Usability Evaluation of a Personal Health Record

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This is a review of Segall et al 2011, Usability Evaluation of a Personal Health Record. [1]


According to Segall et al, the main objective of this study is to evaluate usability and functionality of Health View electronic personal health record (PHR) system of Duke University Health System using human centered design. [1]The article claims that use of PHR would improve the quality of healthcare delivered to a patient, however studies based on outcome measure of the system provided little and mixed information about this claim. Therefore, the study uses HCD to evaluate the PHR system and improve the usability and functionality of a system based on results from evaluation.


The article defines PHR as an internet-based tool that contains individual’s life long health information. It is assumed that the system will provide cost effective coordinated care, especially among chronically ill patients by helping them to actively participant in their care decision. Further it explains, some of the main concerns in the use of PHR are: privacy, security and poor interface usability. It also points out that the success of PHR heavily depends on its usability, which encompasses: learnability, ease of navigation and intuitive use. As a consequence, the study used HCD to test those features. On top of that, the study incorporated a protocol called A think aloud where participants articulate their experience while using a system under test.


According to the article, the study selected twenty participants with chronic cardiovascular disease and three additional subjects with no chorionic cardiovascular disease. While explaining about their experience as they navigate through the system, each participant performs nine tasks or scenarios in a random order. The participants were asked to "think aloud" as they carried out these tasks. Further, the participants were interviewed about usability problems they encountered, whether they would use the system in the future, or if not, what features they would recommend for future versions of the system. Participants also completed a background survey, a usability survey eliciting their reaction to HealthView, and a survey gauging their interest in accessing differetn types of online health information.


The article reported, participants who are unfamiliar with the system before reported a positive experience with it, while all subjects consider opening a new account or recommending one to a friend. Majority participants believed the system could improve their overall healthcare delivery. Further, the participants rated Heath View’s usability 3.9 on a scale of 1 to 5 for consistency, clarity of message, learnability and information organization. On the other hand, participants reported difficulties on navigation, data entry and medical terminology.


Based up on results from the study, the article made some recommendations and improvements in areas such as: navigation, consistency, efficiency, functionality, error massage and the likes.


In conclusion, the article promoted the idea of using HCD methods to evaluate a system that is being developed. HCD methods facilitate a way to evaluate the system before a final work is done, which is much better way than evaluating a system at the end, which potentially can be very costly. In addition to that, the article recommends involving users while developing a new system so that its usability improves well.


There are mixed and limited studies done regarding the effect of PHR on healthcare delivery. This study added more needed information regarding the issue. In general the article indicated PHR will improve healthcare delivery, however some improvement needed to be done on its usability and functionality features. Aside from that, unlike previous studies, which evaluate a system after final products is done, this study used HCD methods to evaluate one that is being developed. Additionally, it incorporated potential users in the process of evaluation, which makes it very efficient and cost effective evaluation.

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  1. 1.0 1.1 Segall, N, Saville, J, Engle, P, Carlson, B, Wright, M, Schulman, K, Tcheng, J. (2011). Usability Evaluation of a Personal Health Record. AMIA, 2011, 1233-1242.