评估使用商业电子健康记录的语音识别创建临床文档的可用性。

Evaluating the usability of speech recognition to create clinical documentation using a commercial electronic health record.

机构信息

Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, L6 75 Talavera Rd, North Ryde, NSW 2109, Australia.

出版信息

Int J Med Inform. 2018 May;113:38-42. doi: 10.1016/j.ijmedinf.2018.02.011. Epub 2018 Feb 21.

DOI:10.1016/j.ijmedinf.2018.02.011

PMID:29602431

Abstract

OBJECTIVE

To conduct a usability study exploring the value of using speech recognition (SR) for clinical documentation tasks within an electronic health record (EHR) system.

METHODS

Thirty-five emergency department clinicians completed a system usability scale (SUS) questionnaire. The study was undertaken after participants undertook randomly allocated clinical documentation tasks using keyboard and mouse (KBM) or SR. SUS scores were analyzed and the results with KBM were compared to SR results.

RESULTS

Significant difference in SUS scores between EHR system use with and without SR were observed (KBM 67, SR 61; P = 0.045; CI, 0.1 to 12.0). Nineteen of 35 participants scored higher for EHR with KBM, 11 higher for EHR with SR and 5 gave the same score for both. Factor analysis showed no significant difference in scores for the sub-element of usability (EHR with KBM 65, EHR with SR 62; P = 0.255; CI, -2.6 to 9.5). Scores for the sub-element of learnability were significantly different (KBM 72, SR 55; P < 0.001; CI, 9.8 to 23.5). A significant correlation was found between the perceived usability of the two system configurations (EHR with KBM or SR) and the efficiency of documentation (time to document) (P = 0.002; CI, 10.5 to -0.1) but not with safety (number of errors) (P = 0.90; CI, -2.3 to 2.6).

DISCUSSION

SR was associated with significantly reduced overall usability scores, even though it is often positioned as ease of use technology. SR was perceived to impose larger costs in terms of learnability via training and support requirements for EHR based documentation when compared to using KBM. Lower usability scores were significantly associated with longer documentation times.

CONCLUSION

The usability of EHR systems with any input modality is an area that requires continued development. The addition of an SR component to an EHR system may cause a significant reduction in terms of perceived usability by clinicians.

摘要

目的

开展一项可用性研究，探索在电子健康记录（EHR）系统中使用语音识别（SR）进行临床文档记录任务的价值。

方法

35 名急诊临床医生完成了系统可用性量表（SUS）问卷。在参与者使用键盘和鼠标（KBM）或 SR 随机分配临床文档记录任务后，进行了这项研究。分析了 SUS 评分，并将 KBM 结果与 SR 结果进行了比较。

结果

在使用 EHR 系统时，使用和不使用 SR 的 SUS 评分存在显著差异（KBM 为 67，SR 为 61；P=0.045；CI，0.1 至 12.0）。35 名参与者中有 19 名认为 KBM 与 EHR 配合使用时的 EHR 评分更高，11 名认为 SR 与 EHR 配合使用时的 EHR 评分更高，5 名认为两者的评分相同。因子分析显示，可用性子元素的评分无显著差异（KBM 为 65，SR 为 62；P=0.255；CI，-2.6 至 9.5）。可学习性子元素的评分有显著差异（KBM 为 72，SR 为 55；P<0.001；CI，9.8 至 23.5）。两个系统配置（使用 KBM 或 SR 的 EHR）的感知可用性与文档记录的效率（记录时间）之间存在显著相关性（P=0.002；CI，10.5 至-0.1），但与安全性（错误数量）无关（P=0.90；CI，-2.3 至 2.6）。