Difference between revisions of "Article Review: An Interface-driven Analysis of User Interactions with an Electronic Health Records System"
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Revision as of 05:48, 12 February 2015
Contents
Research Article
Kai Zheng et al. An Interface Driven Analysis of User Interactions with an Electronic Health Records System. J Am Med Inform Assoc. 2009; 16: 228-237.
Objectives
This was a study that investigated user interactions or experience with an electronic health records (EHR) system called the Clinical Reminder System (CRS) in terms of its user interface (UI) and application Flow (AF) design.
Research Questions
Do user interface (UI) and application flow (AF) design deficiencies influence end users’ day-to-day clinical practice? Does a poor fit between UI/AF designs influence the way clinicians navigate through an electronic health record (EHR) system? Can user behavior be used to improve the system’s usability?
Methods
Environment
The study site used was West Penn Medical Associates, an ambulatory primary care clinic at Western Pennsylvania hospital, a teaching hospital where all primary users were internal medicine residents.
Design
Recurring UI navigational patterns were uncovered using sequential pattern analysis (SPA) and a first-order Markov chain model. SPA was used to search for recurring patterns; consecutive EHR features access events at given points in time. EHR usage patterns and data were recorded and analyzed during a 10-month period.
Measurements
Using the EHR’s transaction database, the study utilized computer-recorded event sequences of different features of the EHR by users to show patterns in the way they were accessed.
Results
In all, seventeen main EHR features were recorded. During the study period, users of CRS recorded 973 patient encounters. Using the transaction database of CRS, sequential patterns across encounter sessions were constructed and data analyzed. Patterns of consecutive feature access events were recorded; eleven were identified as maximal with levels of support ranging from 15 to 51.16 percent; Within-session recurring rates of sequential patterns showed levels of support between 51.35 and 70.22 percent.
Conclusion
User interface (UI) and application flow (AF) design deficiencies may influence end users’ day-to-day clinical practice. Poor fit between UI/AF designs may influence the way clinicians navigate through an electronic health record (EHR) system. Users demonstrated consistent UI navigational patterns when performing different clinical tasks. Some of these patterns deviated from the EHR system’s original UI/AF design principles. User behavior and such deviations should be considered when designing health information technology (HIT) systems.
Comments
UI/AF design has the tendency to influence how the user navigates an EHR system. UI navigational patterns might have an effect on clinical practice. End users may not have the full benefits of an EHR implementation from poorly designed UI and AF. When this happens, decreased time efficiency, coupled with user dissatisfaction can adversely affect the quality of care and patient safety. Superior user experience is eminent with appealing, intuitive UI and AF designs. User behavior can be used to improve an EHR system’s usability.
