User-Centered Design and Evaluation of ARTTS: an Augmented Reality Triage Tool Suite for Mass Casualty Incidents

In this work we present ARTTS: a head-worn Augmented Reality (AR) Triage Tool Suite containing an initial sorting tool, virtual assessment tool, and virtual triage tag to assist emergency responders in mass casualty incidents. The initial sorting tool can prompt novice responders through first-wave tasks to aid recalibration from shock to triage. The virtual assessment tool provides novice responders, potentially confused by the chaos, with a walkthrough of the SALT triage flowchart. Finally, current emergency medical triage processes leverage static paper tags susceptible to loss or illegible damage. ARTTS’ virtual triage tags are dynamic, can be updated through responder interaction, and employ user interface emergent features based on individual patient conditions. This paper describes ARTTS’ capabilities, as well as the applied user-centered design process including review of existing triage material, subject-matter expert interview transcripts, wireframing, application of usability and user-centered design principles, as well as iterative usability subject-matter expert assessments and design walkthroughs. The ARTTS user experience aims to enhance, not upend, existing triage processes. Finally, this paper provides a usability evaluation comparing ARTTS’ virtual triage tag to a physical paper triage tag. Our tag achieved requisite System Usability Scale (SUS) scores and showed negligible differences to the paper triage tag on usability and mental workload.