Romaric Marcilly

• PhD
• Researcher at Centre Hospitalier Universitaire de Lille

Background Computerized decision support systems (CDSS) help hospital-based clinical pharmacists to perform medication reviews and so are promising tools for improving medication safety. However, their poor usability can reduce effectiveness and acceptability. Objectives To evaluate the usability and perceived usefulness of a CDSS for medication r...

Marginalised people experience diminished access to pharmaceutical care and worse medication-related outcomes than the general population. Health equity is a global priority. This article explores the key evidence of health inequity and medication use, structures the causes and contributory factors and suggests opportunities that can be taken to ad...

Objective: Two tools are currently available in the literature to evaluate the usability of medication alert systems, the instrument for evaluating human factors principles in medication-related decision support alerts (I-MeDeSA) and the tool for evaluating medication alerting systems (TEMAS). This study aimed to compare their convergent validity,...

Patient care involves multiple healthcare professionals and carries inherent risks. Addressing human factors is essential to mitigating these risks and improving professional practices. Cognitive aids are one strategy to standardize tasks based on clinical guidelines. A multidisciplinary team, consisting of anesthesiologists, pharmacists, ergonomis...

Despite the growing importance of Usability and User eXperience (U/UX) methods in healthcare technology, significant barriers hinder their effective application. We performed a narrative review to identify existing knowledge and uncover gaps to suggest actionable steps for improving adoption of U/UX methods. Results highlight that usability issues...

Explainable Artificial Intelligence (XAI) is crucial for enhancing transparency, interpretability and actionability of AI systems, particularly in healthcare. The SAD XAI Dashboard, a clinical decision support (CDS) tool for sepsis-associated delirium (SAD), assists physicians in understanding AI-driven predictions for SAD. Our study aimed to evalu...

Simulations are often used in medical education to practice developing skills in low-stakes situations. We created a telemedicine simulation for residents in obstetrics, gynaecology, and family medicine to teach best practices in telehealth care. We wrote a case of a patient with gestational hypertension that tested resident performance in eight pu...

Medical educators frequently use simulations with standardised patients in their curriculum to expose learners to high-stakes scenarios in a safe, monitored context. It can be challenging to ensure a standardised experience for learners and provide consistent opportunities for faculty to measure competencies before piloting with target learners. We...

External validity is the extent to which the findings of an experimental study are applicable or can be generalized to other people and contexts. External validity includes both population validity (i.e., the representativeness of the sample) and ecological validity (i.e., the representativeness of other contextual variables such as the stimuli, wo...

Introduction Type 2 diabetes is a chronic condition associated with impaired glucose tolerance and a high prevalence of comorbidity, polypharmacy and medication safety incidents. Little is known about the patient work associated with using diabetes management technologies by patients and their informal caregivers at home. This study aims to apply a...

Background Clinical decision support systems (CDSSs) enable the automated, real-time detection of situations associated with a risk of adverse drug events (ADEs). However, the effectiveness of CDSS in reducing ADEs has yet to be demonstrated. We have chosen to focus on the detection of ADE such as hyperkalemia and/or acute kidney injury (AKI), whic...

Application of usability evaluations throughout the health technology lifecycle is necessary to improve the efficiency, safety, and effectiveness of health service delivery. Unfortunately, technology vendors and healthcare organizations may not have funding, time or expertise to conduct usability studies. In this paper, we describe how usability ch...

Background: The ecological validity associated with usability testing of health information technologies (HITs) can affect test results and the predictability of real-world performance. It is, therefore, necessary to identify conditions with the greatest effect on validity. Method: We conducted a comparative analysis of two usability testing condit...

BACKGROUND Telemedicine has emerged rapidly as a novel and secure tool to deliver medical information and prescription. A secure, connected healthcare application (Wistim) has been developed in order to facilitate dialogue between patients and the medical team during an ovarian stimulation cycle for medically assisted reproduction (MAR). OBJECTIVE...

Background Telemedicine has emerged rapidly as a novel and secure tool to deliver medical information and prescriptions. A secure, connected health care app (WiStim) has been developed in order to facilitate dialogue between patients and the medical team during an ovarian stimulation cycle for medically assisted reproduction (MAR). Objective This...

Objectives: To offer diverse but complementary perspectives on how biomedical and health informatics can be informed by and help to achieve the vision of One Health. Methods: Overview of key considerations and critical discussion of common themes, barriers and opportunities, based on collaborative review by International Medical Informatics Associa...

Auto-injector pens (AIPs) can improve a patient’s quality of life. However, some human factors problems in AIP design can prompt the occurrence of use errors with sometimes dramatic consequences. AIP manufacturers are required to identify characteristics of the user interface that might lead to use errors. This identification can be time-consuming...

Medical Informatics brings methods and solutions that could support reducing healthcare's ecological footprint. Initial frameworks for Green Medical Informatics solutions are available, however these do not address organizational and human factors. Including these factors in evaluation or analysis of (technical) interventions aimed at making health...

The DetecIP project aims to implement multifactorial dynamic rules within a computerized decision support system (CDSS) for pharmaceutical analysis of orders to reduce the rate and severity of iatrogenic hyperkalemia and acute kidney injury. However, understanding the impact of this intervention (if any) requires that the way in which it influences...

Follow-up of patients with type 2 diabetes mellitus (T2DM) involves several healthcare professionals. The quality of their communication is crucial for optimizing care. This exploratory work aims to characterize those communications and their problems. Interviews were performed with general practitioners (GP), patients and other professionals. Data...

Background: Healthcare is increasingly delivered closer to the patients’ homes, which increases the level of responsibility that patients and informal carers take for managing their medication-taking, although this is associated with hazards. Medication self-management has been conceptualised as work taking place in non-formal settings ( e.g. , hou...

Purpose To reduce the risk of dehydration in older adults, the French company Auxivia has developed a smart drinking glass (SDG) that can measure the amount of water drunk. The present study looked at the various work systems (WSs) designed for use of the SDG in a nursing home. The study’s objectives were to (i) determine the WSs’ impact on the sta...

Introduction Health care information systems can generate and/or record huge volumes of data, some of which may be reused for research, clinical trials, or teaching. However, these databases can be affected by data quality problems; hence, an important step in the data reuse process consists in detecting and rectifying these issues. With a view to...

Health data science is an emerging discipline that bridges computer science, statistics and health domain knowledge. This consists of taking advantage of the large volume of data, often complex, to extract information to improve decision-making. We have created a Master’s degree in Health Data Science to meet the growing need for data scientists in...

This paper describes the development and implementation of an anesthesia data warehouse in the Lille University Hospital. We share the lessons learned from a ten-year project and provide guidance for the implementation of such a project. Our clinical data warehouse is mainly fed with data collected by the anesthesia information management system an...

To improve parents’ experience in the pediatric emergency waiting room by means of an information tool, the information needs of parents and pediatric patients need to be determined. It is necessary to find an optimal design for the information needed to be understandable by and useful to the parents. This paper presents the first step of designing...

The objective of this study was to assess the perception of French general practitioners (GPs) and the impact of the Google® online physician rating system. We questioned the French GPs with a self-administered questionnaire. A total of 412 GPs had answered the complete questionnaire. 83.25% of respondents did not validate the relevance of the phys...

Objectives: Involving representative users in usability testing of health information technology (HIT) is central to user-centered design. However, (vulnerable) older adults as representative users have unique requirements. Aging processes may affect physical capabilities and cognitive skills, which can hamper testing with this demographic and may...

Background A major factor in the success of any search engine is the relevance of the search results; a tool should sort the search results to present the most relevant documents first. Assessing the performance of the ranking formula is an important part of search engine evaluation. However, the methods currently used to evaluate ranking formulae...

Software apps for health and wellness are proliferating rapidly.1 Policy makers, health-care providers, and consumers can benefit from assessment and standardisation of these apps, to support decision making in a rapidly developing field. Recognising this unmet need, the International Organization for Standardization (ISO) published a standard in J...

Clinical pharmacy activities contribute to improve patient safety. Yet, the work system’s characteristics influence how clinical pharmacy activities are performed and conversely clinical pharmacy causes that work system to evolve. This exploratory study aims to identify the different ways in which clinical pharmacy activities are performed in diffe...

The COVID-19 pandemic has disrupted many global industries and shifted the digital health landscape by stimulating and accelerating the delivery of digital care. It has emphasized the need for a system level informatics implementation that supports the healthcare management of populations at a macro level while also providing the necessary support...

Introduction Many recent studies have investigated the hospital volume-outcome relationship in surgery. In some cases, the results have prompted the centralization of surgical activity. However, the methodologies and interpretations differ markedly from one study to another. The objective of the present scoping review was to describe the various fe...

Background Clinical decision support systems (CDSSs) can improve the quality of patient care by helping physicians to review their prescriptions and thus to optimize drug treatments. Nevertheless, the “alert fatigue” brought on by a large number of irrelevant alerts can decrease a CDSS’s effectiveness and thus clinical value. Involving a clinical p...

Introduction Research has shown that improvements to the usability of medication alert systems are needed. For designers and decisions-makers to assess usability of their alert systems, two paper-based tools are currently available: the instrument for evaluating human-factors principles in medication-related decision support alerts (I-MeDeSA) and t...

Objectives For medical devices, a usability assessment is mandatory for market access; the objective is to detect potentially harmful use errors that stem from the device’s design. The manufacturer assesses the final version of the device and determines the risk-benefit ratio for remaining errors. Nevertheless, the decision rule currently used to d...

It is necessary for hospitals to be able to compare the usability of electronic health records (EHR) before acquisition. Adding usability as a critical element of the procurement process is therefore crucial. During the competitive usability evaluation of several EHRs, the usability walkthrough method has the potential of making end-users more acti...

Background As a major public health crisis, the novel coronavirus disease 2019 (COVID-19) pandemic demonstrates the urgent need for safe, effective, and evidence-based implementations of digital health. The urgency stems from the frequent tendency to focus attention on seemingly high promising digital health interventions despite being poorly valid...

BACKGROUND A major factor in the success of any search engine is the relevance of the search results; a tool should sort the search results to present the most relevant documents first. Assessing the performance of the ranking formula is an important part of search engine evaluation. However, the methods currently used to evaluate ranking formulae...

Après la crise sanitaire, de nombreux journaux et blogs soulignent le fait que celle-ci a été un accélérateur de la transformation numérique des hôpitaux au travers de l’adoption massive des outils de télémédecine. Cependant, il est important de souligner que la télémédecine et la continuité des soins reposent sur un outil plus ancien : le Dossier...

Background: Medical terminologies are commonly used in medicine. For instance, to answer a pharmacovigilance question, pharmacovigilance specialists (PVS) search in a pharmacovigilance database for reports in relation to a given drug. To do that, they first need to identify all MedDRA terms that might have been used to code an adverse reaction in t...

Introduction: Even if a positive volume-outcome correlation in surgery is mostly admitted in many surgical fields, the various ways to assess this relationship make it difficult for researchers and policymakers to use it. Our aim is therefore to provide an overview of the way hospital volume-outcome relationship was assessed. Through this overview,...

A large proportion of the patient injuries or deaths attributable to medical device (MD) misuse can be eliminated and/or mitigated by adopting an effective human factors/ergonomics (HFE) approach. The implementation of a usability engineering process is now mandatory for MD manufacturers seeking to obtain the European Union's CE Mark. Here, we desc...

BACKGROUND It is well known that recommendations from electronic medication alerts are seldom accepted or acted on by users. Key factors affecting the effectiveness of medication alerts include system usability and alert design. In response, human factors principles that apply knowledge of human capabilities and limitations are increasingly used in...

Background It is well known that recommendations from electronic medication alerts are seldom accepted or acted on by users. Key factors affecting the effectiveness of medication alerts include system usability and alert design. Thus, human factors principles that apply knowledge of human capabilities and limitations are increasingly used in the de...

OBJECTIVE: Human and Organizational Factors (HOF) studies in health technology involve human beings and thus require Institutional Review Board (IRB) approval. Yet HOF studies have specific constraints and methods that may not fit standard regulations and IRB practices. Gaining IRB approval may pose difficulties for HOF researchers. This paper aims...

Aim: To provide a person-centered set of recommendations that will help (i) healthcare professionals to implement the medication review process at hospital and (ii) tactical stakeholders to promote medication reviews as standard practice in clinical pharmacy. Background: Although the medication review process is highly relevant for the safety of in...

Managers, physicians and researchers need to study patient's path for purposes of management, quality of care and research. We present the proof of concept of the use of a flow diagram, the Sankey diagram, to visualize the trajectory of a population that experienced an event. This representation was tested with two case studies in populations from...

Clinical dashboards summarize indicators of high-volume patient data in a concise, user-friendly visual format. There are few studies of the use of dashboards to improve professional practice in anesthesiology. The objective of the present study was to describe the user-centered development, implementation and preliminary evaluation of clinical das...

Objective: Human and Organizational Factors (HOF) studies in health technology involve human beings and thus require Institutional Review Board (IRB) approval. Yet HOF studies have specific constraints and methods that may not fit standard regulations and IRB practices. Gaining IRB approval may pose difficulties for HOF researchers. This paper aims...

BACKGROUND Overcrowding in the emergency departments has become an increasingly significant problem. Patient triage strategies are acknowledged to help clinicians manage patient flow and reduce patients’ waiting time. Yet, electronic patient triage systems are not developed so that they comply with clinicians’ work’s habits. OBJECTIVE This case st...

Background: Overcrowding in the emergency departments has become an increasingly significant problem. Patient triage strategies are acknowledged to help clinicians manage patient flow and reduce patients' waiting time. However, electronic patient triage systems are not developed so that they comply with clinicians' workflow. Objective: This case...

Aim: To provide a person-centered set of recommendations that will help (i) healthcare professionals to implement the medication review process at hospital and (ii) tactical stakeholders to promote medication reviews as standard practice in clinical pharmacy. Background: Although the medication review process is highly relevant for the safety of in...

To prevent cardiovascular diseases, eHealth solutions may be used as tools, involving health care consumers in the set-up of their prevention plan, a fundamental condition for improving their long-term adherence to the plan. This paper presents the first step in a web platform design aiming to support the co-elaboration by health care consumers and...

Introduction: Overcrowding is a common problem in emergency departments. This is true for adult and pediatric emergency department (PED) and issues are potentially important (e.g. quality of care, financial, social, ethical). Optimum is one among several solutions implemented to fight this phenomenon. It is an electronic patient prioritization too...

The digital transformation of health care delivery remains an elusive work in progress. Contextual variation continues to be a significant barrier to the development of sustainable health information systems. In this paper we characterize health informaticians as modern alchemists and use this characterization to describe informatics progress in ad...

This paper presents preliminary results from a larger project led with the French company Auxivia. The latter offers a smart drinking glass (SDG), supporting monitoring daily water intakes of elderly people and helping identify residents to encourage. Contexts and work organizations can deeply differ from a nursing home to another and can impact th...

Background The contribution of usability flaws to patient safety issues is acknowledged but not well-investigated. Free-text descriptions of incident reports may provide useful data to identify the connection between health information technology (HIT) usability flaws and patient safety. Objectives This article examines the feasibility of using inc...

Electronic health record (EHR) systems were initially developed to improve health care delivery by facilitating the healthcare professionals' access to electronically-stored patient information, but problems are regularly reported in the literature. We present here a preliminary study conducted at a 950-bed university hospital. They have implemente...

In the information retrieval task, searching and choosing keywords to form the query is crucial. The present study analyzes and describes the keywords' search strategy into a thesaurus in the field of pharmacovigilance. Two ergonomics experts shadowed 22 pharmacovigilance specialists during their daily work. They focus on the strategies for searchi...

Auto-injection devices must be easy and intuitive to use, especially in emergency situations. However, there are many reports of safety-related issues affecting auto-injectors and pen injectors, due to usability deficits. To minimize this type of problem, the identification of potential use errors is an important and critical task in usability engi...

Pharmacovigilance is in charge of studying the adverse effects of pharmaceutical products. In this field, pharmacovigilance specialists experience several difficulties when searching and exploring their patient data despite the existence of standardized terminologies (MedDRA). In this paper, we present our approach to enhance the way pharmacovigila...

Pharmacovigilance is in charge of studying the adverse effects of pharmaceutical products. In this field, pharmacovigilance specialists experience several difficulties when searching and exploring their patient data despite the existence of standardized terminologies (MedDRA). In this paper, we present our approach to enhance the way pharmacovigila...

Introduction: Due to high volumes of data routinely recorded through Hospital Information System, data reuse has become important in recent years. A data warehouse was developed in the Lille University Hospital to reuse anesthesia data. At the moment, it is mainly used for clinical research, by offering extraction of data tables to answer a clinica...

Background: Usability flaws in medication alerting systems may have a negative impact on clinical use and patient safety. In order to prevent the release of alerting systems that contain such flaws, it is necessary to provide designers and evaluators with evidence-based usability design principles. The objective of the present study was to develop...

Poor usability of health technology is thought to diminish work system performance, increase error rates and, potentially, harm patients. The present study (i) used a combination of usability evaluation methods to highlight the chain that leads from usability flaws to usage problems experienced by users and, ultimately, to negative patient outcomes...

The study presents the evaluation of the reliability of the information displayed on the user interface of a homegrown electronic patient prioritization tool dedicated to pediatric emergency department (namely Optimum). Two ergonomists shadowed physicians and nurses throughout their shift in order to (i) identify consistencies and discrepancies bet...

Introduction: Due to high volumes of data routinely recorded through Hospital Information System, data reuse has become important in recent years. A data warehouse was developed in the Lille University Hospital to reuse anesthesia data. At the moment, it is mainly used for clinical research, by offering extraction of data tables to answer a clinic...

The study presents the evaluation of the reliability of the information displayed on the user interface of a homegrown electronic patient prioritization tool dedicated to pediatric emergency department (namely Optimum). Two ergonomists shadowed physicians and nurses throughout their shift in order to (i) identify consistencies and discrepancies bet...

Introduction: While quantitative evaluations, such as clinical trials, are well-known and formalized, the situation is different for qualitative evaluations such as usability validation: they are insufficiently defined despite the imposition of the EU Medical Device (MD) Directive. The challenge for usability validation of MD is to make sure that r...

Introduction: The project Useval-DM aims to establish scientific evidence of critical methodological choices for usability validations. Different variables and their influence on evaluation results are analyzed (e.g. number of participants; fidelity of the testing environment; cultural differences). In that context three different medical devices a...

This paper discusses how and why to build evidence-based knowledge on usability evaluation methods. At each step of building evidence, requisites and difficulties to achieve it are highlighted. Specifically, the paper presents how usability evaluation studies should be designed to allow capitalizing evidence. Reciprocally, it presents how evidence-...

In order to prevent use errors with their medical devices, manufacturers have to integrate a safety-oriented usability engineering process in their product development lifecycle. A critical step of this process is the identification of potential use-errors. Standards and guidelines recommend to triangulate several sources of information e.g. scient...

This paper discusses how and why to build evidence-based knowledge on usability evaluation methods. At each step of building evidence, requisites and difficulties to achieve it are highlighted. Specifically, the paper presents how usability evaluation studies should be designed to allow capitalizing evidence. Reciprocally, it presents how evidence-...

In order to prevent use errors with their medical devices, manufacturers have to integrate a safety-oriented usability engineering process in their product development lifecycle. A critical step of this process is the identification of potential use-errors. Standards and guidelines recommend to triangulate several sources of information e.g. scient...

Summary Objectives: The objectives of this paper are to review and discuss the methods that are being used internationally to report on, mitigate, and eliminate technology-induced errors. Methods: The IMIA Working Group for Health Informatics for Patient Safety worked together to review and synthesize some of the main methods and approaches associa...

Usability is a critical factor in the acceptance, safe use, and success of health IT. The User-Centred Design process is widely promoted to improve usability. However, this traditional case by case approach that is rooted in the sound understanding of users' needs is not sufficient to improve technologies' usability and prevent usability-induced us...

Abnormal values of vital parameters such as hypotension or tachycardia may occur during anesthesia and may be detected by analyzing time-series data collected during the procedure by the Anesthesia Information Management System. When crossed with other data from the Hospital Information System, abnormal values of vital parameters have been linked w...

Data stored in operational databases are not reusable directly. Aggregation modules are necessary to facilitate secondary use. They decrease volume of data while increasing the number of available information. In this paper, we present four automated engines of aggregation, integrated into an anaesthesia data warehouse. Four instances of clinical q...

Governments around the world are actively promoting citizens electronic access to their health data as one of a number of ways to respond to the challenges of health care delivery in the 21st century. While numerous approaches have been utilized it is evident from crosscountry comparisons that there are different conceptualizations of: both the exp...

Medication alerting system use errors and lack of adoption are often attributed to usability issues. Previous work has used evidence from the literature to reveal usability principles specific to medication alerting systems and identify potential consequences of violating these principles. The current study sought to explore how best to convey thes...

Usability is a critical factor in the acceptance, safe use, and success of health IT. The User-Centred Design process is widely promoted to improve usability. However, this traditional case by case approach that is rooted in the sound understanding of users' needs is not sufficient to improve technologies' usability and prevent usability-induced us...

Medication alerting system use errors and lack of adoption are often attributed to usability issues. Previous work has used evidence from the literature to reveal usability principles specific to medication alerting systems and identify potential consequences of violating these principles. The current study sought to explore how best to convey thes...

At the end of an inpatient stay, the hospital physician produces a discharge letter intended for the General Practitioner in order to ensure the continuity of care between hospital and general practice. The French National Health Authority recommends (i) that the discharge letter should reach its addressee within 8 days and (ii) that it includes th...

This paper presents how, in compliance with the standard ISO 9241-210:2010, Human Factors activities were implemented in the design of a patient scheduling system in order to decrease the overcrowding in a pediatric emergency department. More specifically, an original method to assess an algorithm with end-users is described. First, a work system a...