Understanding workflow in telehealth video visits: observations from the IDEATel project.

Home telemedicine is an emerging healthcare paradigm that has the potential to transform the treatment of chronic illness. The purpose of this paper is to: (1) develop a theoretical and methodological framework for studying workflow in telemediated clinician-patient encounters drawing on a distributed cognition approach and (2) employ the framework in an in-depth analysis of workflow in the IDEATel project, a telemedicine program for older adults with diabetes. The methods employed in this research included (a) videotaped observations of 27 nurse-patient encounters and (b) semi-structured interviews with participants.

Understanding dimensions of complexity in nurse case managers' workflow in a telemedicine program.

Telehealth can provide powerful self-management tools for patients with chronic illness. A methodological framework for evaluating nurse case manager workflow is proposed. The framework focuses on work practices, cognitive tasks and artifacts.

Redesign of the Columbia University Infobutton Manager.

Background: The Infobutton Manager (IM) is an application that provides clinical users with context-specific links to health information resources. Usage of the first version (IM-1) suggested that the user interface was suboptimal.

Methods: We conducted a laboratory-based observational study of IM-1, use, applied standard user interface design techniques to address observed problems, developed a new version (IM-2), conducted a second observational study and analyzed log files of the actual use of IM-1 and IM-2.

Developing computer skills and competencies in seniors.

We developed a training protocol for elderly participants of a home telemedicine study, grounded in prior usability research. The training aimed to reduce barriers in developing system mastery. Our findings are indicative of both the promises and challenges involved in bridging the digital divide.

A cognitive framework for understanding barriers to the productive use of a diabetes home telemedicine system.

Telemedicine has the potential to transcend geographic and socio-cultural barriers to the delivery of high quality health care to the medically underserved populations. However, there are significant cognitive and usability barriers. This paper presents a multifaceted cognitive evaluation of the IDEATel diabetes education and telemedicine program.

Usability in the real world: assessing medical information technologies in patients' homes.

Objective: This paper presents an approach to usability evaluation of computer-based health care systems designed for patient use in their homes. Although such devices are becoming more prevalent, there is very little known about their usability.

Design: The theoretical foundations for the methods are discussed.