usability evaluation of a personal health record...usability evaluation of a personal health record...
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Usability Evaluation of a Personal Health Record Noa Segall1, Jeffrey G. Saville2, Pete L’Engle2, Boyd Carlson2, Melanie C. Wright3, Kevin Schulman4, James E. Tcheng1,2 1Duke University Medical Center, Durham, NC 2Duke University Health System, Durham, NC 3St. Alphonsus Medical Center, Boise, ID 4Duke Clinical Research Institute, Durham, NC
Introduction Electronic personal health records (PHRs) can
facilitate patient-centered care Usability and utility to patients have received
little attention Outcome-based PHR studies
Mixed findings Little information to support design and
functionality decisions Used human-centered design methods to
evaluate a PHR
HealthView
Methods 20 participants 9 tasks Interview Surveys
Participant background
Usability Functionality
Measures Effectiveness Efficiency Satisfaction Qualitative
Tasks Finding lab results
Tasks Making an appointment
Tasks Making an appointment
Questions Interview Questions
What do you think are the most useful features in HealthView that can improve the quality of care you receive?
If you could make one significant change to the HealthView website, what change would you make?
Would you consider opening a HealthView account? Why or why not?
Survey Questions How often do you use
the internet to look up information about medications?
How interested would you be in using the internet to make a doctor appointment?
Organization of information is… Confusing 1 2 3 4 5 Very Clear
Results 23 participants
Age 27 to 84 (average, 53) 48% males 70% Caucasian 78% had cardiovascular disease 74% had education/training beyond high
school 70% beginner/average computer skills 61% spent <10 hours/week using computers 61% had a HealthView account
How often do you use the internet for the following tasks?
How interested would you be in using the internet to do any of the following tasks?
Functionality: Interviews “I have high blood pressure, a batch of things… I try to take control. HealthView… helps me buy into my health, my wellbeing, better. So I feel really good about it.
“I think it's a very informative and useful website. I think it can help you a lot… it keeps a lot of information for you.
Functionality: Surveys
Usability: Surveys
Usability: Surveys
Usability: Observations Task Errors/Gave Up Help Requests Find and interpret 4 lab results 17.5% of labs 41.3% of labs Make an appointment and reschedule it
31.9% of subtasks 14.5% of subtasks
Describe how to take 7 medications 13.5% of medications
0.8% of medications
Interpret trends in vital signs data 22.4% of subtasks 12.2% of subtasks Determine allergy documentation 5.3% of subtasks 5.3% of subtasks Find and print a payment history 25% of subtasks 0% of subtasks Update personal information 11.9% of subtasks 5.1% of subtasks Add a child to the health record 5% of subtasks 15% of subtasks Find an introduction video 5% of subtasks 25% of subtasks
Usability: Interviews “The website is very good, it’s very informative… Once you get used to where you’re going… just like anything else, you have to learn it. But once you learn it, it’s a piece of cake.
“I received my own report back and was very, very confused by what everything meant. And while it said, no cause for alarm, you're OK, there were items in this report that I didn't know what they were.
“The intent is there, but the user interface needs a lot of work.
Design Recommendations Current Display
Normal value 14.6 g/dL [12-15.5] Abnormal value *16.7 g/dL [12-15.5]
Recommended Display
Normal value
Abnormal value 12 15.5
14.6
12 15.5
16.7
Design Recommendations Current Display Recommended Displays
Previous Next Back to Lab Reports
Design Recommendations Current Display Recommended Display
Appointments
Appointments
Schedule Appointment Request Appointment
Appointments >
New Appointment View/Change Appointments
Conclusions Study participants were pleased with
HealthView functionality Participants encountered many usability
problems Difficulty navigating the website Long task completion times Misleading interfaces leading to errors Unclear medical terminology
Conclusions Human-centered design and evaluation
Improved performance Increased system acceptance Improved usage and satisfaction
Employing HCD methods throughout the design process may have prevented many usability problems
Discrepancy between survey data and interview and observation data highlights need to apply multiple methods during evaluation