INTRODUCTION
Background
Problem Statement and Research Questions
METHODS
Study Context
Usability Workshop Implementation
Usability Instructional Sessions
Workshop Design
Profile | Abstract of CLIPS and tasks |
---|---|
Pharmacist (n = 1) | Validation of a prescription, entry of medication dispensation |
Admissions officer (n = 1) | Entry of new patient’s administrative data, of administrative discharge, of consultation and day hospital pre-admissions |
Secretary (n = 1) | Dictation transcription, search and entry of appointments bookings for consultation and hospitalization |
Nurses (n = 3) | Patient's arrival in the emergency room: entry of reason for admission, vital parameters, patient prioritization, medication administration, patient orientation, transfer to another service Patient hospitalization: entry of the bed installation, of the entry synthesis, of the initial clinical synthesis, of the autonomy assessment, of the Braden score, of the blood test, of the care planning, of the therapeutic administration, of the care delivery, of the traceability of a bandage, of the urinary catheter insertion, of the department exit, visualization of the care plan, correction of an error, update of a targeted transmission |
Physicians (n =3) | Patient's arrival in the emergency room: entry of medical observation, prescription, medical decision, and coding Patient hospitalization: entry of medical history and disease, of the usual treatment, of allergies, of the initial prescription, of the progress note, of the discharge order and coding, visualization of laboratory results, of the care plan, of the prescriptions, of the medical observations and of the vital parameters, change of prescription, request for infectious advice, dictation of discharge letter. |
Data Collection and Analysis
Question 1: Can end-users Detect, Describe, and Prioritize Usability Problems?
Question 2: Does the Usability Walkthrough Method Identify Problems that Require Clinical Domain Expertise to be Detected?
Question 3: How Satisfied are end-users that Participate in a Usability Walkthrough?
Question 4: What are the Challenges Associated with Implementing a Usability Walkthrough during an EHR Procurement Process?
RESULTS
Are End-Users Able to Detect, Describe, and Prioritize Usability Problems?
User profile | Number of end-users detecting the problem | Number of problems detected (% per profile where relevant) | Sum | ||
---|---|---|---|---|---|
EHR1 | EHR 2 | EHR3 | |||
Physician | 0 (UE) | 1 (2.3%) | 1 (2.4%) | 1 (6.25%) | 3 |
1 | 31 (72%) | 25 (61%) | 8 (50%) | 64 | |
2 | 8 (18.6%) | 11 (26.8%) | 4 (25%) | 23 | |
3 | 3 (7%) | 4 (9.7%) | 3 (18.75%) | 10 | |
Nurse | 0 (UE) | 1 (3.8%) | 0 | 2 (6.9%) | 3 |
1 | 15 (53.8%) | 14 (63.6%) | 17 (58.6%) | 46 | |
2 | 8 (30.8%) | 3 (13.6%) | 8 (27.6%) | 19 | |
3 | 3 (11.5) | 5 (22.7%) | 2 (6.9%) | 10 | |
Pharmacist | 0 (UE) | 0 | 0 | 0 | 0 |
1 | 14 (100%) | 23 (100%) | 9 (100%) | 46 | |
Medical clerk | 0 (UE) | 0 | 0 | 0 | 0 |
1 | 10 (100%) | 9 (100%) | 6 (100%) | 25 | |
Admission officer | 0 (UE) | 1 (20%) | 0 | 0 | 1 |
1 | 4 (80%) | 5(100%) | 6 (100%) | 15 | |
Sum | 99 | 100 | 66 | 265 |
End-users | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Guidance | Workload | Compatibility | Signif. of codes | Error manag. | Consistency | Adaptability | Explicit control | No criterion | Sum | ||
Usability experts | Guidance | 45 | 7 | 4 | 3 | 2 | 1 | 3 | 1 | 16 | 82 |
Workload | 8 | 32 | 5 | 1 | 2 | 0 | 4 | 0 | 12 | 64 | |
Compatibility | 1 | 4 | 25 | 1 | 0 | 1 | 5 | 0 | 6 | 43 | |
Significance of codes | 0 | 1 | 1 | 23 | 0 | 0 | 0 | 0 | 2 | 27 | |
Error manag. | 0 | 1 | 1 | 0 | 15 | 0 | 0 | 0 | 3 | 20 | |
Consistency | 0 | 0 | 0 | 0 | 0 | 11 | 0 | 0 | 0 | 11 | |
Adaptability | 1 | 0 | 0 | 1 | 0 | 0 | 3 | 0 | 1 | 6 | |
Explicit control | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 3 | 1 | 5 | |
Sum | 55 | 45 | 37 | 29 | 19 | 13 | 15 | 4 | 41 | 258 |
End-users | ||||||
---|---|---|---|---|---|---|
Light | Minor | Major | No severity | Sum | ||
Usability experts | Light | 68 | 6 | 0 | 21 | 95 |
Minor | 28 | 63 | 16 | 14 | 121 | |
Major | 0 | 2 | 34 | 6 | 42 | |
Sum | 96 | 71 | 50 | 41 | 258 |
Does the Usability Walkthrough Method Identify Problems That Require Clinical Domain Expertise to Be Detected?
How Satisfied are End-Users with the Usability Walkthrough?
Likert items | N | Mean | SD | Median | Range | W | p |
---|---|---|---|---|---|---|---|
I think I understood the usability walkthrough method | 9 | 4.11 | 0.60 | 4 | 3 – 5 | 36 | 0.005 |
I felt efficient during the usability walkthrough | 9 | 4.11 | 0.60 | 4 | 3 – 5 | 36 | 0.005 |
Using the usability walkthrough was easy for me | 9 | 4 | 0.73 | 4 | 3 – 5 | 28 | 0.009 |
I think I understood the usability criteria | 9 | 4.22 | 0.67 | 4 | 3 – 5 | 36 | 0.006 |
I feel able to evaluate the EHR software using the criteria | 9 | 4 | 0.71 | 4 | 3 – 5 | 28 | 0.009 |
Using the usability criteria was easy for me | 9 | 4 | 0.71 | 4 | 3 – 5 | 28 | 0.009 |
I found this method relevant for the EHR procurement process | 8 | 4.38 | 0.52 | 4 | 4 – 5 | 36 | 0.006 |
I would appreciate to apply this method in other projects. | 8 | 4.38 | 0.71 | 4 | 4 – 5 | 28 | 0.010 |
What Challenges Exist when Implementing a Usability Walkthrough during an EHR Procurement Process?
EHR | Nurse physician (group 1) | Nurse physician (group 2) | Nurse physician (group 3) | Medical secretary | Admission officer | Pharmacist |
---|---|---|---|---|---|---|
1 | 23/50 (46%) | 31/50 (62%) | 27/50 (54%) | 3/3 (100%) | 3/4 (75%) | 2/2 (100%) |
2 | 23/50 (46%) | 28/50 (56%) | 26/50 (52%) | 3/3 (100%) | 3/4 (75%) | 2/2 (100%) |
3 | 33/50 (66%) | 42/50 (84%) | 25/50 (50%) | 3/3 (100%) | 4/4 (100%) | 2/2 (100%) |