Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, United States.
Department of Child Health, University of Missouri, Columbia, Missouri, United States.
Appl Clin Inform. 2020 Aug;11(4):580-588. doi: 10.1055/s-0040-1715828. Epub 2020 Sep 9.
Improving the usability of electronic health records (EHR) continues to be a focus of clinicians, vendors, researchers, and regulatory bodies. To understand the impact of usability redesign of an existing, site-configurable feature, we evaluated the user interface (UI) used to screen for depression, alcohol and drug misuse, fall risk, and the existence of advance directive information in ambulatory settings.
As part of a quality improvement project, based on heuristic analysis, the existing UI was redesigned. Using an iterative, user-centered design process, several usability defects were corrected. Summative usability testing was performed as part of the product development and implementation cycle. Clinical quality measures reflecting rolling 12-month rates of screening were examined over 8 months prior to the implementation of the redesigned UI and 9 months after implementation.
Summative usability testing demonstrated improvements in task time, error rates, and System Usability Scale scores. Interrupted time series analysis demonstrated significant improvements in all screening rates after implementation of the redesigned UI compared with the original implementation.
User-centered redesign of an existing site-specific UI may lead to significant improvements in measures of usability and quality of patient care.
提高电子健康记录（EHR）的可用性仍然是临床医生、供应商、研究人员和监管机构关注的焦点。为了了解对现有、可现场配置功能的用户界面（UI）进行可用性重新设计的影响，我们评估了在门诊环境中用于筛选抑郁症、酒精和药物滥用、跌倒风险以及预先指示信息存在的 UI。
作为质量改进项目的一部分，根据启发式分析，对现有 UI 进行了重新设计。使用迭代的、以用户为中心的设计过程，纠正了几个可用性缺陷。总结性可用性测试是产品开发和实施周期的一部分。在实施重新设计的 UI 之前的 8 个月和之后的 9 个月，检查反映滚动 12 个月筛选率的临床质量指标。
总结性可用性测试表明，任务时间、错误率和系统可用性量表得分都有所提高。中断时间序列分析表明，与原始实施相比，实施重新设计的 UI 后，所有筛选率均有显著提高。
对现有特定于站点的 UI 进行以用户为中心的重新设计，可能会显著提高可用性和患者护理质量的衡量标准。
