All that Glitters is not Gold : Six Steps before Selecting and Prioritizing e-Health Services

Since the market for e-health applications is constantly growing, it is getting an ever more complex endeavor to select and prioritize the right service offering given a particular situation. In examining the extant literature, it was revealed that little emphasis is actually placed on how to analyze contextual or environmental factors prior to the selection and prioritization of e-health services. With this paper, we therefore propose a formative framework consisting of six fundamental yet very pragmatic steps that may support decision makers in identifying the most important contextual pre-requisites that e-health services need to fulfill in order to be considered as effective for their environment to be implemented

Identifying Physicians’ User Experience (UX) Pain Points in Using Electronic Health Record (EHR) Systems

Healthcare institutions have migrated to online electronic documentation through the means of Electronic Health Record (EHR) systems. Physicians rely on these systems to support their various clinical work processes, such as entering clinical orders, reviewing essential clinical data, and making important medical decisions using reporting analytics. Although EHR systems appear to be useful and have known advantages over paper records, studies suggest there are persistent user interface design problems that may hinder physician productivity. The study focused on the research problem that EHR system designs create productivity problems for physician users who frequently report that system workflows are inefficient and do not map to their clinical process needs. Although researchers have examined EHR system adaptation and user interface design with various stakeholders, research is limited on the lived experiences of physicians who use the system. A few studies have focused on quantifying the factors that describe the phenomena of “meaningful use” of EHR systems. A qualitative approach to studying the phenomenon of physicians\u27 use of EHR systems is understudied and is relevant to investigate given EHR systems have become commonplace tools in clinical settings. An interpretive phenomenological analysis (IPA) study was conducted with the goal to discover what emergency room physicians describe as the pain points of their user experiences with EHR systems, which may include many different experiences to be uncovered, and their perspectives about how they manage the difficulty of system tasks and demands. Eight participants who represented a purposeful sample were recruited from one hospital in the Southeast region of the United States and participated in semi-structured interviews with open-ended questions. The data derived from the personal lived experiences of the participants were reviewed and analyzed through a step-by-step analytical process to develop five super-ordinate themes: Historical Chart Review, Inadequate Note Documentation, Difficult Order Entry, Patient Throughput Barriers, and Poor System Performance. The findings reveal consistencies with previous research that suggests physicians experience mental burden and burnout using EHR systems due to task complexity, task demand, and inefficiencies of system design. The findings have multiple implications for information technology (IT) system designers, healthcare administrators, and physician end users. This study provides future research opportunities to investigate the experiences of individuals who work in a different specialized area of the hospital, such as the intensive care unit (ICU)

An Investigation of the Impact of Task-Types on the Reactivity of the Concurrent Think-Aloud in Usability Testing

The Concurrent think-aloud (CTA) is primarily used to understand users’ task based cognitive processes. However, is not without limitations. CTA procedures varies widely among practitioners. Also, it has been known to cause reactivity: an artificial change in task performance. This is problematic because it may alter the accuracy of task performance. Also, research on reactivity within usability testing have shown mixed findings. Thus, conclusions cannot be drawn to attest to whether reactivity occurs due to varying administration procedures and therefore we must now consider its relationship to other test-based factors. This research will be the first to systematically investigate the impact of task-type on reactivity of the CTA and the first to systematically investigates practitioners working habit in terms of their views on reactivity when using CTA in practice. Three studies were conducted, the first study investigates the Impact of task-types on the Reactivity of CTA and uses a mixed design. The results suggest that, thinking aloud during usability testing does not cause reactivity, and task type does not impact concurrent think-aloud. However, sensemaking tasks increase mental demand. The second study investigates the impact of task-type on two different think-aloud protocols and uses a mixed design. The result indicates that, the classic think-aloud method led to more successful task completion and no reactivity, while the explicit instruction produced fewer successful task completions and a higher mental workload. The explicit instruction produced less verbalisation, resulting in fewer relevant explanatory utterances, contradicting expectations. The third study uses an interview method to explores practitioners' experiences, views on reactivity and challenges when using the think-aloud method within usability testing. These studies demonstrates unequivocally that CTA should not be abandoned in usability studies as it provided valuable think-aloud data and helped identify usability issues. Additionally, practitioners should not replace the traditional think- aloud approach with explicit instruction, as explicit instruction had a greater influence on participants' behaviour. Ericsson and Simon's recommendations should be used for concurrent data collection, as it ensures data validity and generates the same type of data as explicit instruction while reducing reactivity