Trust and Human Factors in the Design of Healthcare Technology

  • Simone BorsciEmail author
  • Peter Buckle
  • Simon Walne
  • Davide Salanitri
Conference paper
Part of the Advances in Intelligent Systems and Computing book series (AISC, volume 824)


Every day people use multiple technologies to perform complex tasks, such as buying products online, informing their decision making, or supporting their work activities. In many cases, as in healthcare, high risk processes are dependent on the technology to deliver the appropriate service - e.g. diagnostics outcomes, deliver treatments to patients. Hence there is a need for the users and stakeholders of healthcare technologies to trust that these produce accurate and reliable results. Research suggests that trust is: (i) a set of beliefs that a person has before they use or the experience a technology or system; (ii) built throughout the relationship between user and system, and (iii) dependent on the cumulative experience with a specific system. This paper explores the current studies on trust, and its relationship with the concept of user experience. The main contribution is to: (i) propose a definition of Trust Towards Systems (TTS) to bridge the concept of trust and experience; (ii) highlight the importance of TTS given findings for research on trust in other (non-health) settings and to show how design can be used to change perceptions of trust.


Trust Medical devices Healthcare technology Health technology assessment Human factors User experience Evidence generation 



The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.


  1. 1.
    Hosmer LT (1995) Trust: the connecting link between organizational theory and philosophical ethics. Acad Manage Rev 20:379–403MathSciNetCrossRefGoogle Scholar
  2. 2.
    Mayer RC, Davis JH, Schoorman FD (1995) An integrative model of organizational trust. Acad Manage Rev 20:709–734CrossRefGoogle Scholar
  3. 3.
    Rousseau DM, Sitkin SB, Burt RS, Camerer C (1998) Not so different after all: a cross-discipline view of trust. Acad Manage Rev 23:393–404CrossRefGoogle Scholar
  4. 4.
    Friedman B, Khan PH Jr, Howe DC (2000) Trust online. Commun ACM 43:34–40CrossRefGoogle Scholar
  5. 5.
    Shneiderman B (2000) Designing trust into online experiences. Commun ACM 43:57–59CrossRefGoogle Scholar
  6. 6.
    Aljazzaf ZM, Perry M, Capretz MA (2010) Online trust: definition and principles. In: ICCGI Conference, pp 163–168. IEEEGoogle Scholar
  7. 7.
    Wang W, Benbasat I (2007) Recommendation agents for electronic commerce: effects of explanation facilities on trusting beliefs. J Manage Inf Syst 23:217–246CrossRefGoogle Scholar
  8. 8.
    Xiu D, Liu Z (2005) A formal definition for trust in distributed systems. In: International conference on information security, pp 482–489. SpringerGoogle Scholar
  9. 9.
    Golbeck J (2006) Computing with trust: definition, properties, and algorithms. In: Securecomm and workshops, pp 1–7. IEEEGoogle Scholar
  10. 10.
    Thatcher JB, McKnight DH, Baker EW, Arsal RE, Roberts NH (2011) The role of trust in postadoption IT exploration: an empirical examination of knowledge management systems. IEEE Trans Eng Manage 58:56–70CrossRefGoogle Scholar
  11. 11.
    Borsci S, Lawson G, Salanitri D, Jha B (2016) When simulated environments make the difference: the effectiveness of different types of training of car service procedures. Virtual Reality 20:83–99CrossRefGoogle Scholar
  12. 12.
    Salanitri D, Hare C, Borsci S, Lawson G, Sharples S, Waterfield B (2015) Relationship between trust and usability in virtual environments: an ongoing study. In: HCII 2015, pp 49–59. Springer International PublishingGoogle Scholar
  13. 13.
    Salanitri D, Lawson G, Waterfield B (2016) The relationship between presence and trust in virtual reality. In: Proceedings of the European Conference on Cognitive Ergonomics, pp 1–4. ACM, NottinghamGoogle Scholar
  14. 14.
    Lankton NK, McKnight DH, Tripp J (2015) Technology, humanness, and trust: rethinking trust in technology. J Assoc Inf Syst 16:880Google Scholar
  15. 15.
    Gefen D (2000) E-commerce: the role of familiarity and trust. Omega 28:725–737CrossRefGoogle Scholar
  16. 16.
    Pennington R, Wilcox HD, Grover V (2003) The role of system trust in business-to-consumer transactions. J Manage Inf Syst 20:197–226CrossRefGoogle Scholar
  17. 17.
    Lankton NK, McKnight DH (2011) What does it mean to trust facebook? Examining technology and interpersonal trust beliefs. SIGMIS Database 42:32–54CrossRefGoogle Scholar
  18. 18.
    Lippert SK, Swiercz PM (2005) Human resource information systems (HRIS) and technology trust. J Inf Sci 31:340–353CrossRefGoogle Scholar
  19. 19.
    Fruhling AL, Lee SM (2006) The influence of user interface usability on rural consumers’ trust of e-health services. Int J Electron Healthc 2:305–321CrossRefGoogle Scholar
  20. 20.
    Lawson G, Salanitri D, Waterfield B (2016) Future directions for the development of virtual reality within an automotive manufacturer. Appl Ergon 53:323–330CrossRefGoogle Scholar
  21. 21.
    Mcknight DH, Carter M, Thatcher JB, Clay PF (2011) Trust in a specific technology: an investigation of its components and measures. ACM Trans Manage Inf Syst 2:1–25CrossRefGoogle Scholar
  22. 22.
    McKnight DH, Choudhury V, Kacmar C (2002) Developing and validating trust measures for e-commerce: an integrative typology. Inf Syst Res 13:334–359CrossRefGoogle Scholar
  23. 23.
    Law EL-C, Vermeeren APOS, Hassenzahl M, Blythe M (2007) Towards a UX manifesto. In: 21st British HCI group annual conference, vol 2, pp 205–206. BCS Learning & Development Ltd., LancasterGoogle Scholar
  24. 24.
    Hassenzahl M, Law EL-C, Hvannberg ET (2006) User experience-towards a unified view. Ux Ws Nordichi 6:1–3Google Scholar
  25. 25.
    International Organization for Standardization (2010) ISO 9241-210: Ergonomics of human-system interaction - Human-centred design for interactive systems. CEN, BrusselsGoogle Scholar
  26. 26.
    Holden RJ, Carayon P, Gurses AP, Hoonakker P, Hundt AS, Ozok AA, Rivera-Rodriguez AJ (2013) SEIPS 2.0: a human factors framework for studying and improving the work of healthcare professionals and patients. Ergonomics 56:1669–1686CrossRefGoogle Scholar
  27. 27.
    Carayon P, Hundt AS, Karsh BT, Gurses AP, Alvarado CJ, Smith M, Brennan PF (2006) Work system design for patient safety: the SEIPS model. Qual Safety Health Care 15:50–58CrossRefGoogle Scholar
  28. 28.
    Xie A, Carayon P (2015) A systematic review of human factors and ergonomics (HFE)-based healthcare system redesign for quality of care and patient Saf. Ergonomics 58:33–49CrossRefGoogle Scholar
  29. 29.
    Catchpole K (2013) Spreading human factors expertise in healthcare: untangling the knots in people and systems. BMJ Qual Saf 22:793–797CrossRefGoogle Scholar
  30. 30.
    Pu P, Chen L (2006) Trust building with explanation interfaces. In: Proceedings of the 11th international conference on Intelligent user interfaces, pp 93–100. ACM, SydneyGoogle Scholar
  31. 31.
    Bussolon S (2016) The X factor. In: DUXU 2016, pp 15–24. SpringerGoogle Scholar
  32. 32.
    Kujala S, Vogel M, Pohlmeyer AE, Obrist M (2013) Lost in time: the meaning of temporal aspects in user experience. In: CHI 2013, pp 559–564. ACM, ParisGoogle Scholar
  33. 33.
    Law EL-C, Roto V, Hassenzahl M, Vermeeren APOS, Kort J (2009) Understanding, scoping and defining user experience: a survey approach. In: SIGCHI conference on human factors in computing systems, pp 719–728. ACM, BostonGoogle Scholar
  34. 34.
    Hsu M-H, Ju TL, Yen C-H, Chang C-M (2007) Knowledge sharing behavior in virtual communities: the relationship between trust, self-efficacy, and outcome expectations. Int J Hum Comput Stud 65:153–169CrossRefGoogle Scholar
  35. 35.
    Borsci S, Kuljis J, Barnett J, Pecchia L (2016) Beyond the user preferences: aligning the prototype design to the users’ expectations. Hum Factors Ergon Manuf Serv Ind 26:16–39CrossRefGoogle Scholar
  36. 36.
    Lee S, Koubek RJ (2010) Understanding user preferences based on usability and aesthetics before and after actual use. Interact Comput 22:530–543CrossRefGoogle Scholar
  37. 37.
    Pengnate S, Sarathy R (2017) An experimental investigation of the influence of website emotional design features on trust in unfamiliar online vendors. Comput Hum Behav 67:49–60CrossRefGoogle Scholar
  38. 38.
    Ashleigh MJ, Higgs M, Dulewicz V (2012) A new propensity to trust scale and its relationship with individual well-being: implications for HRM policies and practices. Hum Resour Manage J 22:360–376CrossRefGoogle Scholar
  39. 39.
    Gigerenzer G, Brighton H (2009) Homo heuristicus: why biased minds make better inferences. Topics Cognit Sci 1:107–143CrossRefGoogle Scholar
  40. 40.
    McKay RT, Dennett DC (2009) Our evolving beliefs about evolved misbelief. Behav Brain Sci 32:541–561CrossRefGoogle Scholar
  41. 41.
    Goldstein DG, Gigerenzer G (2002) Models of ecological rationality: the recognition heuristic. Psychol Rev 109:75CrossRefGoogle Scholar
  42. 42.
    Konstan JA, Riedl J (2012) Recommender systems: from algorithms to user experience. User Model User Adapt Interact 22:101–123CrossRefGoogle Scholar
  43. 43.
    Skinner D, Dietz G, Weibel A (2014) The dark side of trust: when trust becomes a ‘poisoned chalice’. Organization 21:206–224CrossRefGoogle Scholar
  44. 44.
    Zagal JP, Björk S, Lewis C (2013) Dark patterns in the design of games. In: Foundations of digital games 2013Google Scholar
  45. 45.
    Greenberg S, Boring S, Vermeulen J, Dostal J (2014) Dark patterns in proxemic interactions: a critical perspective. In: Designing interactive systems conference, pp 523–532. ACMGoogle Scholar
  46. 46.
    UK British and Irish Hypertension Society.
  47. 47.
    Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN, Jones DW, Kurtz T, Sheps SG, Roccella EJ (2005) Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Circulation 111:697–716CrossRefGoogle Scholar
  48. 48.
    Celis H, Den Hond E, Staessen JA (2005) Self-measurement of blood pressure at home in the management of hypertension. Clin Med Res 3:19–26CrossRefGoogle Scholar
  49. 49.
    Fischer T, Halmerbauer G, Meyr E, Riedl R (2018) Blood pressure measurement: a classic of stress measurement and its role in technostress research. In: Information systems and neuroscience, pp 25–35. SpringerGoogle Scholar
  50. 50.
    Borsci S, Uchegbu I, Buckle P, Ni Z, Walne S, Hanna GB (2018) Designing medical technology for resilience: integrating health economics and human factors approaches. Expert Rev Med Devices 15:15–26CrossRefGoogle Scholar
  51. 51.
    International Organization for Standardization: IEC 62366-1 (2015) Medical devices – part 1: application of usability engineering to medical devices. CEN, BrusselsGoogle Scholar
  52. 52.
    Wicks P, Chiauzzi E (2015) ‘Trust but verify’ – five approaches to ensure safe medical apps. BMC Med 13:205CrossRefGoogle Scholar
  53. 53.
    Monheit AC (2013) A matter of trust. INQUIRY J Health Care Organ Provis Finan 50:3–8Google Scholar
  54. 54.
    Borsci S, Buckle P, Huddy J, Alaestante Z, Ni Z, Hanna GB (2017) Usability study of pH strips for nasogastric tube placement. PloS one 12:e0189013CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Cognitive Psychology and Ergonomics, Faculty of Behavioural, Management and Social SciencesUniversity of TwenteEnschedeNetherlands
  2. 2.NIHR London IVD Cooperative, Department of Surgery and CancerImperial College LondonLondonUK
  3. 3.Human Factors Research Group, Faculty of EngineeringThe University of NottinghamNottinghamUK

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