Usability Evaluation Of MEDIGATE Interactive System

Interactive systems

Interactive systems are a collection of computer hardware and software entities that enable human interaction through a user interface that enable input of instructions and output of analysed or stored information. 

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As stated by Dix (2009), MEDIGATE interactive system is analysed and evaluated. MEDIGATE is an interactive software able to run on Macintosh and Windows operating system that allows input of data and visualize textual and graphic representation of the data. The program utilizes the interface design of modern workstations to allow user interactivity to input and visualize data. The interface includes input devices such as text fields, sizable desktop windows, menus, icons and graphic designed objects that allow recording, analysis and storage of medical data.

MEDIGATE interactive system is used by the medical professionals. The program acts as an electronic recording tool that allows the replacement of the old and traditional manual file records. The user population include medical employees in the different medical departments responsible for the input and utilization of patient data such as the outpatient department, in-patient department, laboratory and the pharmacy. The employees include clinical officers, nurses, medical physicians, laboratory technicians, imaging consultants and pharmacists, Reisner  (2011).

It is reasonable to make the assumptions that the employees using the MEDIGATE software program have the basic knowledge of computing. The knowledge include ability to work with text input computer peripheral devices such as keyboards, ability to use computer mouse and training on the basic computer packages such as Office, Excel and Spreadsheets.  

The MEDIGATE offers primarily a tool that is able to compliment if not replace the old and traditional technique of records keeping.

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According to Chin(2011), MEDIGATE is a wide tool used across the health care setting. Inn this evaluation, focused is drawn to the usability of the program tool by the medical physician in recording and computer assisted medical decisions through input of patient’s data through a graphical simulation comprising of sketchy images and texts of the physical findings of the patient’s data.

The program provides a complicated user interface that enables the physician to interact with to input the data including regions of the body such as tenderness, cellulitis, distention and, masses.  

Data records including sketchy images of abdominal pathologies were evaluated which is part of the system functionality.

The usability and acceptability of MEDIGATE by the medical physicians was apprised by determining the adaptability to the user needs and problems and challenges encountered by the users during the procedure, Whitefield, Wilson & Dowell (2013).

Choice of Interactive System

The following assessment tools were considered during the evaluation process of the MEDIGATE system:

What were the physician’s data needs?

What was the quality of data from the physical examinations that was input into the program?

Was the data input into the MEDIGATE aid in the clinical diagnosis and management?

Was the system usability easy to learn?

What was the process of data input into the system?

What were the challenges encountered during the procedure?

Can the system be used in emergency situations?

The IMPACT (Intention, Metrics, People, Activities, Context and Technology) model was utilized to evaluate the user easy and performance of the MEDIGATE tool.

The role of the user in the evaluation process was to carry out the specified tasks recommended by the system developer to enable a fluid functionality.

The controller, the interviewer, strongly in control of the procedure to ensure that the steps designed in the user manual of the program are adhered to.

In reference to Yoder (2012), the study and evaluation was carried in a clinical set up of the medical ward using a predetermined patient, presented with abdominal symptoms of a mass in the right upper quadrant associated with tenderness in the region, who was selected by the interviewer and had that consented to be used in the evaluation process for maximum of 20 minutes.

The evaluation process was carried out during the major ward rounds, a time when most of the clinical procedures are carried out.

The type of data used in the evaluation process was the physician’s opinion of what type of data would be more useful in making clinical diagnosis and management of the patient’s condition.

The applied approach was based on the experimentation outlined.

The results of the system performance were determined through analysis of the flexibility, ease of use, duration for use and the errors reported during the whole procedure.

The sure tasks evaluated during the procedure were.

Patient’s data input into the MEDIGATE system. The data included a summary of the patient’s biodata, the chief complaint, important positives and negatives, important past medical history and review of systems.

Copy and paste or duplication of the physical findings on a pre-determined human anatomy sketch. The physicians click on the abdomen sketch on the MEDIGATE system and using a mouse, indicates the exact position of the clinical findings. The procedure was completed into either of two practises; a computer aided drawing or a drag and drop mechanism.

The Usability Evaluation

Retrieval of data was evaluated through direct observation of the graphical designs saved during the prior two procedures.

The following instructions were given to the physicians using the MEDIGATE system:

It is the system that is being evaluated, not them.

A running commentary will be utilized during the evaluation with a set of useful prompt questions employed.

  1. A draft lift of the tasks to be performed was prepared and handed to the physician.
  2. A system expert estimated that the process would take 15 minutes for the junior medical officer who was a beginner and five more minutes were allowed for each session.
  3. The system was prepared in the ward, a list of prompt questions readied and the audio equipment set.
  4. The tasks were introduced and the physician reminded that it is the system being evaluated, not them.
  5. The physician started the tasks while giving a running commentary explaining what was being done and why. Areas of hardships were noted.
  6. The physician was interviewed briefly following the procedure on the usability of MEDIGATE and preferences between the traditional pen and paper over the machine.
  7. The participants were thanked.
  8. A usability report was generated using the data collected as observations, notes and audio files.

Conducting the physical examination, the physicians choose their own custom sequences that make it easier to input the data while utilizing the shortest time possible, Yoder, Schultz & Williams (2008).

The physicians use the pre-determined tool and windows on the MEDIGATE system. The windows are dependent on the protocols available on the main window that is displayed after launching the program.

The program is customized to enable categorical input of data with the following.:

  1. A title bar containing the patients’ identifications of the name, age and gender.
  2. A ribbon, giving the user the options to choose the tasks to be undertakes under:
  3. That enables the user to save or rename the new medical record data window.
  4. Allows the physician to edit a past medical record of the patient.
  • Gives the physician the chance to choose between text and graphical input options.
  1. Contains the different graphical representations of the human anatomy to be input in to the system, the abdomen and the pelvis.
  2. Font, to be used.
  3. Allows the physicians to make different measurements of the physical findings in centimetres, length and weight.
  • Style, gives the physician an option to choose the different physical observations made and represent them on the system such as bruits, dullness, masses, tympani, scars and tenderness.
  • Admin panel, requires log in credentials to the system to make changes that related to the privacy of the patient data.
  1. Document window, is the work space that contains the different text or graphical input workstations.

The first task to be carried is the text input of the patient’s summary. The user interface contains the predetermined spaces that allow the physician enter the patient data such as name, gender, age, place of residence, occupation, in-patient number and blood group. The document window contains a summary and description window that allows the physician input the patients’ medical history and positive findings. A column allows the physician to enter the differential diagnosis or a working diagnosis depending on the quantity of data received from the other departments of the hospital such as the laboratory or the imaging department, Williams (2014).

The design of the MEDIGATE interactive system minimizes the number of the frame selections required by the physicians to enter the data. These frames are combined into a single pre-determined sequence that can be modified by the physician to suit their environment, flow of data, practice in terms of experience and knowledge base and patient conform. Such factors determine and improve the quality and sequence of the examination, data findings needed and the details of the data too. All this factors were used significantly in the clinical diagnosis judgement and patient management.  

The second task allows the physician place a given finding of the patient in the desired position on the anatomical representation of the graph. These findings are selected from the drop down menu of the styles window on the ribbon of the workstation. Once a given attribute of the finding has been set in the desired anatomical quadrant, the physician may choose characteristics about the findings through the database of information contained inside the attribute indicated. The characteristics chosen are shown and are likewise utilized for age of the account notes of the physical findings and afterward for entry to the information base. A few qualities may likewise produce notable patterns too, such as when bruits, tenderness and scars are superimposed on an abdominal mass or distention, generating findings that are significantly more translated utilizing the present shading realistic capacities of the graphical designs. Another element vital to the compiling the findings are the several quadrants overlying the anatomic graphical design that might be utilized to demonstrate the regional subdivision descriptors that will be utilized as a part of diagnostic formulations.

The MEDIGATE use cases

The design of the user interface allows the active window to use input data devices such as the mouse and the trackball. These input devices offer good flexibility in the location of the input’s anatomical region and also provide much better resolution of the data input. The ease and flexibility of use of the MEDIGATE system during the interaction with the physicians additionally reduces the curiosity and does not draw the patients’ attention to interfere with the physical examination process.

The system provides a great depth of anticipated data. This allows the physicians, according to the prompt questions and answers, not to collect more than enough data that would interfere with the understanding of the physical findings. The physician is therefore able to leave out portions of the examination without generating complex data and or expressing uncertainties over the clinical judgement over too little data.

The MEDIGATE system uses the database of the physiologic information to illustrate the anatomic and physiologic properties of the different body systems and regions. Therefore, the system has a higher validity and reliability in illustrating what is normal in the physical examination procedure where no pathology is evident.   

As the data and graphical designs are entered on the screen and workstation windows, an anatomical representation of the patients’ physical condition is generated and displayed on the screen that is easy to understand and retrieve. The subdivision of the textual data input offers a telegraphic understanding equal to the short hand notes used in the clinical setting traditionally.

The participants, that is physicians, utilized their time well during the procedure. They would balance well between the physical examination procedure and data input. The system was more of a compliment to their understanding of physical examination process and as thus replaced the traditional short notes recorded during the procedure.

The system was easy to interact with. The frames, icons and sequences were well outlined and therefore the physicians did not find a lot of trouble interacting to the system. However, the anatomical designed were a little difficult for the beginners despite of the training they had undergone to use the system.

The answers to the debriefing and prompt questions displayed a proper understanding of the system. There were however instances of the physicians getting stuck and requiring the assistance of the system technician.

Usability aim.

Effectiveness measurements.


Overall usability

Percentage of fully completed tasks


Percentage of physicians completing tasks


Meeting the expectations of the trained users.  

Percentage of complex tasks completed


Percentage of basic functions completed.


Meeting the demands for daily use.

Percentage of functions completed at initial trail


Meeting the demands for intermittent use.

Percentage of tasks completed after a one month period of not using the system



Percentage of functions learnt


Percentage of physicians demonstrated pre-specified knowledge.  


Time rating of usability.

Usability aim.

Efficiency measurements.  


Overall usability

Time taken to  fully complete tasks

12 minutes average.

Time taken remembering procedures

3 minutes.

Meeting the expectations of the trained users.  

Time taken to complete  complex tasks

5 minutes.

Time taken to perform  basic functions

1 minute.

Meeting the demands for daily use.

Time spent on using help functions

3 minutes.

Meeting the demands for intermittent use.

Time spent on re-learning forgotten functions and tasks.

5 minutes.


Number of repetitive errors

4 errors.

Time taken to learn functions.

4 weeks.

MEDIGATE interactive system rating.

Usability aim.

Satisfaction measurements.


Meets the expectations of the trained users.

Satisfaction with progressed features.


Meets the daily use criterion.

Voluntary use


Meets the intermittent use demands.

Frequency of re-use



Scale for ease of learning.


Replace the note book and pen.

Use MEDIGATE instead of pen and paper.


Use in emergency situations.

Emergency room or casualty use.



The solution to the unique problems by the MEDIGATE system is based upon the usability and friendliness of the interface to adopt to the physicians and nor the other way round. The system efficiency has shown positive impact on the development of an efficient health management system. However, more effort need to be put in the design and development of a more user friendly interface, Byun et al (2016).

Assessment tools

Building up a superior PC framework needs revising every one of the mistakes and issues which are experienced while utilizing the framework. Likewise, fusing of the considerable number of necessities which have been resolute by the framework clients is additionally extremely urgent. The proposed framework must have the capacity to fulfill the necessities of its clients.

According to Byun et al (2016), the software engineers and engineers have built up the MITIGATE framework basing on every one of the necessities that are required when creating and outlining current PC frameworks. This framework has been produced utilizing symbols whereby distinctive symbols are utilized to speak to various articles.

The standards basic the way toward outlining the MEDIGATE System can be consolidated in any up and coming frameworks that uses the voice distinguishing proof strategies. Additionally, they can be fused in the frameworks that utilizations pens as one of the apparatuses. In this manner, this can upgrade the simplicity of embracing and utilizing the framework. MEDIGATE framework can be connected in numerous advanced frameworks empowering them to accomplish their motivation and capacities.

With the accessibility of different media innovations, the combination of sound and video connections might be very essential and fundamental to the MEDIGATE framework. It will empower the doctor to call up a therapeutic reference or a video photo of a methodology of concern, thus getting immediate input and updates, Byun et al (2016).

It is trusted that these standards will assume an imperative part in future PC based therapeutic data frameworks by empowering the gathering of pertinent data and accommodating introduction and most extreme usage of the information, thus advancing the courses on which the patients are dealt with, administration and controlling of the mistakes in the frameworks, and improving the looks into that are identified with the field of medication.

However sufficient examination of the usefulness of the framework is just valuable when the deformities of the framework are managed upon in an auspicious way. Evaluators and architects require a sorted out rundown of discoveries for organizing upgrade work. The software engineers ought to settle the mistakes that are recognized while the framework is working.

The report ought to be organized by either regions of the framework concerned, or by seriousness of the issue. For the last mentioned, a five-point scale ought to be received, running from ‘would keep client from continuing further’ to ‘minor bothering’. Including a note of the general ease of use rule concerned may enable planners to comprehend why there is a trouble, however regularly more specific elaboration will be required. In lieu, some of the time the issue is apparent to the point that clarification is excess, Byun et al (2016). An eye to eye meeting may have more impact than a composed archive alone and this would be the perfect scene for indicating short video clasps and playing sound records of client issues,

Physicians and other medical professionals will definitely benefit from the interaction with the MEDIGATE system in data entry to compliment the process of medical judgement in clinical diagnosis and management.

The user interface focus broadly generates a need to perform a detailed physical examination and hence will improve the overall process. When integrated into electronic health records and artificial intelligence programs such as deep learning, the MEDIGATE system will transform the practice of medicine into a service efficient system with better patient care delivery and information relevant for clinical research, Byun et al (2016).


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