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Yearb Med Inform 2000; 09(01): 79-86
DOI: 10.1055/s-0038-1637945
Review Paper
Georg Thieme Verlag KG Stuttgart

Patient-centered Information Systems

P. Flatley Brennan
1   School of Nursing and College of Engineering, University of Wisconsin-Madison, Madison, WI, USA
,
Y.-S. Kuang
1   School of Nursing and College of Engineering, University of Wisconsin-Madison, Madison, WI, USA
,
K. Volrathongchai
1   School of Nursing and College of Engineering, University of Wisconsin-Madison, Madison, WI, USA
› Author Affiliations
Further Information

Address of the authors:

Patricia Flatley Brennan, RN, PhD, FAAN, FACMI, Yung-ShinKuang, MSIE, Kanittha Volrathongchai, MSN
School of Nursing and College of
Engineering
University of Wisconsin-Madison
1513 University Avenue
Madison, WI 53706, USA.

Publication History

Publication Date:
07 March 2018 (online)

 
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Abstract

Patient-centered information systems augment traditional approaches to health information management with specific functions designed to support patient participation in health care decision making and treatment activities. In addition to computer-based record systems and business management applications, patient-centered information systems must include functionality that support communication between clinician and patient, and that provide information and peer support in a timely fashion to the patient. Current progress in information systems demonstrates the existence and feasibility of consumer health informatics, patient access to computerized clinical records, and technical and organizational solutions to integrating computerized patient information systems. We are now proposing a model of patient -centered system that incorporates all those components, and provides a vision of the future.


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  • References

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    PubMedGoogle Scholar
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    CrossrefPubMedGoogle Scholar
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    CrossrefPubMedGoogle Scholar
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    PubMedGoogle Scholar
  • 12 Brennan PF, Moore SM, Smyth KA. The effects of a special computer network on caregivers of persons with Alzheimer’s disease. Nurs Res 1995; 44: 166-72.
    PubMedGoogle Scholar
  • 13 Brennan PF, Caldwell B, Moore SM, Sreenath N, Jones J. Designing Heart Care: custom computerized home care for patients recovering from CABG surgery. J Am Med Inform Soc 1998; 5: S381-5.
    PubMedGoogle Scholar
  • 14 Magrabi F, Lovell NH, Celler BG. A web-based approach for electrocardiogrammonitaring in the home. Int J Med Inf 1999; 54: 145-53.
    CrossrefPubMedGoogle Scholar
  • 15 Neill RA, Mainous 3d AG., Clark JR, Hagen MD. The utility of electronic mail as a medium forpatient-physician communication. Arch Fam Med 1994; 3: 268-71.
    CrossrefPubMedGoogle Scholar
  • 16 Fridsma DB, Ford P, Altman R. A suzvey of patient access to electronic mail: attitudes, barriers, and opportunities. In Ozbolt JG. ed Proceedings SCAMC 1994. Transforming Information, Changing Health Care . Philadelphia: Hanley & Belfus Inc; 1994: 15-19.
    Google Scholar
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    PubMedGoogle Scholar
  • 18 Coulter A. Paternalism or-partnership?. Patients have grown up-and there’s no going back. Br Med J 1999; 319: 719-20.
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  • 19 Cahill J. Patient participation-a review of the literature. J Clin Nurs 1998; 7: 119-28.
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    PubMedGoogle Scholar
  • 23 Wald JS, Rind D, Safran C, Kowaloff H, Barker R, Slack WV. Patient entries in the electronic medical record: an interactive interview used in primary care. In Gardner RM. ed Proceedings SCAMC 1995 . Philadelphia: Hanley & Belfus Inc; 1995: 147-51.
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    PubMedGoogle Scholar
  • 25 Baker DB, Masys DR. PCASSO: a design for secure communication of personal health information via the internet. Int J Med Inf 1999; 54: 97-104.
    CrossrefPubMedGoogle Scholar
  • 26 Cimino JJ, Sengupta S, Clayton PD, Patel VL, Kushniruk A, Huang X. Architecture for a Web-based clinical information system that keeps the design open and the access closed. J Am Med inform Soc 1998; 5: S121-5.
    PubMedGoogle Scholar
  • 27 Krauss N, Machlin S, Kass B. Use of health care services, 1996 . Rockville (MD): Agency for Health Care Policy and Research; 1999. MEPS Research Findings No.7, AHCPR Pub. No. 99-0018
    Google Scholar
  • 28 Duncan KA. CHINs in the context of an evolving health care system. In Cimino JJ. ed Proceedings 1996 AMIA Annual Fall Symp. Philadelphia: Hanley & Belfus Inc; 1996: 604-7.
    Google Scholar
  • 29 Kohane IS, van Wingerde FJ, Fackler JC, Cimino C, Kilbridge P, Murphy S. et al. Sharing electronic medical records across multiple heterogeneous and competing in-stitutions. In Cimino JJ. ed Proceedings 1996 AMIA Annual Fall Symp . Philadelphia: Hanley & Belfus Inc; 1996: 608-12.
    Google Scholar
  • 30 Halamka JD, Safran C. Care Web, a webbased medical record for an integrated healthcare delivery system. In Cesnik B, McCray AT, Scherrer J-R.. Proceesings Medinfo 1998. Amsterdam: IOS Press; 1998: 36-9.
    Google Scholar
  • 31 Bates DW, Pappius E, Kuperman OJ, Sittig D, Burstin H, Fairchild D. et al. Using information systems to measure and improve quality. Int J Med Inf 1999; 53: 115-24.
    CrossrefPubMedGoogle Scholar
  • 32 Van Ginneken AM, Vander Lei J, Van Bemmel JH. Chapter 29: Structuring the computer-based patient record. In Van Bemmel JH, Musen MA. eds Handbook of Medical Informatics . Houten: Bohn Stafleu Van Lochum; 1997: 449-62.
    Google Scholar
  • 33 Safran C, Porter D, Lightfoot J, Rury CD, Underhill LH, Bleich HL. et al. Clin Query: a system for online searching of data in a teaching hospital. Ann Intern Med 1989; 111: 751-6.
    CrossrefPubMedGoogle Scholar
  • 34 Korpman RA. Integrated patient-centered computing: operations optimization for the 21st century. Top Health Inf Manage 1994; 14: 11-23.
    PubMedGoogle Scholar
  • 35 Tuttle MS, Sheretz DD, Fagan LM, Carlson RW, Cole WG, Schipma PB. et al. Toward an interim standard for patient-centered knowledge-access. In Frisse ME. ed Proceedings SCAMC 1993 . New York: McGraw-Hill; 1993: 564-68.
    Google Scholar
  • 36 Balas EA, Austin SM, Mitchell JA, Ewigman BG, Bopp KD, Brown GD. The clinical value of computerized information services. A review of 98 randomized clinical trials. Arch Fam Med 1996; 5: 271-8.
    CrossrefPubMedGoogle Scholar
  • 37 Masys DR, Baker DB. Patient-Centered Access to Secure Systems Online (PCASSO): a secure approach to clinical data access via the World Wide Web. In Masys DR. ed Proceedings AMIA Annual Fall Symposium. 1997: 340-3.
    Google Scholar
  • 38 Masys DR, Baker DB. Protecting clinical data on Web client computers: the PCASSO approach. J Am Med Inform Assoc 1998; 5: S366-70.
    PubMedGoogle Scholar
  • 39 Israel BA, Sherman SJ. Social support, control and the stress process. In: Health Behavior and Health Education . Glanz K, Lewis FM, Rimer B. Eds San Francisco, CA: Jossey-Bass; 1990: 187-215.
    Google Scholar
  • 40 Anderson RM, Funnell MM, Butler PM, Arnold MS, Fitzgerald JT, Feste CC. Patient empowerment. Results of a randomized controlled trial. Diabetes Care 1995; 18: 943-9.
    CrossrefPubMedGoogle Scholar
  • 41 Masys DR, Baker DB. Patient-Centered Access to Secure Systems Online (PCASSO): a secure approach to clinical data access via the World Wide Web. In Masys DR. ed Proceedings AM/A Annual Fall Symposium. 1997: 340-3.
    Google Scholar
  • 42 Celler BG, Lovell NH, Hesketh T, Ilsar ED, Earnshaw W, Betbeder-Matibet L. Remote home monitoring of health status of the elderly. In Greenes RA, Peterson HE, Protti DJ. eds Proceedings of the 8th World Congress on Medical Informatics. Medinfo 1995 . Amsterdam: North-Holland; 1995: 615-9.
    Google Scholar
  • 43 Iakovidisi. Towards personal health record: current situation, obstacles and trends in implementation of electronic healthcare recordin Europe. Int J Med Inf 1998; 52: 105-15.
    CrossrefPubMedGoogle Scholar
  • 44 Ingenerf J. Taxonomic vocabularies in medicine: the intention of usage determines different established structures. In Greenes RA, Peterson HE, Protti DJ. eds Proceedings of the 8th World Congresson Medical Informatics. Medinfo 1995 . Amsterdam: North-Holland; 1995: 136-9.
    Google Scholar
  • 45 Balas EA, Boren SA, Griffmg G. Computerized management of diabetes: a synthesis of controlled trials. J Am Med Inform Assoc 1998; 5: S295-9.
    PubMedGoogle Scholar
  • 46 Gustafson DH, Hawkins R, Boberg E. et al. Impact of a patient-centered, computerbased health information/support system. Am J Prev Med 1999; 16: 1-9.
    PubMedGoogle Scholar
  • 47 Kannry JL, Wright L, Shifman M, Silverstein S, Miller PL. Portability issues for a structured clinical vocabulary: mapping from Yale to the Columbia medical entities dictionary. J Am Medinform Assoc 1996; 3: 66-78.
    PubMedGoogle Scholar
  • 48 Giuse DA, Mickish A. Increasing the availability of the computerized patient record. In Cimino JJ. ed Proceedings 1996 AMIA Annual Fall Symp . Philadelphia: Hanley & Belfus Inc; 1996: 633-7.
    Google Scholar
  • 49 Zielstorff RD, Tronni C, Basque J, Griffin LR, Welebob EM. Mapping nursing diagnosis nomenclatures for coordinated care. Image J Nurs Sch 1998; 30: 369-73.
    CrossrefPubMedGoogle Scholar
  • 50 Robinson L, Hughes LC, Adler DC, Strumpf N, Grobe SJ, McCorkle R. Describing the work of nursing: the case of postsurgical nursing interventions for men with prostate cancer. Res Nurs Health 1999; 22: 321-8.
    CrossrefPubMedGoogle Scholar
  • 51 Henry SB, Holzemer WL. A comparison of problem lists generated by physicians, nurses, and patients: implications for CPR systems. Proceedings SCAMC 1995. In Gardner RM. ed Philadelphia: Hanley & Belfus Inc; 1995: 382-6.
    Google Scholar
  • 52 National Telecommunication & Information Administration, U.S. Dept. of Commerce. Falling through the Net: defming the digital divide http://www.ntia.doc.gov/ntiahome/fttn99/contents.html
    PubMed
  • 53 Nielsen J. Usability Engineering . Boston: AP Professional; 1993
    Google Scholar

Address of the authors:

Patricia Flatley Brennan, RN, PhD, FAAN, FACMI, Yung-ShinKuang, MSIE, Kanittha Volrathongchai, MSN
School of Nursing and College of
Engineering
University of Wisconsin-Madison
1513 University Avenue
Madison, WI 53706, USA.

  • References

  • 1 Radwin LE. Knowing the patient: a process model for individualized interventions. Nurs Res 1995; 6: 364-70.
    PubMedGoogle Scholar
  • 2 Jewell SE. Patient manipulation: what does it mean to nurses?. J Adv Nurs 1994; 19: 433-8.
    CrossrefPubMedGoogle Scholar
  • 3 Gerteis M, Edgman-Levitan S, Daley J, Delbanco TL. (Eds.) Through the patient’s eyes. San Francisco, CA: Jossey-Bass; 1993
    Google Scholar
  • 4 Krishna S, Balas EA, Spencer DC, Griffin JZ, Boren SA. Clinical trials of interactive computerized patient education: implications for family practice. J Fam Pract 1997; 45: 25-33.
    PubMedGoogle Scholar
  • 5 Tang PC, Newcomb C. Informing patients: a guide for providing patient health information. J Am Med Inform Assoc 1998; 5: 563-70.
    CrossrefPubMedGoogle Scholar
  • 6 Jimison H, Adler L, Coye M, Mulley Jr A., Eng TR. Health care providers and purchasers and evaluation of interactive health communication applications. Science Panel on Interactive Communication and Health. Am J Prev Med 1999; 16: 16-22.
    PubMedGoogle Scholar
  • 7 Brug J, Campbell M, van Assema P. The application and impact of computer-generated personalized nutrition education: a review of the literature. Patient Educ Couns 1999; 36: 145-56.
    CrossrefPubMedGoogle Scholar
  • 8 De Vries H, Brug J. Computer-tailored interventions motivating people to adopt health promoting behaviours: introduction to a new approach. Patient Educ Couns 1999; 36: 99-105.
    CrossrefPubMedGoogle Scholar
  • 9 Jadad AR, Gagliardi A. Rating health information on the Internet: navigating to knowledgeorto Babel?. JAMA 1998; 279: 611-4.
    CrossrefPubMedGoogle Scholar
  • 10 Gustafson DH, Hawkins R, Boberg E, Pingree S, Serlin RE, Graziano F. at al Impact of a patient-centered, computerbased health information/support system. Am J Prev Med 1999; 16: 1-9.
    PubMedGoogle Scholar
  • 11 Brennan PF. A computer network home care support demonstration: a randomized trial in persons living with AIDS. Comput Biol Med 1998; 5: 489-508.
    PubMedGoogle Scholar
  • 12 Brennan PF, Moore SM, Smyth KA. The effects of a special computer network on caregivers of persons with Alzheimer’s disease. Nurs Res 1995; 44: 166-72.
    PubMedGoogle Scholar
  • 13 Brennan PF, Caldwell B, Moore SM, Sreenath N, Jones J. Designing Heart Care: custom computerized home care for patients recovering from CABG surgery. J Am Med Inform Soc 1998; 5: S381-5.
    PubMedGoogle Scholar
  • 14 Magrabi F, Lovell NH, Celler BG. A web-based approach for electrocardiogrammonitaring in the home. Int J Med Inf 1999; 54: 145-53.
    CrossrefPubMedGoogle Scholar
  • 15 Neill RA, Mainous 3d AG., Clark JR, Hagen MD. The utility of electronic mail as a medium forpatient-physician communication. Arch Fam Med 1994; 3: 268-71.
    CrossrefPubMedGoogle Scholar
  • 16 Fridsma DB, Ford P, Altman R. A suzvey of patient access to electronic mail: attitudes, barriers, and opportunities. In Ozbolt JG. ed Proceedings SCAMC 1994. Transforming Information, Changing Health Care . Philadelphia: Hanley & Belfus Inc; 1994: 15-19.
    Google Scholar
  • 17 Kane B, Sands DZ. Guidelines for the clinical use of electronic mail with patients. The AMIA Internet Working Group, Task Force on Guidelines for the Use of Clinic Patient Electronic Mail. J Am Med Inform Soc 1998; 5: 104-11.
    PubMedGoogle Scholar
  • 18 Coulter A. Paternalism or-partnership?. Patients have grown up-and there’s no going back. Br Med J 1999; 319: 719-20.
    CrossrefPubMedGoogle Scholar
  • 19 Cahill J. Patient participation-a review of the literature. J Clin Nurs 1998; 7: 119-28.
    CrossrefPubMedGoogle Scholar
  • 20 Safran C. Opening lecture. Symposium on Computer Applications in Medical Care. Oct. 1993. Washington, DC:
    Google Scholar
  • 21 Bennetts AB, Lubic RW. The free-standing birth centre. Lancet 1982; 1: 378-80.
    PubMedGoogle Scholar
  • 22 Locke SE, Kowaloff HB, Hoff RG, Safran C, Popovsky MA, Cotton DJ. et al. Computer-based interview for screening blood donors for risk of HIV transmission. J AMA 1992; 268: 1301-5.
    PubMedGoogle Scholar
  • 23 Wald JS, Rind D, Safran C, Kowaloff H, Barker R, Slack WV. Patient entries in the electronic medical record: an interactive interview used in primary care. In Gardner RM. ed Proceedings SCAMC 1995 . Philadelphia: Hanley & Belfus Inc; 1995: 147-51.
    Google Scholar
  • 24 Slack WV, Safran C, Kowaloff HB, Pearce J, Delbanco TL. A computer-administered health screening interview for hospital personnel. MD Comput 1995; 12: 25-30.
    PubMedGoogle Scholar
  • 25 Baker DB, Masys DR. PCASSO: a design for secure communication of personal health information via the internet. Int J Med Inf 1999; 54: 97-104.
    CrossrefPubMedGoogle Scholar
  • 26 Cimino JJ, Sengupta S, Clayton PD, Patel VL, Kushniruk A, Huang X. Architecture for a Web-based clinical information system that keeps the design open and the access closed. J Am Med inform Soc 1998; 5: S121-5.
    PubMedGoogle Scholar
  • 27 Krauss N, Machlin S, Kass B. Use of health care services, 1996 . Rockville (MD): Agency for Health Care Policy and Research; 1999. MEPS Research Findings No.7, AHCPR Pub. No. 99-0018
    Google Scholar
  • 28 Duncan KA. CHINs in the context of an evolving health care system. In Cimino JJ. ed Proceedings 1996 AMIA Annual Fall Symp. Philadelphia: Hanley & Belfus Inc; 1996: 604-7.
    Google Scholar
  • 29 Kohane IS, van Wingerde FJ, Fackler JC, Cimino C, Kilbridge P, Murphy S. et al. Sharing electronic medical records across multiple heterogeneous and competing in-stitutions. In Cimino JJ. ed Proceedings 1996 AMIA Annual Fall Symp . Philadelphia: Hanley & Belfus Inc; 1996: 608-12.
    Google Scholar
  • 30 Halamka JD, Safran C. Care Web, a webbased medical record for an integrated healthcare delivery system. In Cesnik B, McCray AT, Scherrer J-R.. Proceesings Medinfo 1998. Amsterdam: IOS Press; 1998: 36-9.
    Google Scholar
  • 31 Bates DW, Pappius E, Kuperman OJ, Sittig D, Burstin H, Fairchild D. et al. Using information systems to measure and improve quality. Int J Med Inf 1999; 53: 115-24.
    CrossrefPubMedGoogle Scholar
  • 32 Van Ginneken AM, Vander Lei J, Van Bemmel JH. Chapter 29: Structuring the computer-based patient record. In Van Bemmel JH, Musen MA. eds Handbook of Medical Informatics . Houten: Bohn Stafleu Van Lochum; 1997: 449-62.
    Google Scholar
  • 33 Safran C, Porter D, Lightfoot J, Rury CD, Underhill LH, Bleich HL. et al. Clin Query: a system for online searching of data in a teaching hospital. Ann Intern Med 1989; 111: 751-6.
    CrossrefPubMedGoogle Scholar
  • 34 Korpman RA. Integrated patient-centered computing: operations optimization for the 21st century. Top Health Inf Manage 1994; 14: 11-23.
    PubMedGoogle Scholar
  • 35 Tuttle MS, Sheretz DD, Fagan LM, Carlson RW, Cole WG, Schipma PB. et al. Toward an interim standard for patient-centered knowledge-access. In Frisse ME. ed Proceedings SCAMC 1993 . New York: McGraw-Hill; 1993: 564-68.
    Google Scholar
  • 36 Balas EA, Austin SM, Mitchell JA, Ewigman BG, Bopp KD, Brown GD. The clinical value of computerized information services. A review of 98 randomized clinical trials. Arch Fam Med 1996; 5: 271-8.
    CrossrefPubMedGoogle Scholar
  • 37 Masys DR, Baker DB. Patient-Centered Access to Secure Systems Online (PCASSO): a secure approach to clinical data access via the World Wide Web. In Masys DR. ed Proceedings AMIA Annual Fall Symposium. 1997: 340-3.
    Google Scholar
  • 38 Masys DR, Baker DB. Protecting clinical data on Web client computers: the PCASSO approach. J Am Med Inform Assoc 1998; 5: S366-70.
    PubMedGoogle Scholar
  • 39 Israel BA, Sherman SJ. Social support, control and the stress process. In: Health Behavior and Health Education . Glanz K, Lewis FM, Rimer B. Eds San Francisco, CA: Jossey-Bass; 1990: 187-215.
    Google Scholar
  • 40 Anderson RM, Funnell MM, Butler PM, Arnold MS, Fitzgerald JT, Feste CC. Patient empowerment. Results of a randomized controlled trial. Diabetes Care 1995; 18: 943-9.
    CrossrefPubMedGoogle Scholar
  • 41 Masys DR, Baker DB. Patient-Centered Access to Secure Systems Online (PCASSO): a secure approach to clinical data access via the World Wide Web. In Masys DR. ed Proceedings AM/A Annual Fall Symposium. 1997: 340-3.
    Google Scholar
  • 42 Celler BG, Lovell NH, Hesketh T, Ilsar ED, Earnshaw W, Betbeder-Matibet L. Remote home monitoring of health status of the elderly. In Greenes RA, Peterson HE, Protti DJ. eds Proceedings of the 8th World Congress on Medical Informatics. Medinfo 1995 . Amsterdam: North-Holland; 1995: 615-9.
    Google Scholar
  • 43 Iakovidisi. Towards personal health record: current situation, obstacles and trends in implementation of electronic healthcare recordin Europe. Int J Med Inf 1998; 52: 105-15.
    CrossrefPubMedGoogle Scholar
  • 44 Ingenerf J. Taxonomic vocabularies in medicine: the intention of usage determines different established structures. In Greenes RA, Peterson HE, Protti DJ. eds Proceedings of the 8th World Congresson Medical Informatics. Medinfo 1995 . Amsterdam: North-Holland; 1995: 136-9.
    Google Scholar
  • 45 Balas EA, Boren SA, Griffmg G. Computerized management of diabetes: a synthesis of controlled trials. J Am Med Inform Assoc 1998; 5: S295-9.
    PubMedGoogle Scholar
  • 46 Gustafson DH, Hawkins R, Boberg E. et al. Impact of a patient-centered, computerbased health information/support system. Am J Prev Med 1999; 16: 1-9.
    PubMedGoogle Scholar
  • 47 Kannry JL, Wright L, Shifman M, Silverstein S, Miller PL. Portability issues for a structured clinical vocabulary: mapping from Yale to the Columbia medical entities dictionary. J Am Medinform Assoc 1996; 3: 66-78.
    PubMedGoogle Scholar
  • 48 Giuse DA, Mickish A. Increasing the availability of the computerized patient record. In Cimino JJ. ed Proceedings 1996 AMIA Annual Fall Symp . Philadelphia: Hanley & Belfus Inc; 1996: 633-7.
    Google Scholar
  • 49 Zielstorff RD, Tronni C, Basque J, Griffin LR, Welebob EM. Mapping nursing diagnosis nomenclatures for coordinated care. Image J Nurs Sch 1998; 30: 369-73.
    CrossrefPubMedGoogle Scholar
  • 50 Robinson L, Hughes LC, Adler DC, Strumpf N, Grobe SJ, McCorkle R. Describing the work of nursing: the case of postsurgical nursing interventions for men with prostate cancer. Res Nurs Health 1999; 22: 321-8.
    CrossrefPubMedGoogle Scholar
  • 51 Henry SB, Holzemer WL. A comparison of problem lists generated by physicians, nurses, and patients: implications for CPR systems. Proceedings SCAMC 1995. In Gardner RM. ed Philadelphia: Hanley & Belfus Inc; 1995: 382-6.
    Google Scholar
  • 52 National Telecommunication & Information Administration, U.S. Dept. of Commerce. Falling through the Net: defming the digital divide http://www.ntia.doc.gov/ntiahome/fttn99/contents.html
    PubMed
  • 53 Nielsen J. Usability Engineering . Boston: AP Professional; 1993
    Google Scholar

   Permissions and Reprints