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Appl Clin Inform 2016; 07(02): 502-515
DOI: 10.4338/ACI-2015-10-RA-0129
Research Article
Schattauer GmbH

Usability Testing of Two Ambulatory EHR Navigators

Gretchen Hultman
1   Institute for Health Informatics, University of Minnesota, Minneapolis, MN
,
Jenna Marquard
4   College of Engineering, University of Massachusetts Amherst, Amherst, MA
,
Elliot Arsoniadis
1   Institute for Health Informatics, University of Minnesota, Minneapolis, MN
2   Department of Surgery, University of Minnesota, Minneapolis, MN
,
Pamela Mink
5   Division of Applied Research, Allina Health, Minneapolis, MN
,
Rubina Rizvi
1   Institute for Health Informatics, University of Minnesota, Minneapolis, MN
,
Tim Ramer
3   Department of Family Medicine, University of Minnesota, Minneapolis, MN
,
Saif Khairat
6   Carolina Health Informatics Program, University of North Carolina, Chapel Hill, NC
,
Keri Fickau
7   Fairview Health Services, Minneapolis, MN
,
Genevieve B. Melton
1   Institute for Health Informatics, University of Minnesota, Minneapolis, MN
2   Department of Surgery, University of Minnesota, Minneapolis, MN
7   Fairview Health Services, Minneapolis, MN
› Institutsangaben
This work was supported by the Agency for Healthcare Research and Quality Award #R01HS022085 (GM) and National Science Foundation Award #CMMI-1150057 (JM).
Weitere Informationen

Correspondence to:

Genevieve B. Melton
420 Delaware Street SE
Mayo Mail Code 450
Minneapolis MN 55455

Publikationsverlauf

received: 16. Oktober 2015

Accepted: 29. März 2016

Publikationsdatum:
16. Dezember 2017 (online)

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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.


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Keywords

Electronic health record - usability - meaningful use

 


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Conflicts of Interest

The authors declare that they have no conflicts of interest in this research.

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Correspondence to:

Genevieve B. Melton
420 Delaware Street SE
Mayo Mail Code 450
Minneapolis MN 55455

  • 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.
    PubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 4 Abran A, Khelifi A, Suryn W, Seffah A. Usability meanings and interpretations in ISO standards. Software Quality Journal 2003; 11 (04) 325-338.
    CrossrefPubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 6 Boren MT, Ramey J. Thinking aloud: Reconciling theory and practice. IEEE Transactions on Professional Communication 2000; 43 (03) 261-278.
    CrossrefPubMedGoogle Scholar
  • 7 Stage. 02. 2015 Available from: https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncen tivePrograms/Stage_2.html
    PubMedGoogle Scholar
  • 8 Han H, Lopp L. Writing and reading in the electronic health record: an entirely new world. Med Educ Online 2013; 18: 1-7.
    PubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    Google Scholar
  • 12 Brooke J. SUS: A “quick and dirty” usability scale. Usability evaluation in industry 1996; 189-194.
    PubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar

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