Usability Evaluation of Electronic Health Record System around Clinical Notes Usage-An Ethnographic Study
Usability Evaluation of Electronic Health Record System around Clinical Notes Usage-An Ethnographic Study
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DOI：
10.4338/aci-2017-04-ra-0067
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发表时间：
2017-01-01
影响因子：
2.9
通讯作者：
Melton, Genevieve B.
中科院分区：
文献类型：
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作者：
Rizvi, Rubina F.;Marquard, Jenna L.;Melton, Genevieve B.
背景目前的电子健康记录（EHR）可用性和潜在的最佳可用性之间存在着巨大的差距。目的评价两种电子病历图形用户界面（EHR GUI）在重要临床病历使用中的可用性优势和不足。方法12名内科住院医师与两种EHR系统中的一种进行交互（位置A的系统-1和位置B的系统-2）由两名可用性评价员采用人种学方法进行观察。分析了两项关键任务的用户评论和观察者发现：（1）临床笔记输入和（2）相关信息搜索任务。从两个角度分析数据：（1）可用性评价者将可用性参考分类为积极、消极或模棱两可;（2）通过7分严重性评级量表测量每个功能的可用性影响。调查结果也验证了用户的反应后observation questionnaire.Results临床笔记条目，系统1超过系统2与更多的积极（26%比12%）比消极（12%比34%）的可用性参考。对临床笔记输入的EHR可用性（与每个功能相关的严重度评分）影响最大的功能是：自动填充（6）、屏幕选项（5.5）、通信（5）、复制粘贴（4.5）、错误预防（4.5）、编辑能力（4）以及听写和转录（3.5）。两个系统在信息搜索任务上表现同样出色，对EHRusability影响最大的功能是笔记导航（7）和其他功能（例如，查找辅助数据; 5.5）.人种学观察支持后续的问卷results.Conclusion这项研究提供了可用性的具体见解，以告知未来，改进，EHR接口，更好地与UCD的方法。
Background A substantial gap exists between current Electronic Health Record (EHR) usability and potential optimal usability. One of the fundamental reasons for this discrepancy is poor incorporation of a User-Centered Design (UCD) approach during the Graphical User Interface (GUI) development process.Objective To evaluate usability strengths and weaknesses of two widely implemented EHR GUIs for critical clinical notes usage tasks.Methods Twelve Internal Medicine resident physicians interacting with one of the two EHR systems (System-1 at Location-A and System-2 at Location-B) were observed by two usability evaluators employing an ethnographic approach. User comments and observer findings were analyzed for two critical tasks: (1) clinical notes entry and (2) related information-seeking tasks. Data were analyzed from two standpoints: (1) usability references categorized by usability evaluators as positive, negative, or equivocal and (2) usability impact of each feature measured through a 7-point severity rating scale. Findings were also validated by user responses to a post observation questionnaire.Results For clinical notes entry, System-1 surpassed System-2 with more positive (26% vs. 12%) than negative (12% vs. 34%) usability references. Greatest impact features on EHR usability (severity score pertaining to each feature) for clinical notes entry were: autopopulation (6), screen options (5.5), communication (5), copy pasting (4.5), error prevention (4.5), edit ability (4), and dictation and transcription (3.5). Both systems performed equally well on information-seeking tasks and features with greatest impacts on EHRusability were navigation for notes (7) and others (e.g., looking for ancillary data; 5.5). Ethnographic observations were supported by follow-up questionnaire responses.Conclusion This study provides usability-specific insights to inform future, improved, EHR interface that is better aligned with UCD approach.