Assessing the Relationships between Task Demand, Task Difficulty and Performance during Physicians' Interaction with EHR systems

The study’s aim was to relate task demand, task difficulty with performance during physicians’ interaction with electronic health records (EHR) system. The results indicated that there was a significant effect of task demands on task difficulty and performance; task difficulty was also related to performance. Practically, the results suggest that EHR designers might be able to positively affect physicians’ performance by enhancing usability of interfaces aimed at directing physician’ EHR-related interaction strategies.Master of Science in Information Scienc

Usability Heuristic Violations, Provider Burden, and Performance During Interactions with Electronic Health Records

Electronic health records (EHRs) are widely used, but their suboptimal usability can pose risks for patient safety. This study uses data collected in a simulated environment in which providers interacted with ‘current’ and ‘enhanced’ Epic EHR interfaces to manage patients’ test results and missed appointments. Interactions were quantified and categorized by high or low burden in terms of displayed behavioral and physiological data. Using recorded video data, the interface was inspected for violations of usability heuristics, and providers’ workflow and performance was recorded. Overall, 22 heuristic violations were identified from 19 issues across all screens. Suboptimal performance was found to be associated with high burden level as well as the current EHR design. Findings can be incorporated into future design of EHRs in order to reduce providers’ burden.Master of Science in Information Scienc

The Impact of Individual Learning on Electronic Health Record Routinization: An Empirical Study

Since the passage of the HITECH Act, adoption of electronic health records (EHR) has increased significantly EHR refers to an electronic version of a patient’s medical history. The adoption of EHR has potential to reduce medical errors, duplication of testing, and delays in treatment. However, current literature indicates that implementation of EHR is not resulting in the automatic routinization of EHR. Routinization refers to the notion that truly successful technological innovations are no longer perceived as being new or out-of-the-ordinary. The complexity of EHRs allow individual users to use these systems at different levels of sophistication. Research shows that healthcare professionals are using non-standard ways to use or circumvent the EHR to complete their work and are limited in EHR systems use. Further, although workarounds may seem necessary to physicians and are not perceived to be problematic, they can pose a threat to patient safety and hinder the potential benefits. Hence, we argue the EHR implementations are limited in their potential due to the lack of routinization. Any new technological innovation requires the physician support and willingness to learn about the system to move to the routinization phase of implementation. Hence, we draw from the literature on organization learning, individual learning, and routines to understand factors that influence EHR routinization

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)

The Impact of Individual Learning on Electronic Health Record Routinization: An Empirical Study

Since the passage of the HITECH Act, adoption of electronic health records (EHR) has increased significantly EHR refers to an electronic version of a patient’s medical history. The adoption of EHR has potential to reduce medical errors, duplication of testing, and delays in treatment. However, current literature indicates that implementation of EHR is not resulting in the automatic routinization of EHR. Routinization refers to the notion that truly successful technological innovations are no longer perceived as being new or out-of-the-ordinary. The complexity of EHRs allow individual users to use these systems at different levels of sophistication. Research shows that healthcare professionals are using non-standard ways to use or circumvent the EHR to complete their work and are limited in EHR systems use. Further, although workarounds may seem necessary to physicians and are not perceived to be problematic, they can pose a threat to patient safety and hinder the potential benefits. Hence, we argue the EHR implementations are limited in their potential due to the lack of routinization. Any new technological innovation requires the physician support and willingness to learn about the system to move to the routinization phase of implementation. Hence, we draw from the literature on organization learning, individual learning, and routines to understand factors that influence EHR routinization

Transactions of 2015 International Conference on Health Information Technology Advancement Vol.3, No. 1

The Third International Conference on Health Information Technology Advancement Kalamazoo, Michigan, October 30-31, 2015 Conference Chair Bernard Han, Ph.D., HIT Pro Department of Business Information Systems Haworth College of Business Western Michigan University Kalamazoo, MI 49008 Transactions Editor Dr. Huei Lee, Professor Department of Computer Information Systems Eastern Michigan University Ypsilanti, MI 48197 Volume 3, No. 1 Hosted by The Center for Health Information Technology Advancement, WM

Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe

Guidelines for the user interface design of electronic medical records in optometry

With the prevalence of digitalisation in the medical industry, e-health systems have largely replaced the traditional paper-based recording methods. At the centre of these e-health systems are Electronic Health Records (EHRs) and Electronic Medical Records (EMRs), whose benefits significantly improve physician workflows. However, provision for user interface designs (UIDs) of these systems have been so poor that they have severely hindered physician usability, disrupted their workflows and risked patient safety. UID and usability guidelines have been provided, but have been very high level and general, mostly suitable for EHRs (which are used in general practices and hospitals). These guidelines have thus been ineffective in applicability for EMRs, which are typically used in niche medical environments. Within the niche field of Optometry, physicians experience disrupted workflows as a result of poor EMR UID and usability, of which EMR guidelines to improve these challenges are scarce. Hence, the need for this research arose, aiming to create UID guidelines for EMRs in Optometry, which will help improve the usability of the optometrists’ EMR. The main research question was successfully answered to produce the set of UID Guidelines for EMRs in Optometry, which includes guidelines built upon from literature and made contextually relevant, as well as some new additions, which are more patient focused. Design Science Research (DSR) was chosen as a suitable approach, and the phased Design Science Research Process Model (DSRPM) was used to guide this research. A literature review was conducted, including EHR and EMR, usability, UIDs, Optometry, related fields, and studies previously conducted to provide guidelines, frameworks and models. The review also included studying usability problems reported on the systems and the methods to overcome them. Task Analysis (TA) was used to observe and understand the optometrists’ workflows and their interactions with their EMRs during patient appointments, also identifying EMR problem areas. To address these problems, Focus Groups (FGs) were used to brainstorm solutions in the form of EMR UID features that optometrists’ required to improve their usability. From the literature review, TAs and FGs, proposed guidelines were created. The created guidelines informed the UID of an EMR prototype, which was successfully demonstrated to optometrists during Usability Testing sessions for the evaluation. Surveys were also used for the evaluation. The results proved the guidelines were successful, and were usable, effective, efficient and of good quality. A revised, final set of guidelines was then presented. Future researchers and designers may benefit from the contributions made from this research, which are both theoretical and practical

Linking Research and Policy: Assessing a Framework for Organic Agricultural Support in Ireland

This paper links social science research and agricultural policy through an analysis of support for organic agriculture and food. Globally, sales of organic food have experienced 20% annual increases for the past two decades, and represent the fastest growing segment of the grocery market. Although consumer interest has increased, farmers are not keeping up with demand. This is partly due to a lack of political support provided to farmers in their transition from conventional to organic production. Support policies vary by country and in some nations, such as the US, vary by state/province. There have been few attempts to document the types of support currently in place. This research draws on an existing Framework tool to investigate regionally specific and relevant policy support available to organic farmers in Ireland. This exploratory study develops a case study of Ireland within the framework of ten key categories of organic agricultural support: leadership, policy, research, technical support, financial support, marketing and promotion, education and information, consumer issues, inter-agency activities, and future developments. Data from the Irish Department of Agriculture, Fisheries and Food, the Irish Agriculture and Food Development Authority (Teagasc), and other governmental and semi-governmental agencies provide the basis for an assessment of support in each category. Assessments are based on the number of activities, availability of information to farmers, and attention from governmental personnel for each of the ten categories. This policy framework is a valuable tool for farmers, researchers, state agencies, and citizen groups seeking to document existing types of organic agricultural support and discover policy areas which deserve more attention