Wanda Pratt

University of Washington | UW · Department of Human-computer interaction (HCI)

This article is an extended version of our 2018 ASSETS paper entitled, “Incorporating Social Factors in Accessible Design.” In our ASSETS paper, we demonstrated the viability of the Design for Social Accessibility perspective through a series of user-centered workshops with professional designers. With this expanded article, we conducted a follow-u...

Importance Current electronic health records (EHRs) contribute to increased physician cognitive workload when completing clinical tasks. Objective To assess the association of different design features of an EHR-based information visualization tool with the cognitive load of physicians during the clinical prioritization process. Design, Setting,...

Objective: Inpatients could play an important role in identifying, preventing, and reporting problems in the quality and safety of their care. To support them effectively in that role, informatics solutions must align with their experiences. Thus, we set out to understand how inpatients experience undesirable events (UEs) and to surface opportunit...

Background: As people increasingly receive personal health information through technology, there is increased importance for this information to be communicated with empathy and consideration for the patient's experience of consuming it. Although technology enables people to have more frequent and faster access to their health information, it coul...

To ensure that new health information technology supports its intended users, researchers and developers need to follow human-centered methods during all stages of the software development lifecycle, including early stage evaluations. These evaluations need to include realistic testing scenarios to ensure that they provide valuable and accurate fee...

Although patient portals-technologies that give patients access to their health information-are recognized as key to increasing patient engagement, we have a limited understanding of how these technologies should be designed to meet the needs of hospitalized patients and caregivers. Through semi-structured interviews with 30 patients and caregivers...

Healthcare systems worldwide have dedicated several years, special attention, and action toward improving safety for their patients. Although many innovative technological solutions have helped providers reduce medical errors, hospitalized patients lack access to these solutions, and face difficulties in having a proactive role in their safety. In...

Despite wide recognition of the value, expertise, and support that patient-peers provide in a variety of health contexts, mechanisms to design and enable peer support in the inpatient setting have not been sufficiently explored. To better understand the opportunities for an inpatient peer support tool, we surveyed 100 adult patients and caregivers,...

We designed five novel collaborative health reminders using data-driven low-fidelity prototyping methods. Each collaborative reminder-Symbolic Reminder Band, Social Reminder App, Reminder Invitation, Conversation Reminder, and Actionable Notification-was designed for patients to engage, discuss, and share their health information for collaboration...

Personal technologies are rarely designed to be accessible to disabled people, partly due to the perceived challenge of including disability in design. Through design workshops, we addressed this challenge by infusing user-centered design activities with Design for Social Accessibility-a perspective emphasizing social aspects of accessibility-to in...

The hospital setting creates a high-stakes environment where patients' lives depend on accurate tracking of health data. Despite recent work emphasizing the importance of patients' engagement in their own health care, less is known about how patients track their health and care in the hospital. Through interviews and design probes, we investigated...

Historically, tattoos have been perceived as a mark of deviant behavior from the perspective of Western medicine. However, cancer survivor tattoos are one of many strategies used to recover from the trauma of cancer diagnosis and treatment. In this study, we seek to understand the significance of these tattoos in the context of survivorship. We int...

Talk therapy is a common, effective, and desirable form of mental health treatment. Yet, it is inaccessible to many people. Enabling peers to chat online using effective principles of talk therapy could help scale this form of mental health care. To understand how such chats could be designed, we conducted a two-week field experiment with 40 people...

Background: For many people, tracking health indicators is central to managing a chronic illness. However, previous informatics research has largely viewed tracking as a solitary process that lacks the characteristics essential to tracking in support of chronic illness management. Objective: To inform development of effective technologies that a...

The hospital setting creates a high-stakes environment where patients' lives depend on accurate tracking of health data. Despite recent work emphasizing the importance of patients' engagement in their own health care, less is known about how patients track their health and care in the hospital. Through interviews and design probes, we investigated...

Patients with chronic health conditions use online health communities to seek support and information to help manage their condition. For clinically related topics, patients can benefit from getting opinions from clinical experts, and many are concerned about misinformation and biased information being spread online. However, a large volume of comm...

The use of pharmacogenomics (PGx) in clinical practice still faces challenges to fully adopt genetic information in targeting drug therapy. To incorporate genetics into clinical practice, many support the use of Pharmacogenomics Clinical Decision Support Systems (PGx-CDS) for medication prescriptions. This support was fueled by new guidelines to in...

Although research has demonstrated improved outcomes for outpatients who receive peer support-such as through online health communities, support groups, and mentoring systems-hospitalized patients have few mechanisms to receive such valuable support. To explore the opportunities for a hospital-based peer support system, we administered a survey to...

Barriers to accessing mental health care leave the majority of people with mental illnesses without professional care. Peer support has been shown to address gaps in care, and could scale to wider audiences through technology. But technology design for mental health peer support lags far behind tools for individuals and clinicians. To identify oppo...

Young adult cancer survivors-individuals in their 20's and 30's-must cope with complicated informational and emotional needs that differ from those of other age groups. Although young adult cancer survivors are resourceful in finding information and support to help meet those needs, they face three distinct, ongoing challenges during and after the...

Involving patients in healthcare safety practices has long been an area of priority and importance. However, we still need to understand how patients perceive undesirable events during their hospital stay, and what role patients play in the prevention of these events. To address this gap, we surveyed pediatric inpatients and caregivers to understan...

Although hospital care is carefully documented and that information is electronically available to clinicians, few information systems exist for patients and their families to use while they are in the hospital. Information often appears trapped within the hospital room. In this paper, we present findings from three participatory design sessions th...

Participatory design, a method by which system users and stakeholders meaningfully contribute to the development of a new process or technology, has great potential to revolutionize healthcare technology, yet has seen limited adoption. We conducted a design session with eleven physicians working to create a novel clinical information tool utilizing...

People with a chronic illness must manage a myriad of tasks to support their health. Online patient portals can provide vital information and support in managing health tasks through notification and reminder features. However, little is known about the efficacy of these features in managing health tasks via the portal. To elicit feedback about rem...

Health reminders are integral to self-managing chronic illness. However, to act on these health reminders, patients face many challenges, such as lack of motivation and ability to perform health tasks. As a result, patients experience negative consequences for their health. To investigate the design of health reminders that persuade patients to tak...

Full text can be found here: https://www.jmir.org/2016/11/e284/ Background Patients increasingly use online health communities to exchange health information and peer support. During the progression of health discussions, a change of topic—topic drift—can occur. Topic drift is a frequent phenomenon linked to incoherence and frustration in online co...

Online health communities provide a rich source of expertise from experienced patients, but uncovering "peer mentors" with shared circumstances is like finding a needle in a haystack - a problem that will escalate as these communities grow and diversify.We investigated interactive health interest profiles (HIPs) that summarize health-related terms...

Patient engagement leads to better health outcomes and experiences of health care. However, existing patient engagement systems in the hospital environment focus on the passive receipt of information by patients rather than the active contribution of the patient or caregiver as a partner in their care. Through interviews with hospitalized patients...

Patients going home after a hospitalization face many challenges. This transition period exposes patients to unnecessary risks related to inadequate preparation prior to leaving the hospital, potentially leading to errors and patient harm. Although patients engaging in self-management have better health outcomes and increased self-efficacy, little...

Objective The proposed Meaningful Use Stage 3 recommendations require healthcare providers to accept patient-generated health data (PGHD) by 2017. Yet, we know little about the tensions that arise in supporting the needs of both patients and providers in this context. We sought to examine these tensions when designing a novel, patient-centered tech...

Informal caregivers, such as close friends and family, play an important role in a hospital patient’s care. Although CSCW researchers have shown the potential for social computing technologies to help patients and their caregivers manage chronic conditions and support health behavior change, few studies focus on caregivers’ role during a multi-...

Objective Online health communities offer a diverse peer support base, yet users can struggle to identify suitable peer mentors as these communities grow. To facilitate mentoring connections, we designed a peer-matching system that automatically profiles and recommends peer mentors to mentees based on person-generated health data (PGHD). This study...

Healthcare providers are moving towards tailoring self-management interventions to include the communication technologies patients use in daily life. Accurate understanding of patients' attitudes towards both technology and involvement in managing chronic conditions will be critical for informing effective self-management strategies. The tailoring...

Diabetes management is a complex, dynamic process that is largely incumbent on patient choices and behavior. We explore how health-management needs-and the needs for technological support-change over time for individuals with diabetes. Through interviews and a focus group, we found that after initial diagnosis, individuals face acute information ne...

Asynchronous communication outside the clinical setting has both enriched and complicated patient-clinician interactions. Many patients can now interact with a patient portal 24 hours a day, asking questions of their clinicians via secure message, checking lab results, ordering medication refills, or making appointments. However, the mode of commun...

Despite growing use of patient-facing technologies such as patient portals to address information needs for outpatients, we understand little about how patients manage information and use information technologies in an inpatient context. Based on hospital observations and responses to an online questionnaire from previously hospitalized patients an...

Online health communities provide popular platforms for individuals to exchange psychosocial support and form ties. Although regular active participation (i.e., posting to interact with other members) in online health communities can provide important benefits, sustained active participation remains challenging for these communities. Leveraging pre...

Manual tracking of health behaviors affords many benefits, including increased awareness and engagement. However, the capture burden makes long-term manual tracking challenging. In this study on sleep tracking, we examine ways to reduce the capture burden of manual tracking while leveraging its benefits. We report on the design and evaluation of Sl...

Full text can be found here: http://www.jmir.org/2015/8/e212/ The prevalence and value of patient-generated health text are increasing, but processing such text remains problematic. Although existing biomedical natural language processing (NLP) tools are appealing, most were developed to process clinician- or researcher-generated text, such as clin...

We introduce a mixed-methods approach for determining how people weigh tradeoffs in values related to health and technologies for health self-management. Our approach combines interviews with Q-methodology, a method from psychology uniquely suited to quantifying opinions. We derive the framework for structured data collection and analysis for the Q...

The electronic health record (EHR) has evolved as a tool primarily dictated by the needs of health care clinicians and organizations, providing important functions supporting day to day work in health care. However, the EHR and supporting information systems contain the potential to incorporate patient workflows and tasks as well. Integrating patie...

What is the role of shared calendars for home health management? Utilizing a maximum variation sampling method, we interviewed 20 adult individuals with diabetes and 20 mothers of children with asthma to understand calendar use in the context of chronic disease home health management. In comparing the experiences of these two groups, we explore par...

Children diagnosed with a chronic illness, such as cancer, experience a vastly different childhood than their healthy counterparts. They may struggle with accepting that they are no longer seen as "normal". We surveyed 10 children who have a chronic illness and interviewed 15 healthcare professionals and 7 parents of chronically ill children to und...

Individuals with chronic conditions face challenges with maintaining lifelong adherence to self-management activities. Although reminders can help support the cognitive demands of managing daily and future health tasks, we understand little of how they fit into people’s daily lives. Utilizing a maximum variation sampling method, we interviewed and...

Patient-generated health data (PGHD) offers a promising resource for shaping patient care, self-management, population health, and health policy. Although emerging technologies bolster opportunities to extract PGHD and profile the needs and experiences of patients, few efforts examine the validity and use of such profiles from the patient’s perspec...

Information seeking and synthesis are time consuming processes for physicians. Although systems have the potential to simplify these tasks, future improvements must be based on an understanding of how physicians perform these tasks during clinical prioritization. We enrolled 23 physicians in semi-structured focus groups, and gave them fictional cas...

Many current mobile health applications ("apps") and most previous research have been directed at management of chronic illnesses. However, little is known about patient preferences and design considerations for apps intended to help in a post-acute setting. Our team is developing an mHealth platform to engage patients in wound tracking to identify...

Studies have shown positive impact of video blogs (vlogs) on patient education. However, we know little on how patient-initiated vlogs shape the relationships among vloggers and viewers. We qualitatively analyzed 72 vlogs on YouTube by users diagnosed with HIV, diabetes, or cancer and 1,274 comments posted to the vlogs to understand viewers' perspe...

Introduction: This article is part of the focus theme of Methods of Information in Medicine on "Pervasive Intelligent Technologies for Health". Background: Effective nonverbal communication between patients and clinicians fosters both the delivery of empathic patient-centered care and positive patient outcomes. Although nonverbal skill training...

Many patients visit online health communities to receive support. In face-to-face support groups, health professionals facilitate peer-patients exchanging experience while adding their clinical expertise when necessary. However, the large scale of online health communities makes it challenging for such health professional moderators' involvement to...

Researchers have studied how people use self-tracking technologies and discovered a long list of barriers including lack of time and motivation as well as difficulty in data integration and interpretation. Despite the barriers, an increasing number of Quantified-Selfers diligently track many kinds of data about themselves, and some of them share th...

The growth of smartphones has far-reaching implications for healthcare. Simply put, smartphones and other mobile technologies might be the single most promising avenue one has to help individuals manage their health, and to do so at scale. A key focus of mHealth research and development in the past few years has been on helping individuals to adopt...

Many current mobile health applications (“apps”) and most previous research have been directed at management of chronic illnesses. However, little is known about patient preferences and design considerations for apps intended to help in a post-acute setting. Our team is developing an mHealth platform to engage patients in wound tracking to identify...

Individuals with chronic conditions face challenges with maintaining lifelong adherence to self-management activities. Although reminders can help support the cognitive demands of managing daily and future health tasks, we understand little of how they fit into people’s daily lives. Utilizing a maximum variation sampling method, we interviewed and...

Abstract Objective: To improve our understanding of the potential of incentives to enhance diabetes self-management (type 1 and type 2) and to integrate incentives into a conceptual model of diabetes self-management over time. Design: A qualitative analysis of in-depth individual interviews with 12 patients and 9 providers. Main outcome measures: i...

An increasing number of people visit online health communities to share experiences and seek health information. Although studies have enumerated reasons for patients' visits to online communities for health information from peers, we know little about how patients gain health information from the moderators in these communities. We qualitatively a...

Self-monitoring technologies have proliferated in recent years as they offer excellent potential for promoting healthy behaviors. Although these technologies have varied ways of providing real-time feedback on a user's current progress, we have a dearth of knowledge of the framing effects on the performance feedback these tools provide. With an aim...

Patients increasingly visit online health communities to get help on managing health. The large scale of these online communities makes it impossible for the moderators to engage in all conversations; yet, some conversations need their expertise. Our work explores low-cost text classification methods to this new domain of determining whether a thre...

Health video blogs (vlogs) allow individuals with chronic illnesses to share their stories, experiences, and knowledge with the general public. Furthermore, health vlogs help in creating a connection between the vlogger and the viewers. In this work, we present a qualitative study examining the various methods that health vloggers use to establish...

Effective communication between patients and their clinicians during clinical encounters has a positive impact on health outcomes. Technology has the potential to help transform this synchronous interaction, but re-searchers are still at early stages of developing interventions to assess and improve patient-clinician communication. In this workshop...

How do we keep consumers engaged in using health technologies? We welcome all researchers and practitioners who are interested in this question to join us for a spirited discussion, hosted by the CHI Health Community.

Nonverbal communication between patients and clinicians affects the delivery of empathic patient-centered care and patient outcomes. To be effective communicators, clinicians must appropriately encode, decode, and regulate nonverbal cues, such as speech rate, pitch, facial expression, and body language. Yet, few efforts to develop tools for enhanci...

Effective nonverbal communication between patients and clinicians fosters both the delivery of empathic patient-centered care and positive patient outcomes. However, few efforts to develop tools for enhancing clinician communication have focused on nonverbal aspects of the clinical encounter. We describe a novel system that both uses social signal...

People with cancer experience many unanticipated symptoms and struggle to communicate them to clinicians. Although researchers have developed patient-reported outcome (PRO) tools to address this problem, such tools capture retrospective data intended for clinicians to review. In contrast, real-time tracking tools with visible results for patients c...

Online health communities that engage the patient as a whole person attend to personal and medical needs in a holistic manner. Whether current communities structure interaction between health professionals and patients to address the whole person is an open question. To gain insights into this question, we examined a sample of online patient commun...

Researchers and practitioners show increasing sinterest in utilizing patient-generated information on the Web. Although the HCI and CSCW communities have provided many exciting opportunities for exploring new ideas and building broad agenda in health, few venues offer a platform for interdisciplinary and collaborative brainstorming about design cha...

Mobile phones are becoming an increasingly important platform for the delivery of health interventions. In recent years, researchers have used mobile phones as tools for encouraging physical activity and healthy diets, for symptom monitoring in asthma and heart disease, for sending patients reminders about upcoming appointments, for supporting smok...

When patients need health information to manage their personal health, they turn to both health professionals and other patients. Yet, we know little about how the information exchanged among patients (ie, patient expertise) contrasts with the information offered by health professionals (ie, clinician expertise). Understanding how patients' experie...

This paper explores how people are using Twitter.com to manage and share information about health-promoting physical activity. We analyzed archived posts, called "tweets", from Twitter.com to learn about the range, patterns, and captured metadata associated with muscle-strengthening, aerobic, and flexibility-enhancing physical activities. The conte...

New technologies for encouraging physical activity, healthy diet, and other types of health behavior change now frequently appear in the HCI literature. Yet, how such technologies should be evaluated within the context of HCI research remains unclear. In this paper, we argue that the obvious answer to this question - that evaluations should assess...

When patients share personal health information with family and friends, their social networks become better equipped to help them through serious health situations. Thus, patients need tools that enable granular control over what personal health information is shared and with whom within social networks. Yet, we know little about how well such too...

Cancer patients often need to manage care-related information when they are away from home, when they are experiencing pain or treatment side effects, or when their abilities to deal with information effectively are otherwise impaired. In this paper, we describe the results from a four-week evaluation of HealthWeaver Mobile, a mobile phone applicat...

Cancer patients manage a great deal of information to coordinate their care. Critical aspects of this work take place while patients are away from home or have diminished attention due to symptoms or side effects. We describe the design of HealthWeaver Mobile, a mobile phone application we developed to help patients manage care-related information...

We have investigated game design and usability for three mobile phone video games designed to deliver diabetes education. The games were refined using focus groups. Six people with diabetes participated in the first focus group and five in the second. Following the focus groups, we incorporated the new findings into the game design, and then conduc...

The purpose of this study is (1) to identify diabetes education video games and pilot studies in the literature, (2) to review themes in diabetes video game design and evaluation, and (3) to evaluate the potential role of educational video games in diabetes self-management education. Studies were systematically identified for inclusion from Medline...

Experts in technology and medicine use diabetes to illustrate how the tools of information technology can improve patient care. The healthcare industry has been slow to join the information technology revolution; handwritten records are still the primary means of organizing patient care. Concerns about patient privacy, the difficulty of developing...

Patients do considerable information work. Technologies that help patients manage health information so they can play active roles in their health-care, such as personal health records, provide patients with effective support for focused and sustained personal health tasks. Yet, little attention has been paid to patients' needs for information mana...

Managing personal aspects of health is challenging for many patients, particularly those facing a serious condition such as cancer. Finding experienced patients, who can share their knowledge from managing a similar health situation, is of tremendous value. Users of health-related social software form a large base of such knowledge, yet these tools...

Social support is a critical, yet underutilized resource when undergoing cancer care. Underutilization occurs in two conditions: (a) when patients fail to seek out information, material assistance, and emotional support from family and friends or (b) when family and friends fail to meet the individualized needs and preferences of patients. Social n...

Although clinic environments are a primary location for exchanging information with clinicians, patients experience these spaces as harsh environments to access, use, exchange, and manage information. In this paper, we present results from an ethnographic-inspired study of breast cancer patients actively interacting with information in clinic envir...

Lifestyle modification is a key facet of the prevention and management of chronic diseases. Mobile devices that people already carry provide a promising platform for facilitating these lifestyle changes. This paper describes key lessons learned from the development and evaluation of two mobile systems for encouraging physical activity. We argue tha...

While medical researchers formulate new hypotheses to test, they need to identify connections to their work from other parts of the medical literature. However, the current volume of information has become a great barrier for this task. Recently, many literature-based discovery (LBD) systems have been developed to help researchers identify new know...

Coping with a new health issue often requires individuals to acquire knowledge and skills to manage personal health. Many patients turn to one another for experiential expertise outside the formal bounds of the health-care system. Internet-based social software can facilitate expertise sharing among patients, but provides only limited ways for user...

In a distributed system of care, patients shuffle among many clinicians and spend the majority of their time away from the treatment center. Although we see the results of patients' work (e.g., medication taken, arrived at appointment) we do not see the work itself. By failing to see this work, industry overlooks issues with vital implications for...