Quality of human-computer interaction - results of a national usability survey of hospital-IT in Germany

<p>Abstract</p> <p>Background</p> <p>Due to the increasing functionality of medical information systems, it is hard to imagine day to day work in hospitals without IT support. Therefore, the design of dialogues between humans and information systems is one of the most important issues to be addressed in health care. This survey presents an analysis of the current quality level of human-computer interaction of healthcare-IT in German hospitals, focused on the users' point of view.</p> <p>Methods</p> <p>To evaluate the usability of clinical-IT according to the design principles of EN ISO 9241-10 the IsoMetrics Inventory, an assessment tool, was used. The focus of this paper has been put on suitability for task, training effort and conformity with user expectations, differentiated by information systems. Effectiveness has been evaluated with the focus on interoperability and functionality of different IT systems.</p> <p>Results</p> <p>4521 persons from 371 hospitals visited the start page of the study, while 1003 persons from 158 hospitals completed the questionnaire. The results show relevant variations between different information systems.</p> <p>Conclusions</p> <p>Specialised information systems with defined functionality received better assessments than clinical information systems in general. This could be attributed to the improved customisation of these specialised systems for specific working environments. The results can be used as reference data for evaluation and benchmarking of human computer engineering in clinical health IT context for future studies.</p

Factors influencing implementation success of guideline-based clinical decision support systems: A systematic review and gaps analysis

To provide an integrated and differentiated understanding of factors influencing guideline-based CDSS implementation and illustrate the gaps in the current literature. A systematic literature review and in-depth exploration of factors impeding or facilitating successful implementation of guideline-based CDSS supporting physicians in clinical decision-making was performed. Factors were identified thematically by textual analysis of the included publications and were individually mapped to the human, organization and technology-fit (HOT-fit) framework for evaluating implementations of health information systems. A total of 421 factors were found in 35 included publications from a total of 3676 publications. The mapping of factors concerning CDSS implementation on the HOT-fit framework revealed gaps in each domain of the framework and showed that research has mainly focused on human and technology factors and less on organizational factors. Future research within the field of guideline-based CDSS should focus on evaluating implementations through the use of socio-technical models to study guideline-based CDSS system implementations from a multidimensional view. Furthermore, research is needed to explore whether use of these models during the planning phases of a CDSS project is useful in anticipating and preventing implementation barriers from occurring and exploiting facilitators to a successful implementation of the syste

A framework for evaluating mHealth tools for Older Patients on Usability

Mobile health (mHealth) apps can play a significant role in supporting older patients. The aging process is yet related to progressive degradation of sensory, physical and cognitive abilities. mHealth apps with touch screen based interfaces thus need to be adapted to the, often impaired, skills and special needs of older patients. However, existing design guidelines for mHealth apps do not address the aging barriers that older users face in working with touch screen based applications. By means of a constructed conceptual framework on cognitive, motivational, physical and visual impairments of older adults, this study revealed possible aging barriers concerning identified usability issues of an mHealth app for older patients. Insights into the aging process barriers that underlie usability issues supports developers in (re)designing mHealth apps that are better attuned to the needs of the older patient populatio

Impact of Patient-centered eHealth Applications on Patient Outcomes: A Review on the Mediating Influence of Human Factor Issues

To examine the evidence of the impact of patient- centered eHealth applications on patient care and to analyze if and how reported human factor issues mediated the outcomes. We searched PubMed (2014-2015) for studies evaluating the impact of patient-centered eHealth applications on patient care (behavior change, self-efficacy, and patient health-related outcomes). The Systems Engineering Initiative for Patient Safety (SEIPS 2.0) model was used as a guidance framework to identify the reported human factors possibly impacting the effectiveness of an eHealth intervention. Of the 348 potentially relevant papers, 10 papers were included for data analysis. None of the 10 papers reported a negative impact of the eHealth intervention. Seven papers involved a randomized controlled trial (RCT) study. Six of these RCTs reported a positive impact of the eHealth intervention on patient care. All 10 papers reported on human factor issues possibly mediating effects of patient-centered eHealth. Human factors involved patient characteristics, perceived social support, and (type of) interaction between patient and provider. While the amount of patient-centered eHealth interventions increases, many questions remain as to whether and to what extent human factors mediate their use and impact. Future research should adopt a formal theory-driven approach towards human factors when investigating those factors' influence on the effectiveness of these interventions. Insights could then be used to better tailor the content and design of eHealth solutions according to patient user profiles, so as to enhance eHealth interventions impact on patient behavior, self-efficacy, and health-related outcome

A Concise and Practical Framework for the Development and Usability Evaluation of Patient Information Websites

The Website Developmental Model for the Healthcare Consumer (WDMHC) is an extensive and successfully evaluated framework that incorporates user-centered design principles. However, due to its extensiveness its application is limited. In the current study we apply a subset of the WDMHC framework in a case study concerning the development and evaluation of a website aimed at childhood cancer survivors (CCS). To assess whether the implementation of a limited subset of the WDMHC-framework is sufficient to deliver a high-quality website with few usability problems, aimed at a specific patient population. The website was developed using a six-step approach divided into three phases derived from the WDMHC: 1) information needs analysis, mock-up creation and focus group discussion; 2) website prototype development; and 3) heuristic evaluation (HE) and think aloud analysis (TA). The HE was performed by three double experts (knowledgeable both in usability engineering and childhood cancer survivorship), who assessed the site using the Nielsen heuristics. Eight end-users were invited to complete three scenarios covering all functionality of the website by TA. The HE and TA were performed concurrently on the website prototype. The HE resulted in 29 unique usability issues; the end-users performing the TA encountered eleven unique problems. Four issues specifically revealed by HE concerned cosmetic design flaws, whereas two problems revealed by TA were related to website content. Based on the subset of the WDMHC framework we were able to deliver a website that closely matched the expectancy of the end-users and resulted in relatively few usability problems during end-user testing. With the successful application of this subset of the WDMHC, we provide developers with a clear and easily applicable framework for the development of healthcare websites with high usability aimed at specific medical population