Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service, Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, United States.
School of Industrial Engineering, Purdue University, West Lafayette, Indiana, United States.
Appl Clin Inform. 2018 Apr;9(2):467-477. doi: 10.1055/s-0038-1660521. Epub 2018 Jun 27.
Web-based patient portals feature secure messaging systems that enable health care providers and patients to communicate information. However, little is known about the usability of these systems for clinical document sharing.
This article evaluates the usability of a secure messaging system for providers and patients in terms of its ability to support sharing of electronic clinical documents.
We conducted usability testing with providers and patients in a human-computer interaction laboratory at a Midwestern U.S. hospital. Providers sent a medication list document to a fictitious patient via secure messaging. Separately, patients retrieved the clinical document from a secure message and returned it to a fictitious provider. We collected use errors, task completion, task time, and satisfaction.
Twenty-nine individuals participated: 19 providers (6 physicians, 6 registered nurses, and 7 pharmacists) and 10 patients. Among providers, 11 (58%) attached and sent the clinical document via secure messaging without requiring assistance, in a median (range) of 4.5 (1.8-12.7) minutes. No patients completed tasks without moderator assistance. Patients accessed the secure messaging system within 3.6 (1.2-15.0) minutes; retrieved the clinical document within 0.8 (0.5-5.7) minutes; and sent the attached clinical document in 6.3 (1.5-18.1) minutes. Although median satisfaction ratings were high, with 5.8 for providers and 6.0 for patients (scale, 0-7), we identified 36 different use errors. Physicians and pharmacists requested additional features to support care coordination via health information technology, while nurses requested features to support efficiency for their tasks.
This study examined the usability of clinical document sharing, a key feature of many secure messaging systems. Our results highlight similarities and differences between provider and patient end-user groups, which can inform secure messaging design to improve learnability and efficiency. The observations suggest recommendations for improving the technical aspects of secure messaging for clinical document sharing.
基于网络的患者门户具有安全消息传递系统，使医疗保健提供者和患者能够交流信息。然而，对于这些系统在临床文档共享方面的可用性知之甚少。
本文评估了一种安全消息传递系统对于提供者和患者在支持电子临床文档共享方面的可用性。
我们在美国中西部一家医院的人机交互实验室中对提供者和患者进行了可用性测试。提供者通过安全消息向虚构患者发送药物清单文档。另外，患者从安全消息中检索临床文档并将其返回给虚构提供者。我们收集了使用错误、任务完成情况、任务时间和满意度。
共有 29 人参与：19 名提供者（6 名医生、6 名注册护士和 7 名药剂师）和 10 名患者。在提供者中，有 11 人（58%）在没有要求帮助的情况下通过安全消息附加并发送了临床文档，中位数（范围）为 4.5（1.8-12.7）分钟。没有患者在没有主持人帮助的情况下完成任务。患者在 3.6（1.2-15.0）分钟内访问安全消息系统；在 0.8（0.5-5.7）分钟内检索临床文档；并在 6.3（1.5-18.1）分钟内发送附加的临床文档。尽管提供者的中位数满意度评分为 5.8，患者的满意度评分为 6.0（评分范围为 0-7），但我们发现了 36 个不同的使用错误。医生和药剂师要求通过健康信息技术提供额外功能以支持护理协调，而护士则要求提供支持其任务效率的功能。
本研究检查了临床文档共享的可用性，这是许多安全消息传递系统的关键功能。我们的结果突出了提供者和患者最终用户群体之间的相似之处和差异，这可以为安全消息传递设计提供信息，以提高可学习性和效率。这些观察结果为改善安全消息传递用于临床文档共享的技术方面提出了建议。
