University of Niš, Faculty of Electronic Engineering, Laboratory for Medical Informatics, Aleksandra Medvedeva 14, 18000 Niš, Serbia.
University of Nis, Faculty of Sciences and Mathematics, Department of Physics, P.O. Box 224, Višegradska 33, 18000 Niš, Serbia.
Int J Med Inform. 2018 Jul;115:80-91. doi: 10.1016/j.ijmedinf.2018.04.011. Epub 2018 Apr 27.
The primary objective of this paper is to identify the main factors which have an impact on the users' attitude towards the functionalities representing the perceived ease of use and to those representing the perceived usefulness. Another objective is to examine whether there occurred a shift towards the perceived usefulness of users' behavior over a period of time. To support these objectives, two different cases are examined - the case in which users are simultaneously offered basic and updated functionalities, and the one in which users are offered a completely new set of features. The results of this study are expected to exert a significant impact on a further development of new software components, as well as the updates of the existing ones.
As the starting point, there were employed the user behavior indicators defined in similar researches and conducted in the countries with a similar cultural background or with a comparatively similar national healthcare system. What ensued was an updated set of functionalities offered within the electronic health record based medical information system. Instead of the survey being posted, the effects of implanted updates were measured through the analysis of the collected data. The data collected in the Nis Primary and Ambulatory Care Center during a four-year period represented the material used in the research. The obtained records indicating the usage of the initial and updated visit registration form, as well as the usage of the new types of visits, were examined in relation to the technology acceptance model and integrated behavior model.
The response to the initial functionalities, perceived as easy to use, was high as expected since they kept the users in their "comfort zone". As regards the updated features, the ones corresponding to the perceived usefulness, the initial overall acceptance rate was 60%, while the overall increase of their acceptance was around 20%. The overall usage of the newly introduced features was doubled in some cases throughout the four-year period, while some of them were not accepted as expected.
Carefully designed additional functionalities, aimed to improve the most common daily activities, have a significant potential to be accepted by the medical professionals. The shift from the perceived ease of use to the perceived usefulness is not uniform, nor is its use in different departments or by the users of the same department. A higher acceptance rate was observed in the departments with more complex administrative procedures, as well as among the users having contacts with more patients and using the system for a longer period.
When accepting new features, medical professionals will initially choose the simpler ones with obvious benefits. If the usage of a feature triggers indirect benefits, the number of examined patients is of a crucial importance for the acceptance of that feature. In the event of the advanced functionality with an extended set of options competing with the simple functionality covering basic requirements, the latter will be used. A feature design, together with a proper training, system stability and ensuring utilization, represent a key point for increasing the positive impact that the information system can have in many application areas, including the healthcare.
本文的主要目的是确定影响用户对易用性感知功能和有用性感知功能的态度的主要因素。另一个目的是检验用户行为在一段时间内是否朝着有用性感知的方向转变。为了支持这些目标,我们检查了两种情况——一种是同时向用户提供基本功能和更新的功能,另一种是向用户提供全新的功能。这项研究的结果有望对新软件组件的进一步开发以及现有软件组件的更新产生重大影响。
作为起点,我们采用了在具有相似文化背景或具有相对相似国家医疗保健系统的国家进行的类似研究中定义的用户行为指标。接下来,我们在电子病历基础上提供了一套更新的功能医学信息系统。我们没有进行调查,而是通过分析收集的数据来衡量已实施更新的效果。我们在尼什初级和门诊护理中心收集了四年的数据,作为研究的材料。我们检查了记录在案的初始和更新访问登记表格的使用情况,以及新类型访问的使用情况,这些都与技术接受模型和综合行为模型有关。
最初的功能,用户认为它们很容易使用,所以响应很高,因为它们让用户感到舒适。至于那些与有用性感知相对应的更新功能,最初的整体接受率为 60%,而整体接受率的提高约为 20%。在四年的时间里,某些情况下新引入的功能的总体使用量翻了一番,但有些功能的接受情况并不如预期的那样。
精心设计的额外功能旨在改善最常见的日常活动,具有被医疗专业人员接受的巨大潜力。从易用性感知到有用性感知的转变并不统一,在不同部门或同一部门的用户中也不统一。在行政程序更复杂的部门,以及与更多患者接触并使用系统时间更长的用户中,接受率更高。
在接受新功能时,医疗专业人员最初会选择具有明显优势的简单功能。如果使用某个功能会带来间接的好处,那么被检查患者的数量对该功能的接受程度至关重要。在具有扩展选项的高级功能与满足基本需求的简单功能竞争时,后者将被使用。功能设计、适当的培训、系统稳定性和利用率是提高信息系统在许多应用领域(包括医疗保健)的积极影响的关键。