primarily intended for emergency system personnel such as emergency medical technicians (EMT’s) in the field and emergency department physicians and nurses. In addition to the implant-stored information, it will record key treatment events and data associated with those events, and digitally communicate between necessary locations needing this information.
 

There was not as much user analysis, as in the Summer_94 projects, but there was an attempt to understand and define the user.  However, there are conflicts in the user analysis.  For example, they considered the users to be highly trained in emergency response techniques and they say they are “expert in emergency medicine.”  However, they did not distinguish the doctor’s training and expertise from that of an EMT.  There was no analysis of the doctor or nurse as a user, although, they stated that they would be users.  The limited analysis that was done was on the EMT.
 

There was no formal task analysis.  They did have a “Usage Scenario” which outlined some emergency scenarios in the EMT setting.  There were no scenarios with a doctor or nurse as a user.  There is no  attempt to perform a formal “Task Decomposition”, “Knowledge Based Analysis” or “Entity-Relationship Based Techniques” analysis of these scenarios.
 

They created a classy WEB page complete with great graphics, organization, nesting, hot keys, and audio.  Wow!  They put a lot of effort into presentation and looks.

Good interviews were performed with three Atlanta EMT’s to find out their reaction to the system and how they worked in a real environment.  This was a good technique.  For example, they found out that the voice I/O that they had proposed for an interface would not work in most emergency environments because of the noise.  They scrapped it.

Four evaluation criterion were stated for the system: consistency, recoverability, observability and flexibility.  The old system, they sought to replace, was well analyzed.
 

The project should have narrowed down its user to the EMT, rather than adding doctors and nurses.  It failed to analyze the doctor and nurse, who work in radically different environments and have different training, expertise and equipment.  There was neither mention of their characteristics nor an analysis of their tasks.  Yet, they indicated them to be users.

There is too much technical detail and features in the project description. The discussion is very hardware dependent.  A higher level understanding of the encounter of a patient in an emergency, with an appropriate HCI model of the encounter by EMT’s and others, would have been better

The group tends to overuse  “techno” jargon.  Some of it is just plain inaccurate.  As an example, they propose a “state-of –the art” flat panel display without establishing the need for “state-of –the art”, or what they mean by it.  Is a conventional standard flat panel adequate?   Another example is the lack of explanation of the need for a “laser equipped stylus” to scan the implant.  None of their referenced pet and animal ID systems use a laser to scan the implanted chip.  They all use a RF signal to make the inquiry.  Perhaps the EMT can burn off skin cancer with the laser, while they are using the system for other things.

At least one or more different EMT groups should have been interviewed, since the expertise, procedures and training might be different from the Atlanta group.  Emergency department doctors and nurses should have been interviewed, since the project team stated they would be users.

Several cultural and implementation issues are not addressed.  Are there religious and cultural objections to the implantation of a subcutaneous chip?  The implant is easy to do in a dog since, they can’t say no, but it is another issue to make this widespread in humans.  The project should have considered some optional means.  A good-looking ring, earring, or bracelet with a chip, could be an alternative

There was no analysis of competitive systems.  They did cite medical data management systems, but no medical identification and treatment aids as they proposed.

It appears that the group may have trouble measuring its evaluation criterion: consistency, recoverability, observability and flexibility.  Stating these more simply, with easily measured criterion, would be helpful.

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