Date of Award

May 2022

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Biomedical and Health Informatics

First Advisor

Jake Luo

Committee Members

Min Wu, Turki Alanzi, Habib Tabatabai

Keywords

Information needs, Medical Reports, Obstetric Ultrasound, Radiology, User Experiance, User Interface

Abstract

Design thinking approach is an approach used widely to solve problems by providing innovative solutions. In this dissertation I focused on the user experience research filed where I designed new obstetric ultrasound reports by adopting the design thinking approach to reach the main goal of the dissertation which is mitigating pregnant women information needs about obstetric ultrasound exam and improve their understanding and knowledge about the obstetric ultrasound report and the exam. I developed two versions of new designed report called SPOUR (Smart Patient-Oriented Obstetric Ultrasound Report). We have conducted five studies to reach the dissertation goal and designed two novel obstetric ultrasound reports that help to make the medical reports more readable for the patient. The evaluation of the designed reports showed that it’s useful and easy to use for the expectant parents who had an obstetric ultrasound exam, and it has shown an improvement in understanding the report content.Study one: Information needs and knowledge of obstetric ultrasound exam to achieve patient-centered care: Literature Review The aim of this study is to explore women information needs about obstetric ultrasound exam in the body of literature. PubMed, Science direct and google scholar databases was searched for English language, peer-reviewed articles from 2000 to 2021. The keywords used are “pregnant women” “ultrasound exam” “obstetric ultrasound” “information need” “knowledge”. The bibliographies of key texts were then used to source further articles. We found that women lack knowledge about the meaning, purpose, capabilities, technical limitation, and safety of the scan, and there is a need for improvement of information provision to the patients. Also they need information especially when abnormality detected or information about down syndrome screening exam. We discussed how the internet become a source of information for women which may increase the uncertainties and anxiety for pregnant women and how it could be mitigated. Study two: Patients’ unmet information needs and gaps of obstetric ultrasound exam: A qualitative content analysis of social media platforms The aim of this study is to find the exact information the women are seeking before or after the ultrasound exam. This was a qualitative content analysis study. We systematically gathered pregnancy-related consumer health questions from three public forums (Yahoo! Answers, BabyCenter, PregnancyForum) and one ultrasound internet forum (Reddit/ultrasound). We used a purposive sampling strategy. We only included questions about ultrasound exams, and we excluded any questions related the cost or training of the ultrasound exam. We also coded the emotion expressed by the women in the questions we included. After coding each question, we categorized the data into thematic topics and subtopics. In this social media study, we discovered major information gaps that should be filled to better support health consumers’ understanding of obstetric ultrasound exam and obstetric ultrasound medical reports. The information gaps could become barriers to healthy decision-making and create stress among pregnant women. More work needs to be done to mitigate the information gaps, such as providing more consumer-friendly and personalized information during pregnancy.

Study three: What Makes a Patient Oriented Obstetric Ultrasound Report: Design-Thinking ApproachThe aim of this study is to discuss and recommended several methods to provide a patient friendly obstetric ultrasound report based on our pervious study. We discussed the design thinking approach we adopted to design a consumer friendly medical report that aim to mitigate patients’ information need. With design thinking approach, we analyzed user’s needs and built a novel prototype of a patient-oriented obstetric ultrasound report. Our recommendations include adopting ideas related to artificial intellegence and UX/UI design principals for designing a patient friendly medical report. We recommended adding features in the results and summary sections to make it readable by a lay person. We also recommended adding new sections (e.g., About ultrasound exam, and what’s next) to increase women’s knowledge about obstetric ultrasounds and pregnancy health. We demonstrated a prototype of our new obstetric ultrasound design for a routine second trimester report which we built based on our findings of a previous study we conducted to explore unmet information needs and gaps of obstetric ultrasound exams. Study four: Evaluating first version of a smart patient-oriented obstetric ultrasound report (SPOUR) The aim of the study is to evaluate the first version of the design by conducting interventional study where we compare our new design with a traditional design. In this design version, we adopted the infographic design where the report designed by providing several sections to the design and separating the result section into two sections, one for the result and the other section for the explanation and terminology definition. This report can be provided to the patient as a responsive PDF and contain all the sections and methods recommended in the previous study except that the report won’t be interactive and does not require any clicking from the patient side. Extra information can be found using barcode which direct patient to reliable websites for further information. To evaluate the design we used five constructs which are: Report understanding, perceived ease of use, perceived usefulness, perceived esthetics, and intention to use the report. The result showed that women understanding of the report is significantly different than their understanding of the traditional report. They found that report easy to use, useful, aesthetic, and they have the intention to use it. Study Five: Evaluating second version of patient-oriented obstetric ultrasound report (POUR) The aim of this study is to evaluate the second version by conducting interventional study where we compare our new design with a traditional design. This version have been discussed widely in the third study where we provided a user interface with several buttons to organize the information for the women when they access their obstetric ultrasound report through patient portal. We found that understanding the report is significantly different in comparison with the old design. Perceived ease of use, perceived usefulness, intention to use, and perceived esthetics were also significantly different than the traditional design. We Also measured the new components we added where we found that these new components were perceived as easy to use and useful by the majority of respondents.

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