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DOI: 10.4338/ACI-2015-10-RA-0129
Usability Testing of Two Ambulatory EHR Navigators
This work was supported by the Agency for Healthcare Research and Quality Award #R01HS022085 (GM) and National Science Foundation Award #CMMI-1150057 (JM).
Correspondence to:
Publikationsverlauf
received:
16. Oktober 2015
Accepted:
29. März 2016
Publikationsdatum:
16. Dezember 2017 (online)
Summary
Background
Despite widespread electronic health record (EHR) adoption, poor EHR system usability continues to be a significant barrier to effective system use for end users. One key to addressing usability problems is to employ user testing and user-centered design.
Objectives
To understand if redesigning an EHR-based navigation tool with clinician input improved user performance and satisfaction.
Methods
A usability evaluation was conducted to compare two versions of a redesigned ambulatory navigator. Participants completed tasks for five patient cases using the navigators, while employing a think-aloud protocol. The tasks were based on Meaningful Use (MU) requirements.
Results
The version of navigator did not affect perceived workload, and time to complete tasks was longer in the redesigned navigator. A relatively small portion of navigator content was used to complete the MU-related tasks, though navigation patterns were highly variable across participants for both navigators. Preferences for EHR navigation structures appeared to be individualized.
Conclusions
This study demonstrates the importance of EHR usability assessments to evaluate group and individual performance of different interfaces and preferences for each design.
Citation: Hultman G, Marquard J, Arsoniadis E, Mink P, Rizvi R, Ramer T, Khairat S, Fickau K, Melton GB. Usability testing of two ambulatory EHR navigators.
Conflicts of Interest
The authors declare that they have no conflicts of interest in this research.
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References
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- 5 Schumacher RM, Lowry SZ. NIST Guide to the Processes Approach for Improving the Usability of Electronic Health Records. NIST Interagency/Internal Report (NISTIR). 2010 Report No.: 7741.
- 6 Boren MT, Ramey J. Thinking aloud: Reconciling theory and practice. IEEE Transactions on Professional Communication 2000; 43 (03) 261-278.
- 7 Stage. 02. 2015 Available from: https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncen tivePrograms/Stage_2.html
- 8 Han H, Lopp L. Writing and reading in the electronic health record: an entirely new world. Med Educ Online 2013; 18: 1-7.
- 9 Zheng K, Padman R, Johnson MP, Diamond HS. An Interface-driven Analysis of User Interactions with an Electronic Health Records System. Journal of the American Medical Informatics Association : JAMIA 2008; 16 (02) 228-237.
- 10 Jiajie Z. Better EHR: Usability, workflow and cognitive support in electronic health records. 1st ed. Zhang J, Walji M. editors. Jiajie Zhang, Muhammad Walji; 2014
- 11 Sauro J, Dumas JS. Comparison of Three One-Question, Post-Task Usability Questionnaires. Greenberg S, Hudson SE, Hinkley K, Ringel-Morris M, Olsen DR. editor. NEW YORK; 1515 BROADWAY, NEW YORK, NY 10036–9998 USA: ASSOC COMPUTING MACHINERY; 2009
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Correspondence to:
-
References
- 1 Johnson CM, Johnson TR, Zhang J. A user-centered framework for redesigning health care interfaces. J Biomed Inform 2016; 38 (01) 75-87.
- 2 Lowry SZ, Quinn MT, Ramaiah M, Schumacher RM, Patterson SEmily, North R, Zhang J, Gibbons MC, Abbott P. Technical Evaluation, Testing, and Validation of the Usability of Electronic Health Records. NIST Interagency/Internal Report (NISTIR) – 7804. 2012 Report No.: 7804.
- 3 Lowry SZ, Ramaiah M, Patterson ES, Vrick D, Gurses AP, Ozok A, Simmons D, Gibbons MC. Integrating Electronic Health Records into Clinical Workflow: An Application of Human Factors Modeling Methods to Ambulatory Care. NIST Interagency/Internal Report. 2011 Report No.: NISTIR 7988.
- 4 Abran A, Khelifi A, Suryn W, Seffah A. Usability meanings and interpretations in ISO standards. Software Quality Journal 2003; 11 (04) 325-338.
- 5 Schumacher RM, Lowry SZ. NIST Guide to the Processes Approach for Improving the Usability of Electronic Health Records. NIST Interagency/Internal Report (NISTIR). 2010 Report No.: 7741.
- 6 Boren MT, Ramey J. Thinking aloud: Reconciling theory and practice. IEEE Transactions on Professional Communication 2000; 43 (03) 261-278.
- 7 Stage. 02. 2015 Available from: https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncen tivePrograms/Stage_2.html
- 8 Han H, Lopp L. Writing and reading in the electronic health record: an entirely new world. Med Educ Online 2013; 18: 1-7.
- 9 Zheng K, Padman R, Johnson MP, Diamond HS. An Interface-driven Analysis of User Interactions with an Electronic Health Records System. Journal of the American Medical Informatics Association : JAMIA 2008; 16 (02) 228-237.
- 10 Jiajie Z. Better EHR: Usability, workflow and cognitive support in electronic health records. 1st ed. Zhang J, Walji M. editors. Jiajie Zhang, Muhammad Walji; 2014
- 11 Sauro J, Dumas JS. Comparison of Three One-Question, Post-Task Usability Questionnaires. Greenberg S, Hudson SE, Hinkley K, Ringel-Morris M, Olsen DR. editor. NEW YORK; 1515 BROADWAY, NEW YORK, NY 10036–9998 USA: ASSOC COMPUTING MACHINERY; 2009
- 12 Brooke J. SUS: A “quick and dirty” usability scale. Usability evaluation in industry 1996; 189-194.
- 13 Saleem JJ, Flanagan ME, Wilck NR, Demetriades J, Doebbeling BN. The next-generation electronic health record: perspectives of key leaders from the US Department of Veterans Affairs. Journal of the American Medical Informatics Association 2013; 20 (e1): e175-e177.
- 14 Jaspers MWM. A comparison of usability methods for testing interactive health technologies: Methodological aspects and empirical evidence. Int J Med Inf 2009; 78 (05) 340-353.