Electronic Health Records, Electronic Special Education Records: What are the issues? (Usability, utility, user-centered design, data security, interoperability, Section 508 accessibility...)

I suppose this topic intrigues me more than most school psychologists because of my IT training.  In recent years,  I've taken a few graduate-level HCI related courses, including a course about looking at privacy and security in IT from a human-computer interaction perspective.  As a user of information systems, I understand that this is a complex issue.


I know that there are important emerging issues in the EHR field that most likely will impact student information systems and electronic special education records, but I'm not sure how this will play out.  Who will be responsible for the expenses that public school districts will incur in the future if EHR regulations and requirements are mandated for student records that include health information?   Who will be responsible for ensuring that the information systems used by public school employees follow usability, accessibility, and privacy/security standards?     


Although school districts are not typically considered to be health organizations,  they employ nurses, occupational, physical, and speech/language therapists, and psychologists.  These professionals serve students who have special needs, and some of their services are reimbursed through Medicaid.    


Like IT systems used in the health care industry,  many IT systems that handle student information were initially developed during the late 1990's, if not before, and over the years have been upgraded and tweaked to handle requirements that simply did not exist even five years ago. Data regarding students is stored in many places, for different purposes, and accessed by different people.  Some student information systems don't play well with one-another.   As more data and information is required to be stored and accessed on-line, the chances for errors and security breaches increase.


 My hunch is that "best practices" in EHR will inform future best practices in electronic student information systems, including systems designed to handle information regarding students with special needs.  This is a topic I'd like to explore further!

Below is a list of of links to a  few articles and presentations I think are important to review if you are interested in this topic:

Electronic Records Usability  (Includes recent publications on this topic, including a few articles about usability and electronic health records that can be accessed through mobile phones and related devices.)  HiMSS 
"Usability is defined as the effectiveness, efficiency and satisfaction with which specific users can achieve a specific set of tasks in a particular environment. (ISO Bulletin. 2003;34:6)."
Can best practices help develop meaningful users? (6/21/2010, Chris Brancato) pdf
Understanding the Landscape of EMR Usability (4/13/2010, Jeff Belden) pdf
Applying Usability and User-Centered Design Methodologies to Achieve Meaningful Use
Lisa Battle, Jasmin Phua & Duane Degler, Design for Context, HiMSS  Virtual Conference 6/2010)
Accessibility of Health IT  (pdf)  Addresses Section 508 applies to E & IT that is developed, used, and maintained. (Government Health IT Innovation 2010 Conference)
Health Information Technology and People with Disabilities (American Association of People with Disabilities)
Health Information Technology and HIPAA  PDF
Access Board "A Federal Agency Committed to Accessible Design" 

• Section 508 Homepage:  Electronic and Information Technology
• Developing Accessible Software Tutorial 

Education Records
National Center for Educational Statistics, National Forum on Education Statistics:
The Forum Guide to Data Ethics
The Forum Guild to Data Ethics Online Course
Crisis Data Management: A Forum Guide to Collecting and Managing Data about Displaced Students
Family Educational Rights and Privacy Act (FERPA)
Section 508 Homepage:  Electronic and Information Technology




RELATED:  For your convenience, I've copied and pasted the following related links from the National Forum on Education Statistics website:

Appendix A: Related Resources

These materials may be useful to school, district, or state education agency staff considering data ethics.

Forum Guide to Metadata: The Meaning Behind Education Data This document was developed to empower staff to use data more effectively as information. It explains what metadata are, why they are critical to the development of sound education data systems, what components comprise a metadata system, what value metadata bring to data management and use, and how to implement and use a metadata system in an education organization.

Every School Day Counts: The Forum Guide to Collecting and Using Attendance Data This Forum guide offers best practice suggestions on collecting and using student attendance data to improve performance. It includes a standard set of codes to make attendance data comparable across districts and states. The publication also presents real-life examples of how attendance information has been used by school districts.

Managing an Identity Crisis: Forum Guide to Implementing New Federal Race and Ethnicity Categories This best-practice guide was developed to assist state and local education agencies in their implementation of the new federal race and ethnicity categories, thereby reducing redundant efforts within and across states, improving data comparability, and minimizing reporting burdens. It serves as a toolkit from which users may select and adopt strategies to help them quickly begin the process of implementation in their agencies.

Forum Guide to the Privacy of Student Information: A Resource for Schools This free publication was written to help school and local education agency staff members better understand and apply the Family Educational Rights and Privacy Act (FERPA), a federal law that protects privacy interests of parents and students in student education records. It defines terms such as "education records" and "directory information"; and offers guidance for developing appropriate privacy policies and information disclosure procedures related to military recruiting, parental rights and annual notification, videotaping, online information, media releases, surveillance cameras, and confidentiality concerns related specifically to health-related information. Much of the guidance relating to privacy policies would be of interest to organizations generating business rules about the topic.

Forum Guide to Protecting the Privacy of Student Information: State and Local Education Agencies This free guide presents a general overview of privacy laws and professional practices that apply to information collected for, and maintained in, student records. The publication also provides an overview of key principles and concepts governing student privacy; summarizes federal privacy laws including recent changes; identifies issues concerning the release of information to both parents and external organizations; and suggests good data management practices for schools, districts, and state education agencies. Much of the guidance relating to privacy policies would be of interest to organizations generating business rules about the topic.

Forum Curriculum for Improving Education Data: A Resource for Local Education Agencies This curriculum supports efforts to improve the quality of education data by serving as training materials for K–12 school and district staff. It provides lesson plans, instructional handouts, and related resources, and presents concepts necessary to help schools develop a culture for improving data quality.

Forum Guide to Education Indicators This publication provides encyclopedia-type entries for 44 commonly used education indicators. Each entry contains a definition, recommended uses, usage caveats and cautions, related policy questions, data element components, a formula, commonly reported subgroups, and display suggestions. This publication will help readers better understand how to appropriately develop, apply, and interpret commonly used education indicators.

NCES Nonfiscal Data Handbook for Early Childhood, Elementary, and Secondary Education (2007) The NCES Handbooks are a valuable source of metadata for organizations and individuals interested in education data. These print and online resources define standard education terms for students, staff, schools, local education agencies, intermediate education agencies, and state education agencies. The Handbooks are intended to serve as a reference for public and private organizations, including education institutions and early childhood centers, as well as education researchers and other users of education data. In order to improve access to this valuable resource, NCES has also developed the NCES Handbooks Online, a webbased tool that allows users to view and download Handbook information via an electronic table of contents, a drill down finder, element name and first letter searches, and advanced query options.

Kids and Tangible Tabletop Interaction: The NIKVision Project

NIKVision is an interactive tangible tabletop designed for young children, but suitable for "kids" of all ages. Javier Marco Rubio shared his team's work on the NIKVision system on the TechSpark website, and I thought I'd share some of the videos on this post. What I like about NIKVision is that the team encouraged the participation of children as design partners, which is a very special approach.

The NIKVision team is part of the GIGA Group, at the Computing Department of the Zaragoza University (Spain). The team collaborates with the ChiCI Group in the University of Central Lancashire, Preston (UK)



NIKVision Tangible Tabletop Demo

NIKVision Tangible Tabletop Demo from Javier Marco on Vimeo.


"NIKVision is a Tangible tabletop in which toys control the games. NIKVision has been created by Javier MMarco, from GIG Group in University of Zaragoza, Spain." http://webdiis.unizar.es/~jmarco
Researchers for this project included Javier Marco, Eva Cerezo, and Sandra Baldassarri.

NIKVision Toys & Games

NIKVision Toys & Games from Javier Marco on Vimeo.

NIKVision, highlighted in the news in Spain (in Spanish)


Cross-posted on the Interactive Multimedia Technology blog.

Hello Haptic flash cards

Tactile Flash Cards for the Blind via Yanko Design

The haptic flashcards were designed by people from the Samsung Design Membership, and were awarded the 2009 Silver International Design Excellence Award:

Designers:

Rhea / Young Soo -- Hongik University
Sunmin -- Ewha Women’s University
Sae Hee--Hanyang University

"The Hello Haptic set of flash cards works with Braille text and other tactile elements from environments the student might not otherwise have access to."

Shneiderman's book, "Leonardo's Laptop" and Don Norman's "The Design of Everyday Things: Must-Reads for Universal Design for Learning Enthusiasts

UNIVERSAL USABILITY DESIGN AND THE EDUCATION CONTROL PANEL

Don Norman and Ben Scheiderman are well known in the fields of Human-Computer Interaction and Human-Centered Computing, but not as well known by K-12 educators.

Don Norman's Design of Everyday Things (2002) was originally issued as the Psychology of Everyday Things, published in 1988. It is a fun book to read, and the inspiration for my hobby of collecting pictures and video clips for my "usability and interaction hall of shame/fame".

Don has a background in cognitive psychology and computer science, and is the co-founder of the Nielson Norman group, a consulting company that focuses on human-centered services and product development.

Here is a quote from his book:

• "Before I wrote this book, I was a cognitive scientist, interested in how the mind works. I studied human perception, memory, and attention. I examined how people learned, how they performed skilled activities. Along the way I became interested in human error, hoping that my understanding of error would provide ways to teach people how to avoid mistakes. But then came the nuclear power plant accident at Three Mile Island in the United States, and I was among a group of social and behavioral scientists who were called in to determine why the control-room operators had made such terrible mistakes. To my surprised, we concluded that they were not to blame: the fault lay in the design of the control room. Indeed, the control panel of many power plants looked as if they were deliberately designed to cause errors."

If you think about it, Norman's insights hold true for the way many textbooks, lessons, and tests are designed. School psychologists and educators are interested in how people learn, and gain much information to guide instruction and interventions from the errors students make. This is also holds true during the process of functional behavioral analysis. We look for patterns of "error" behaviors to inform the sorts of behavioral interventions and supports needed for helping the student gain effective coping strategies, social skills, and related positive behaviors.

Take a few steps back, and think about the "things" common to many schools- the layout of the hallways and classrooms, the configuration of furniture and learning materials within the classroom, the organization of the instructional day, curriculum guidelines, method of instructional delivery and student assessment. How might these be elements be similar to the design of the control panels in power plants?

From this vantage point, administrators, teachers, students, and support staff play the role of the power plant operators. They are the humans embedded in this system, and they must interact within its constraints. Without much notice, the system maximizes the "error rate" for many more students than it should. This is the opposite of the intentions of the humans involved in the design. The faulty design of the education control panel may also also unintentionally contribute to the "errors" made by teachers when they make decisions about instruction and behavior management.

Universal Design for Learning principles entice us to look at how our schools are structured and and instructional methods and materials are designed, in ways that are very much akin to Don Norman's observations. From the UDL perspective, up-front design decisions made by educators or teams of educators, can ensure the likelihood that outcomes for students are maximized and errors are minimized.

On a similar note, Ben Shneiderman, in his book, Leonardo's Laptop: Human Needs and the New Computing Technologies , discusses ways that computers and technology can support the participation of all ages, abilities, and levels of literacy , in modern society.

Shneiderman begins his discussion about the concept of universal usability with the following quote from Thomas Jefferson, from a reply to the American Philosophical Society (1808):

• "I feel... an ardent desire to see knowledge so disseminated through the mass of mankind that it may.. reach even the extremes of society: beggars and kings."

Universal Usability combines the concept of Universal Design with the concepts of accessibility and usability. It is apparent that Shneiderman's thinking is strongly influenced by Jefferson's quote, which in todays terms, can be viewed as a desire for universal knowledge dissemination. This means that we must work towards inclusiveness, and exclude no one.

Shneiderman suggests that it is important to work collaboratively in order to develop methods that bridge the gap between what people know and what people need to know. Although Shneiderman's book has a broad scope,much of what he discusses holds true for K-12 settings. He proposes that education should provide students with learning opportunities beyond the traditional lecture-discussion format. Below is an outline of the components that should be incorporated into the classroom:

• Collect: Gather information and acquire resources

• Relate: Work in collaborative teams

• Create: Develop ambitious projects

• Donate: Produce results that are meaningful to someone outside of the classroom

Take the time to read Design of Everyday Things and Leonardo's Laptop. I think they would be great for school-based book studies.