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Yearb Med Inform 2014; 23(01): 67-81
DOI: 10.15265/IY-2014-0023
Original Article
Georg Thieme Verlag KG Stuttgart

Human Factors in the Large: Experiences from Denmark, Finland and Canada in Moving Towards Regional and National Evaluations of Health Information System Usability

Contribution of the IMIA Human Factors Working Group
A. Kushniruk
1   School of Health Information Science, University of Victoria, Victoria, Canada
5   Department of Development and Planning, Aalborg University, Aalborg, Denmark
,
J. Kaipio
2   Strategic Usability Research Group, Department of Computer Science and Engineering, Aalto University, Espoo, Finland
,
M. Nieminen
2   Strategic Usability Research Group, Department of Computer Science and Engineering, Aalto University, Espoo, Finland
,
H. Hyppönen
3   Information Department, National Institute of Health and Welfare THL, Helsinki, Finland
,
T. Lääveri
4   Division of Infectious Diseases, Dept. of Medicine, Helsinki University Central Hospital, Helsinki, Finland
,
C. Nohr
5   Department of Development and Planning, Aalborg University, Aalborg, Denmark
,
A. M. Kanstrup
6   Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
,
M. Berg Christiansen
5   Department of Development and Planning, Aalborg University, Aalborg, Denmark
,
M.-H. Kuo
1   School of Health Information Science, University of Victoria, Victoria, Canada
,
E. Borycki
1   School of Health Information Science, University of Victoria, Victoria, Canada
› Institutsangaben
Weitere Informationen

Correspondence to:

Andre Kushniruk
School of Health Information Science
University of Victoria Victoria
Canada

Publikationsverlauf

15. August 2014

Publikationsdatum:
05. März 2018 (online)

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Summary

Objectives: The objective of this paper is to explore approaches to understanding the usability of health information systems at regional and national levels.

Methods: Several different methods are discussed in case studies from Denmark, Finland and Canada. They range from small scale qualitative studies involving usability testing of systems to larger scale national level questionnaire studies aimed at assessing the use and usability of health information systems by entire groups of health professionals.

Results: It was found that regional and national usability studies can complement smaller scale usability studies, and that they are needed in order to understand larger trends regarding system usability. Despite adoption of EHRs, many health professionals rate the usability of the systems as low. A range of usability issues have been noted when data is collected on a large scale through use of widely distributed questionnaires and websites designed to monitor user perceptions of usability.

Conclusion: As health information systems are deployed on a widespread basis, studies that examine systems used regionally or nationally are required. In addition, collection of large scale data on the usability of specific IT products is needed in order to complement smaller scale studies of specific systems.


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Keywords

Health informatics - human factors - usability - health information systems - evaluation

 


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  • References

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    PubMedSuche in Google Scholar
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    CrossrefPubMedSuche in Google Scholar
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    CrossrefPubMedSuche in Google Scholar
  • 23 Carvalho CJ, Borycki EM, Kushniruk A. Ensuring the safety of health information systems: Using heuristics for patient safety.. Healthc Q 2009; 12: 49-54.
    CrossrefPubMedSuche in Google Scholar
  • 24 Schumacher RM, Webb JM, Johnson KR. How to select an electronic health record system that healthcare professionals can use.. User centric, Inc.;; 2009. Available from: http://www.user-centric.com/sites/usercentric.com/files/usercentric-ehr-white-paper.pdf
    Suche in Google Scholar
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    PubMedSuche in Google Scholar
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    Suche in Google Scholar
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    PubMedSuche in Google Scholar
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    PubMedSuche in Google Scholar
  • 29 Davis LS. Problems facing large health information systems.. Proceedings of the Annual ACM Conference, 1973, Atlanta, USA. New York, NY, USA: ACM; 1973
    Suche in Google Scholar
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    CrossrefPubMedSuche in Google Scholar
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Correspondence to:

Andre Kushniruk
School of Health Information Science
University of Victoria Victoria
Canada

  • References

  • 1 Nielsen J. Usability engineering.. San Diego: Academic Press, Inc.; 1993
    Suche in Google Scholar
  • 2 Shackel B, Richardson S. editors. Human factors for informatics usability.. New York: Cambridge University Press; 1991
    Suche in Google Scholar
  • 3 Kushniruk AW, Patel V. Cognitive and usability engineering approaches to the evaluation of clinical information systems.. J Biomed Inform 2004; 37 (01) 56-76.
    CrossrefPubMedSuche in Google Scholar
  • 4 Beuscart-Zéphir MC, Pelayo S, Ancequx F, Meaux J, Degroisse M, Degoulet P. Impact of CPOE on doctor–nurse cooperation for the medication ordering and administration process.. Int J Med Inform 2005; 74 (07) 629-41.
    CrossrefPubMedSuche in Google Scholar
  • 5 Kaufman DR, Patel VL, Hiliman PC, Morin J, Pevzner RS, Weinstock RG. et al. Usability in the real world: assessing medical information technologies in patients’ homes.. J Biomed Inform 2003; 36 (01) 45-60.
    CrossrefPubMedSuche in Google Scholar
  • 6 Zhang J, Johnson TR, Patel VL, Paige DL, Kubose T. Using usability heuristics to evaluate patient safety of medical devices.. J Biomed Inform 2003; 36 (01) 23-30.
    CrossrefPubMedSuche in Google Scholar
  • 7 Kjeldskov J, Skov M, Stage J. Instant data analysis: Conducting usability evaluations in a day.. NordiCHI ’04, October 23-27, 2004. Tampere,; Finland;: 2004
    Suche in Google Scholar
  • 8 Kushniruk AW, Triola M, Borycki EM, Stein B, Kannry J. Technology induced error and usability: The relationship between usability problems and prescription errors when using a handheld application.. Int J Med Inform 2005; 74 7-8 519-26.
    CrossrefPubMedSuche in Google Scholar
  • 9 Winblad I, Reponen J, Hämäläinen P, Kangas M. Informaatio- ja kommunikaatioteknologian käyttö Suomen terveydenhuollossa vuonna 2007.. Tilanne ja kehityksen suunta. Stakesin raportteja 37/2008. [Health Care ICT and eHealth in Finland 2007. Status report and future trends. Reports 37/2008] Helsinki. 2008 http://www.stakes.fi/verkkojulkaisut/raportit/R37-2008-VERKKO.pdf. In Finnish.:
    PubMedSuche in Google Scholar
  • 10 Lääveri T, Virtanen A, Paajanen H, Ahtola H, Konki K. Potilaskertomusjärjestelmien käytettävyysselvitys osoitti: Lääkärien mielipiteitä ei ole kuunneltu.. [Study on Usability of Electronic Health Record Systems Shows: Physicians’ Opinions Have Been Ignored].. Finnish Medical Journal 6, 2008. additional part on Electronic health record systems,; 3-33. In Finnish.:
    Suche in Google Scholar
  • 11 Viitanen J, Hyppönen H, Lääveri T, Vänskä J, Reponen J, Winblad I. National questionnaire study on clinical ICT systems proofs: Physicians suffer from poor usability.. Int J Med Inform 2011; 80 (10) 708-25.
    CrossrefPubMedSuche in Google Scholar
  • 12 Hyppönen H, Faxvaag A, Gilstad H, Hardardottir G, Jerlvall L, Kangas M. et al. Nordic eHealth indicators.. Organization of research, first results and the plan for the future.; TemaNord: 2013. 522, http://dx.doi.org/10.6027/TN2013-522, Accessed 5.2.2014
    CrossrefSuche in Google Scholar
  • 13 Viitanen J, Nieminen M, Hyppönen H, Lääveri T. Finnish physicians’ experiences with computer-supported patient information exchange and communication in clinical work.. Int J Electron Healthc 2011; 6 2-4 153-73.
    CrossrefPubMedSuche in Google Scholar
  • 14 Martikainen S, Viitanen J, Korpela M, Lääveri T. Physicians’ experiences of participation in healthcare IT development: Willing but not able.. Int J Med Inform 2012; 81 (02) 98-113.
    CrossrefPubMedSuche in Google Scholar
  • 15 Act on the electronic processing of client data in social and health care services.. Available (in Finnish and Swedish) from http://plus.edilex.fi/kela/fi/lainsaadanto/20070159. Accessed 5.2. 2014
    PubMedSuche in Google Scholar
  • 16 Hyppönen H, Doupi P, Hämäläinen P, Komulainen J, Nykänen P, Suomi R. Towards a national health information system evaluation.. Stud Health Technol Inform 2010; 160 (02) 1216-20.
    PubMedSuche in Google Scholar
  • 17 Hyppönen H, Faxvaag A, Gilstad H, Hardardottir GA, Jerlvall L, Kangas M. et al. Nordic eHealth indicators: organization of research, first results and plan for the future.. Stud Health Technol Inform 2013; 192: 273-7.
    PubMedSuche in Google Scholar
  • 18 National Physician Survey,. 2010 Retrieved from: http:www.nationalphysiciansurvey.ca
    PubMedSuche in Google Scholar
  • 19 Kushniruk A, Owston R, Ho F, Pitts K, Wideman H, Brown C. et al. Design of the VULab: A quantitative and qualitative tool for analyzing use of on-line health information resources.. Proceedings of ITCH 2007 February 2007.
    PubMedSuche in Google Scholar
  • 20 Kushniruk AW, Patel C, Patel VL, Cimino JJ. “Tel-evaluation” of information systems: An integrative approach to design and evaluation of Web-based systems.. Int J Med Inform 2001; 61 (01) 45-70.
    CrossrefPubMedSuche in Google Scholar
  • 21 Felciano RM, Altman RB. Lamprey: Tracking users on the World Wide Web.. In: Proceedings of the 1996 AMIA Ann Fall Symposium;. 1996 p. 757-61.
    PubMedSuche in Google Scholar
  • 22 Kushniruk A, Beuscart-Zéphir MC, Grzes A, Borycki EM, Watbled L, Kannry J. Increasing the safety of healthcare information systems through improved procurement: Toward a framework for selection of safe healthcare systems.. Healthc Q 2010; 13: 53-8.
    CrossrefPubMedSuche in Google Scholar
  • 23 Carvalho CJ, Borycki EM, Kushniruk A. Ensuring the safety of health information systems: Using heuristics for patient safety.. Healthc Q 2009; 12: 49-54.
    CrossrefPubMedSuche in Google Scholar
  • 24 Schumacher RM, Webb JM, Johnson KR. How to select an electronic health record system that healthcare professionals can use.. User centric, Inc.;; 2009. Available from: http://www.user-centric.com/sites/usercentric.com/files/usercentric-ehr-white-paper.pdf
    Suche in Google Scholar
  • 25 Jokela T, Laine J, Nieminen M. Usability in RFP’s: The current practice and outline for the future.. Lecture notes in computer science; 2013; vol. 8005 p. 101-6. Available online from: http://link.springer.com/chapter/10.1007%2F978-3-642-39262-7_12.
    PubMedSuche in Google Scholar
  • 26 ISO 9241-11/ISO 9241. Ergonomic requirements for office work with visual display terminals, Part 11: Guidance on Usability.. Geneve:: International Organization for Standardization, Geneve;; 1998
    Suche in Google Scholar
  • 27 ISO 9241-210 International Standard:. Ergonomics of human-system interaction – Part 210: Human-centred Design for Interactive Systems.. First edition 2010-03-15, 2010 Reference number ISO 9241-210:2010(E).
    PubMedSuche in Google Scholar
  • 28 Hertzum M. Images of usability.. Int J Human-Comp Interact 2010; 26: 567-600.
    PubMedSuche in Google Scholar
  • 29 Davis LS. Problems facing large health information systems.. Proceedings of the Annual ACM Conference, 1973, Atlanta, USA. New York, NY, USA: ACM; 1973
    Suche in Google Scholar
  • 30 DeLone WH, McLean ER. TheDelone and McLean model of information systems success: A ten-year update.. Journal of Management Information Systems 2003; 19: 9-30.
    CrossrefPubMedSuche in Google Scholar
  • 31 Cooper A. Inmates are running the asylum: Why high-tech products drive us crazy and how to restore the sanity.. Sams Publishing;; 1998
    Suche in Google Scholar
  • 32 Fern X, Komireddy C, Grigoreanu V, Burnett M. Mining problem-solving strategies from HCI data.. Trans Comput Hum Interact; 2010. 17(1).
    Suche in Google Scholar
  • 33 Microsoft Health.. Common User Interface.. http://www.mscui.net Accessed May 4 2014
    PubMedSuche in Google Scholar

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