Wearable heart rate (HR) monitors typically implement photoplethysmography (PPG) technology and are used in research as an alternative to electrocardiogram (ECG). However, questions surrounding the accuracy of PPG technology exist. To provide an answer regarding the question of accuracy, we conducted a study to compare average HR readings of two different HR technologies (PPG vs. ECG) after an interval style cardio-based workout. A total of 30 trials were conducted and average HR readings from the two HR technologies were compared using an ANOVA. Results revealed no significant difference between the two technologies. However, when HR reached around 155-160 beats per minute, a difference of +/− 5 beats per minute was observed between the two technologies with PPG HR readings being less than ECG. As a result, future research could consider the wearable PPG HR technology as accurate, but with certain experimental design implications.

Background Challenges persist regarding how to integrate computing effectively into the exam room, while maintaining patient-centered care. Purpose Our objective was to evaluate a new exam room design with respect to the computing layout, which included a wall-mounted monitor for ease of (re)-positioning. Methods In a lab-based experiment, 28 providers used prototypes of the new and older “legacy” outpatient exam room layouts in a within-subject comparison using simulated patient encounters. We measured efficiency, errors, workload, patient-centeredness (proportion of time the provider was focused on the patient), amount of screen sharing with the patient, workflow integration, and provider situation awareness. Results There were no statistically significant differences between the exam room layouts for efficiency, errors, or time spent focused on the patient. However, when using the new layout providers spent 75% more time in screen sharing activities with the patient, had 31% lower workload, and gave higher ratings for situation awareness (14%) and workflow integration (17%). Conclusions Providers seemed to be unwilling to compromise their focus on the patient when the computer was in a fixed position in the corner of the room and, as a result, experienced greater workload, lower situation awareness, and poorer workflow integration when using the old “legacy” layout. A thoughtful design of the exam room with respect to the computing may positively impact providers’ workload, situation awareness, time spent in screen sharing activities, and workflow integration.

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I would like to thank my advisor, Dr. Jason Saleem for his guidance and support throughout this project. I would also like to thank the University of Louisville's School of Nursing for their collaboration. More specifically, I would like to thank Andrea Gibson for serving as a subject-matter expert and providing me with guidance and resources throughout the development of data collection materials. Additionally, I would like to thank Glenda Adams for allowing me to recruit her students in order complete data collection. Finally, many thanks to my other committee members Dr. Gail DePuy and Dr. Angela Thompson for their input and suggestions to help build this thesis.