An Example of an Application of the Semiotic Inspection Method in the Domain of Computerized Patient Record System Weronika Tancredi ab , Olof Torgersson a a Department of Applied Information Technology, Chalmers University of Technology and University of Gothenburg, Gothenburg, Sweden b ESSIQ, Gothenburg, Sweden Abstract Efficiently navigating through an interface and conducting work tasks in flow is what GUI designers strive for. Dental professionals, who alternate between examination and treat- ment of a patient and insertion of data into the Computerized Patient Record system, particularly need an interface that would facilitate the workflow. In this paper we present an in- spection evaluation of an existing and widely used Computer- ized Patient Record system. The Semiotic Inspection Method was applied with the expectation that the method could pro- vide evidence that task flow, navigation and wayfinding were major usability issues of the interface. Also expected was that the Semiotic Inspection would reveal the means and strategies used in the interface in order to communicate the flow. The analysis conducted using the Semiotic Inspection Method showed inconsistencies in the communication of the way for- ward through the interface. In addition, the profile of the us- ers, regarding digital skills, appears to be ambiguous. Finally, the strategies used in the interface for conveying the workflow could be identified as well. Keywords: Semiotic Inspection Method (SIM), Computerized Patient Record System (CPR), Expert Usability Evaluation, Work- flow, Flow, Interface Navigation. Introduction GUI designers strive for user interfaces that give users the possibility to experience flow and a sense of being in control. Navigating through such interfaces and completing work tasks should be seamless, smooth and without interruptions. In this paper we report on a semiotic inspection of a Comput- erized Patient Record System (CPR) for dental health care. An upgrade of the CPR system caused a lot of frustration among users. As a result, a major usability evaluation of the system was undertaken using several different methods. As flow and navigation within the interface are seen as important aspects of usability and user experience [5][6], the usability evaluation of the system focused on the workflow and approaches to wayfinding in the system. The domain of the evaluated CPR puts high demands on the usability of the system: the dental professionals who use the system are under time pressure, they use several systems sim- ultaneously, e.g. an x-ray image handling system and modules for communicating with the social insurance system. The den- tal professionals continuously switch between examining the patient and inserting data into the CPR system. The data that is inserted into the system is often critical and a mistake can lead to inappropriate medication, e.g. using anesthetics that the patient is allergic to or incorrect calculation of payment. The current CPR system was also evaluated with four other inspection methods, specifically two sets of heuristics, a cog- nitive walkthrough and a use error analysis. Each method helped reveal an aspect of the usability of the system, for in- stance if the interface was designed according to the design guidelines, if it is easy to learn and fits the users’ problem solving processes, if it is safe to use and helps prevent use errors. As the Semiotic Inspection Method (SIM) provides an alternative view on the human-computer interaction (HCI) and focuses on the communication of designers to users through the interface, it was seen as an interesting and relevant meth- od. The SIM has been successfully applied to other systems, e.g. on games and human-robot interaction [1][4][7][8], and we believed that it would work to analyse the CPR system as well. The SIM and its strengths in comparison to other meth- ods are explained more extensively in the methodology sec- tion. Below, the arguments for applying the SIM in this evalu- ation of the CPR are presented. The SIM provides an oppor- tunity to assess if the designer’s communication strategy is appropriate for the user group and consistent within the entire interface. The SIM was selected for usability evaluation of the CPR system interface as it allows the examination of the sign- posts that lead or mislead the user on his way through the in- terface and work tasks. Further, the SIM was applied with the expectation that it would help provide evidence that workflow and wayfinding were major usability issues. Another expecta- tion was that SIM would help understand by what means the flow is communicated, and what strategies the designer used to communicate the workflow, i.e. where the user comes from, where (s)he is, and where (s)he should or can go from the cur- rent position in the interface. The inspection we conducted is a technical evaluation [3][9] that was expected to provide evidence for usability problems in the current interface, specifically issues with visual cues and signs conveying workflow. General Organization of the Paper Firstly, the applied method is described, secondly, the results are presented, further, the results are discussed and finally the conclusion is presented. Materials and Methods Semiotic Inspection Method (SIM) The semiotic engineering which makes a theoretic foundation for SIM proposes an alternative model of HCI [2]. In contrast to the model proposed by cognitive engineering and user- MEDINFO 2013 C.U. Lehmann et al. (Eds.) © 2013 IMIA and IOS Press. This article is published online with Open Access by IOS Press and distributed under the terms of the Creative Commons Attribution Non-Commercial License. doi:10.3233/978-1-61499-289-9-471 471