OBJECTIVES: Issues related to lack of system usability and potential safety hazards continue to be reported in the health information technology (HIT) literature. Usability engineering methods are increasingly used to ensure improved system usability and they are also beginning to be applied more widely for ensuring the safety of HIT applications. These methods are being used in the design and implementation of many HIT systems. In this paper we describe evidence-based approaches to applying usability engineering methods. METHODS: A multi-phased approach to ensuring system usability and safety in healthcare is described. Usability inspection methods are first described including the development of evidence-based safety heuristics for HIT. Laboratory-based usability testing is then conducted under artificial conditions to test if a system has any base level usability problems that need to be corrected. Usability problems that are detected are corrected and then a new phase is initiated where the system is tested under more realistic conditions using clinical simulations. This phase may involve testing the system with simulated patients. Finally, an additional phase may be conducted, involving a naturalistic study of system use under real-world clinical conditions. RESULTS: The methods described have been employed in the analysis of the usability and safety of a wide range of HIT applications, including electronic health record systems, decision support systems and consumer health applications. It has been found that at least usability inspection and usability testing should be applied prior to the widespread release of HIT. However, wherever possible, additional layers of testing involving clinical simulations and a naturalistic evaluation will likely detect usability and safety issues that may not otherwise be detected prior to widespread system release. CONCLUSION: The framework presented in the paper can be applied in order to develop more usable and safer HIT, based on multiple layers of evidence.
OBJECTIVES: Issues related to lack of system usability and potential safety hazards continue to be reported in the health information technology (HIT) literature. Usability engineering methods are increasingly used to ensure improved system usability and they are also beginning to be applied more widely for ensuring the safety of HIT applications. These methods are being used in the design and implementation of many HIT systems. In this paper we describe evidence-based approaches to applying usability engineering methods. METHODS: A multi-phased approach to ensuring system usability and safety in healthcare is described. Usability inspection methods are first described including the development of evidence-based safety heuristics for HIT. Laboratory-based usability testing is then conducted under artificial conditions to test if a system has any base level usability problems that need to be corrected. Usability problems that are detected are corrected and then a new phase is initiated where the system is tested under more realistic conditions using clinical simulations. This phase may involve testing the system with simulated patients. Finally, an additional phase may be conducted, involving a naturalistic study of system use under real-world clinical conditions. RESULTS: The methods described have been employed in the analysis of the usability and safety of a wide range of HIT applications, including electronic health record systems, decision support systems and consumer health applications. It has been found that at least usability inspection and usability testing should be applied prior to the widespread release of HIT. However, wherever possible, additional layers of testing involving clinical simulations and a naturalistic evaluation will likely detect usability and safety issues that may not otherwise be detected prior to widespread system release. CONCLUSION: The framework presented in the paper can be applied in order to develop more usable and safer HIT, based on multiple layers of evidence.
Authors: Benjamin J Duncan; Alexandra N Kassis; David R Kaufman; Adela Grando; Karl A Poterack; Rick A Helmers; Timothy K Miksch; Lu Zheng; Bradley N Doebbeling Journal: AMIA Annu Symp Proc Date: 2021-01-25
Authors: E Borycki; J W Dexheimer; C Hullin Lucay Cossio; Y Gong; S Jensen; J Kaipio; S Kennebeck; E Kirkendall; A W Kushniruk; C Kuziemsky; R Marcilly; R Röhrig; K Saranto; Y Senathirajah; J Weber; H Takeda Journal: Yearb Med Inform Date: 2016-11-10
Authors: Richard Harte; Leo R Quinlan; Liam Glynn; Alejandro Rodriguez-Molinero; Thomas Scharf; Carlos Carenas; Elisenda Reixach; Joan Garcia; Jordi Carrabina; Gearóid ÓLaighin Journal: J Pers Med Date: 2015-12-16
Authors: Richard Harte; Leo R Quinlan; Liam Glynn; Alejandro Rodríguez-Molinero; Paul Ma Baker; Thomas Scharf; Gearóid ÓLaighin Journal: JMIR Mhealth Uhealth Date: 2017-05-30 Impact factor: 4.773
Authors: Chris Paton; Andre W Kushniruk; Elizabeth M Borycki; Mike English; Jim Warren Journal: J Med Internet Res Date: 2021-05-27 Impact factor: 5.428
Authors: Benjamin Brown; Panos Balatsoukas; Richard Williams; Matthew Sperrin; Iain Buchan Journal: Int J Med Inform Date: 2016-07-16 Impact factor: 4.046