The Digital Pen and Paper

Summary

Objectives: To evaluate the efficiency and acceptance of digital pen and paper technology for real-time clinical data acquisition.

Methods: A prospective interventional unblinded study involving consecutive patients in two clinical settings during a defined time-frame was proposed. The first trial was designed as a stress test to evaluate acceptance in a workload-intensive environment. Acceptance was assessed using observations and a satisfaction questionnaire. The second trial was intended to determine the reliability of data acquisition in a controlled environment. Reliability was assessed by comparing the performance of the digital pen against scanner analysis and a double human blinded acquisition.

Results: Overall, users were satisfied with the use of the digital pen (median 3 on a Likert-scale (–5, 5)). Without any specific user training, successful data acquisition was greater than 80%. Use of this technology required less adaptation than standard computer devices, and was easy to learn and use. Ergonomic problems shaded the perception of the technology by inducing an increased cognitive load. Digitalized data was missing either because of a bug or due to lack of data validation. The reliability obtained with the digital pen was significantly lower to that obtained with the scanner.

Conclusions: Natural technology such as the digital pen proved to be a good tool in stressful clinical environments without interfering with the normal workload or increasing the time for data acquisition. However, in order to improve quality of data acquisition, designing acquisition forms specifically for the use of digital pens is of paramount importance.

Keywords

Acceptance - usability - cognitive impact - human-machine interface - digital pen - data acquisition

• References

• 1 Payne TH. The transition to automated practitioner order entry in a teaching hospital: the VA Puget Sound experience. In. Proc AMIA Annual Symposium. 1999: 589-93.
• 2 Ball MJ. Better Health Through Informatics: Managing Information to Deliver Value. In. Ward ME. editor. Public Health Informatics and Information Systems. Springer Verlag: 2002
• 3 Lorenzi NM, Riley RT. Managing change: an overview. J Am Med Inform Assoc 2000; 7 (02) 116-24.
• 4 Anderson JG, Aydin CE, Jay SJ. Evaluating Health Care Information Systems – Methods and Applications. Thousand Oaks: Sage; 1994
• 5 Hewett TT, Baecker R, Card S, Carey T, Gasen J, Mantei M. et al. ACM SIGCHI Curricula for Human-Computer Interaction. In. The Association for Computing Machinery. 1996
• 6 Preece J, Rogers Y, Sharp H, Benyon D, Holland S, Carey T. Human-computer interaction. Harlow: Addison-Wesley; 1994
• 7 Hewett, Baecker, Card, Carey, Gasen, Mantei et al. ACM SIGCHI Curricula for Human-Computer Interaction. In. The Association for Computing Machinery. 1996
• 8 Despont-Gros C, Fabry P, Muller H, Geissbuhler H, Lovis C. User acceptance of Clinical Information Systems: A methodological approach to identify the key dimensions allowing a reliable evaluation framework In MedInfo 2004. San Francisco: 2004. (in press)
• 9 Mahmood MA, Burn JM, Gemoets LA, Jacquez C. Variables affecting information technology end-user satisfaction: a meta-analysis of the empirical literature. International Journal of Human Computer Studies 2000; 52 (04) 751-71.
• 10 Doll WJ, Torkzadeh G. The Measurement of End- User Computing Satisfaction: Theoretical and Methodological Issues. MIS-Quarterly 1991; 15: 5-10.
• 11 Chin WW, Lee MKO. A proposed model and measurement instrument for the formation of IS satisfaction: the case of end-user computing satisfaction. In 21st International Conference on Information Systems. Australia: Brisbane, Queensland; 2000: 553-63.
• 12 Garrity EJ, Sanders GL. Dimensions of Information Systems Success. In. Garrity EJ, Sanders GL. editors Information systems success measurement. Hershey, PA: Idea Group Publ; 1998: 12-45.
• 13 Heeks R, Mundy D, Salazar A. Why Health Care Information Systems Succeed or Fail. Working Paper Series, Paper No 9. 1999
• 14 DeLone WH, McLean ER. Information Systems Success Revisited. In 35th Annual Hawaii International Conference on System Sciences (HICSS’02);2002. Big Island, Hawaii: Institute of Electrical and Electronics Engineers, Inc; 2002: 238-48.
• 15 Seddon PB, Staples S, Patnayakuni R, Bowtell M. Dimensions of Information Systems Success. Communications of the Association for Information Systems. 1999: 2
• 16 Bailey JE, Pearson SW. Development of a Tool for Measuring and Analyzing Computer User Satisfaction. Management Science 1983; 29 (05) 530-45.
• 17 Ives B, Olson MH, Baroudi JL. The measurement of user information satisfaction. Communications of the ACM 1983; 26 (010) 785-93.
• 18 Baroudi JJ, Orlikowski WJ. A Short-Form Measure of User Information Satisfaction: A Psychometric Evaluation and Notes on Use. Journal of Management Information Systems 1988; 4 (04) 44-59.