Subscribe to RSS
DOI: 10.4338/ACI-2014-08-RA-0067
User-Centered Design and Usability Testing of an Innovative Health-Related Quality of Life Module
Correspondence to:
Publication History
received:
09 September 2014
accepted:
18 November 2014
Publication Date:
19 December 2017 (online)
Summary
Objectives: Various computerized health risk appraisals (HRAs) are available, but few of them assess health-related quality of life (HRQoL) in a goal-directed framework. This study describes the user-centered development and usability testing of an innovative HRQoL module that extends a validated HRA tool in primary care settings.
Methods: Systematic user-centered design, usability testing, and qualitative methods were used to develop the HRQoL module in primary care practices. Twenty two patients and 5 clinicians participated in two rounds of interactive technology think-out-loud sessions (TOLs) and semi-structured interviews (SSIs) to iteratively develop a four-step, computerized process that collects information on patient goals for meaningful life activities and current level of disability and presents a personalized and prioritized list of preventive recommendations linked to online resources.
Results: Analysis of TOLs and SSIs generated 5 categories and 11 sub-categories related to facilitators and barriers to usability and human-technology interaction. The categories included: Understanding the Purpose, Usability, Perceived Value, Literacy, and Participant Motivation. Some categories were inter-connected. The technology was continually and iteratively improved between sessions until saturation of positive feedback was achieved in 4 categories (addressing motivation will require more research). Usability of all screen units of the module was improved substantially. Clinician feedback emphasized the importance of the module’s ability to translate the patient-centered HRQoL Report into actionable items for clinicians to facilitate shared decision-making. Complete integration of the HRQoL module into the existing HRA will require further development and testing.
Conclusions: Systematic application of user-centered design and human factors principles in technology development and testing may significantly improve the usability and clinical value of health information systems. This more sophisticated approach helped us translate complex clinical concepts, goal-setting steps, and decision-support processes into an accepted and value-added technology.
Citation: Nagykaldi ZJ; Jordan M; Quitoriano J; Ciro CA; Mold JW. User-centered design and usability testing of an innovative health-related quality of life module. Appl Clin Inf 2014; 5: 958–970
http://dx.doi.org/10.4338/ACI-2014-08-RA-0067
#
Keywords
Health risk appraisal - user-centered design - quality of life - goal-directed care - prioritization
#
Conflict of Interest Statement
The authors report no conflicts of interest in the presented research.
-
References
- 1 Annual Wellness Visit (AWV), Including Personalized Prevention Plan Services (PPPS). MLN Matters – Centers for Medicare and Medicaid Services. Accessed at: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM7079.pdf Last Updated: March 27, 2013. Access date: 8/26/2014. 8/26/2014].
- 2 Interim Guidance for Health Risk Assessments and their Modes of Provision for Medicare Beneficiaries. Centers for Medicare and Medicaid Services. Accessed at: https://www.cms.gov/Medicare/Coverage/CoverageGenInfo/downloads/healthriskassessmentsCDCfinal.pdf Publication date: March 23, 2011. Access date: 8/26/2014.
- 3 Rubenstein L. et al. Health Risk Appraisals and Medicare, 2003, US Department of Health and Human Services. Health Care Financing Administration; Baltimore:
- 4 Cyrus Baghelai MS. et al. Health Risk Appraisals in Primary Care: Current Knowledge and Potential Applications To Improve Preventive Services and Chronic Care. 2010 AHRQ Center for Primary Care, Prevention, and Clinical Partnerships: Rockville, MD.
- 5 Nagykaldi ZJ. et al. Novel computerized health risk appraisal may improve longitudinal health and wellness in primary care: a pilot study. Appl Clin Inform 2013; 4 (01) 75-87.
- 6 Academy Remedies CMS’ Lack of Guidance on Health Risk Assessment Requirement. American Academy of Family Physicians. Accessed at: http://www.aafp.org/news/practice-professional-issues/20120215healthriskassessment.html Publication date: February 15, 2012. Access date: 8/26/2014.
- 7 Nagykaldi Z. et al. Impact of a Wellness Portal on the delivery of patient-centered preventive care. J Am Board Fam Med 2012; 25 (02) 158-167.
- 8 International Classification of Functioning, Disability and Health (ICF). World Health Organization. Accessed at: http://www.who.int/classifications/icf/en Last Updated: January 10, 2014. Access Date: 8/26/2014.
- 9 Lewis CH. Using the „Thinking Aloud“ Method In Cognitive Interface Design (Technical report), in IBM. RC-92651982.
- 10 Creswell JW. Qualitative Inquiry and Research Design –Choosing Among Five Approaches. Third ed, 2012. SAGE Publications Inc.;
- 11 Furukawa MF. et al. Despite Substantial Progress In EHR Adoption, Health Information Exchange And Patient Engagement Remain Low In Office Settings. Health Aff (Millwood), 2014
- 12 O’Malley AS. et al. Are electronic medical records helpful for care coordination? Experiences of physician practices. J Gen Intern Med 2010; 25 (03) 177-185.
- 13 Lau F. et al. Impact of electronic medical record on physician practice in office settings: a systematic review. BMC Med Inform Decis Mak 2012; 12: 10.
- 14 Krist AH. et al. Electronic health record functionality needed to better support primary care. J Am Med Inform Assoc 2014; 21 (05) 764-771.
- 15 National Research Council. Defining Primary Care: An Interim Report. Washington, DC: 1994
- 16 Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly 1989; 13 (03) 319-340.
Correspondence to:
-
References
- 1 Annual Wellness Visit (AWV), Including Personalized Prevention Plan Services (PPPS). MLN Matters – Centers for Medicare and Medicaid Services. Accessed at: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM7079.pdf Last Updated: March 27, 2013. Access date: 8/26/2014. 8/26/2014].
- 2 Interim Guidance for Health Risk Assessments and their Modes of Provision for Medicare Beneficiaries. Centers for Medicare and Medicaid Services. Accessed at: https://www.cms.gov/Medicare/Coverage/CoverageGenInfo/downloads/healthriskassessmentsCDCfinal.pdf Publication date: March 23, 2011. Access date: 8/26/2014.
- 3 Rubenstein L. et al. Health Risk Appraisals and Medicare, 2003, US Department of Health and Human Services. Health Care Financing Administration; Baltimore:
- 4 Cyrus Baghelai MS. et al. Health Risk Appraisals in Primary Care: Current Knowledge and Potential Applications To Improve Preventive Services and Chronic Care. 2010 AHRQ Center for Primary Care, Prevention, and Clinical Partnerships: Rockville, MD.
- 5 Nagykaldi ZJ. et al. Novel computerized health risk appraisal may improve longitudinal health and wellness in primary care: a pilot study. Appl Clin Inform 2013; 4 (01) 75-87.
- 6 Academy Remedies CMS’ Lack of Guidance on Health Risk Assessment Requirement. American Academy of Family Physicians. Accessed at: http://www.aafp.org/news/practice-professional-issues/20120215healthriskassessment.html Publication date: February 15, 2012. Access date: 8/26/2014.
- 7 Nagykaldi Z. et al. Impact of a Wellness Portal on the delivery of patient-centered preventive care. J Am Board Fam Med 2012; 25 (02) 158-167.
- 8 International Classification of Functioning, Disability and Health (ICF). World Health Organization. Accessed at: http://www.who.int/classifications/icf/en Last Updated: January 10, 2014. Access Date: 8/26/2014.
- 9 Lewis CH. Using the „Thinking Aloud“ Method In Cognitive Interface Design (Technical report), in IBM. RC-92651982.
- 10 Creswell JW. Qualitative Inquiry and Research Design –Choosing Among Five Approaches. Third ed, 2012. SAGE Publications Inc.;
- 11 Furukawa MF. et al. Despite Substantial Progress In EHR Adoption, Health Information Exchange And Patient Engagement Remain Low In Office Settings. Health Aff (Millwood), 2014
- 12 O’Malley AS. et al. Are electronic medical records helpful for care coordination? Experiences of physician practices. J Gen Intern Med 2010; 25 (03) 177-185.
- 13 Lau F. et al. Impact of electronic medical record on physician practice in office settings: a systematic review. BMC Med Inform Decis Mak 2012; 12: 10.
- 14 Krist AH. et al. Electronic health record functionality needed to better support primary care. J Am Med Inform Assoc 2014; 21 (05) 764-771.
- 15 National Research Council. Defining Primary Care: An Interim Report. Washington, DC: 1994
- 16 Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly 1989; 13 (03) 319-340.