Skip to main content
Log in

Developing a user-friendly interface for a self-service healthcare research portal: cost-effective usability testing

  • Original Article
  • Published:
Health Systems

Abstract

Usability is a critical but often overlooked factor in the design and development of healthcare information technology systems. One system increasingly being leveraged as a research and quality improvement tool is an online research portal that allows self-service access to electronic health record (EHR) data. We discuss the usability testing of such a portal through a low-cost usability inspection method: heuristic evaluation. Using heuristic evaluation methods, we identified 20 usability errors: 15.0% (3/20) were cosmetic, 35.0% (7/20) were minor, 40.0% (8/20) were major, and 10.0% (2/20) were catastrophic. Our heuristic evaluation demonstrates an affordable and efficient method to identify and correct a significant number of problems, thus improving the system using limited effort and resources. A user-friendly environment that follows accepted heuristics for good interface design is essential for ensuring accessibility and usability of data extracted from EHRs for quality improvement and research projects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  • Ash JS, Gorman PN, Seshadri V and Hersh WR (2004) Computerized physician order entry in U.S. hospitals: results of a 2002 survey. Journal of the American Medical Informatics Association 11 (2), 95–99.

    Article  Google Scholar 

  • Association for the Advancement of Medical Instrumentation (2010) Human Factors Engineering – Design of Medical Devices. Association for the Advancement of Medical Instrumentation, Arlington, VA.

  • Bates DW and Gawande AA (2003) Improving safety with information technology. New England Journal of Medicine 348 (25), 2526–2534.

    Article  Google Scholar 

  • Beuscart-Zephir MC, Pelayo S, Anceaux F, Maxwell D and Guerlinger S (2007) Cognitive analysis of physicians and nurses cooperation in the medication ordering and administration process. International Journal of Medical Informatics 76 (Suppl 1), S65–77.

    Article  Google Scholar 

  • Chan J, Shojania KG, Easty AC and Etchells EE (2011) Does user-centred design affect the efficiency, usability and safety of CPOE order sets? Journal of the American Medical Informatics Association 18 (3), 276–281.

    Article  Google Scholar 

  • Choi J and Bakken S (2010) Web-based education for low-literate parents in Neonatal Intensive Care Unit: development of a website and heuristic evaluation and usability testing. International Journal of Medical Informatics 79 (8), 565–575.

    Article  Google Scholar 

  • Chute CG, Beck SA, Fisk TB and Mohr DN (2010) The Enterprise Data Trust at Mayo Clinic: a semantically integrated warehouse of biomedical data. Journal of the American Medical Informatics Association 17 (2), 131–135.

    Article  Google Scholar 

  • Cockton G, Lavery D and Woolrych A (2003) Inspection-based evaluations. In The Human-Computer Interaction Handbook. Fundamentals, Evolving, Technologies and Emerging Applications (Jacko JA and Sears A, Eds, Lawrence Erlbaum Associates, Mahwah, NJ.

    Google Scholar 

  • Edwards PJ, Moloney KP and Jacko JA (2008) Evaluating usability of a commercial electronic health record: a case study. The International Journal of Human-Computer Studies 66 (10), 718–728.

    Article  Google Scholar 

  • Flanagan JC (1954) The critical incident technique. Psychological Bulletin 51 (4), 327.

    Article  Google Scholar 

  • Folmer E and Bosch J (2002) Architecting for usability: A survey. The Journal of Systems and Software 70 (1–2), 61–78.

    Google Scholar 

  • Gerhardt-Powels J (1996) Cognitive engineering principles for enhancing human-computer performance. International Journal of Human–Computer Interaction 8 (2), 189–211.

    Article  Google Scholar 

  • Graham MJ, Kubose TK, Jordan D, Zhang J, Johnson TR and Patel VL (2004) Heuristic evaluation of infusion pumps: implications for patient safety in intensive care units. International Journal of Medical Informatics 73 (11–12), 771–779.

    Article  Google Scholar 

  • Horvath MM, Winfield S, Evans S, Slopek S, Shang H and Ferranti J (2011) The DEDUCE guided query tool: providing simplified access to clinical data for research and quality improvement. Journal of Biomedical Informatics 44 (2), 266–276.

    Article  Google Scholar 

  • Hvannberg ET, Law EL and Larusdottir MK (2006) Heuristic evaluation: comparing ways of finding and reporting usability problems. Interacting with Computers 19 (2), 225–240.

    Article  Google Scholar 

  • Institute of Medicine Roundtable on Evidence-Based Medicine (2007) The National Academies Collection: reports funded by National Institutes of Health. In The Learning Healthcare System: Workshop Summary (Olsen, LA, Aisner, D and McGinnis, JM, Eds) National Academies Press (US), National Academy of Sciences, Washington DC.

  • Johnson CM, Johnson TR and Zhang J (2005) A user-centered framework for redesigning health care interfaces. Journal of Biomedical Informatics 38 (1), 75–87.

    Article  Google Scholar 

  • Johnson CM et al (2011) EHR Usability Toolkit: A Background Report on Usability and Electronic Health Records. Agency for Healthcare Research and Quality, Rockville, MD.

    Google Scholar 

  • Kirwan B and Ainsworth LK (1992) A Guide to Task Analysis. Taylor & Francis, Inc., Philadelphia.

    Book  Google Scholar 

  • Karahoca A, Bayraktar E, Tatoglu E and Karahoca D (2010) Information system design for a hospital emergency department: a usability analysis of software prototypes. Journal of Biomedical Informatics 43 (2), 224–232.

    Article  Google Scholar 

  • Kramer AF, Sirevaag EJ and Braune R (1987) A psychophysiological assessment of operator workload during simulated flight missions. Human Factors 29 (2), 145–160.

    Google Scholar 

  • Lowry SZ et al (2012) Technical evaluation, testing, and validation of the usability of electronic health records. National Institute of Standards and Technology, http://www.nist.gov/healthcare/usability/upload/EUP_WERB_Version_2_23_12-Final-2.pdf.

  • McDonald CJ (1997) The barriers to electronic medical record systems and how to overcome them. Journal of the American Medical Informatics Association 4 (3), 213–221.

    Article  Google Scholar 

  • Mirel BR, Wright Z, Tenenbaum JD, Saxman P and Smith KA (2010) User requirements for exploring a resource inventory for clinical research. AMIA Summits on Translational Science Proceedings, pp 31–35.

  • Newman WM (1998) On simulation, measurement, and piecewise usability evaluation. Human–Computer Interaction 13 (3), 316–323.

    Google Scholar 

  • Nielsen J (1993) Usability Engineering. Academic Press, Boston.

    Google Scholar 

  • Polson PG, Lewis C, Rietman J and Wharton C (1992) Cognitive walkthroughs: a method for theory-based evaluation of user interfaces. International Journal of Man-Machine Studies 35 (5), 741–773.

    Article  Google Scholar 

  • Polson P and Lewis CH (1990) Theory-based design for easily learned interfaces. Human–Computer Interaction 5 (2), 191–220.

    Article  Google Scholar 

  • Roden DM et al (2008) Development of a large-scale de-identified DNA biobank to enable personalized medicine. Clinical Pharmacology & Therapeutics 84 (3), 362–369.

    Article  Google Scholar 

  • Rosenbloom ST et al (2005) Effect of CPOE user interface design on user-initiated access to educational and patient information during clinical care. Journal of the American Medical Informatics Association 12 (4), 458–473.

    Article  Google Scholar 

  • Schneiderman B and Plaisant C (2010) Designing the User Interface. Strategies for Effecting Human Computer Interaction, 5th edn, Addison Wesley Longman, Inc., Boston.

    Google Scholar 

  • Shachak A, Hadas-Dayagi M, Ziv A and Reis S (2009) Primary care physicians’ use of an electronic medical record system: a cognitive task analysis. Journal of General Internal Medicine 24 (3), 341–348.

    Article  Google Scholar 

  • Sittig DF, Krall M, Kaalaas-Sittig J and Ash JS (2005) Emotional aspects of computer-based provider order entry: a qualitative study. Journal of the American Medical Informatics Association 12 (5), 561–567.

    Article  Google Scholar 

  • Sox CM, Gribbon WM, Loring BA, Mandl KD, Batista R and Porter SC (2010) Patient-centered design of an information management module for a personally controlled health record. Journal of Medical Internet Research 12 (3), e36.

    Article  Google Scholar 

  • Tang PC and Patel VL (1994) Major issues in user interface design for health professional workstations: summary and recommendations. Interntional Journal of Biomedical Computing 34 (1–4), 139–148.

    Article  Google Scholar 

  • Thyvalikakath TP, Monaco V, Thambuganipalle H and Schleyer T (2009) Comparative study of heuristic evaluation and usability testing methods. Studies in Health Technology and Informatics 143, 322–327.

    Google Scholar 

  • West R and Lehman KR (2006) Automated summative usability studies: an empirical evaluation. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, Montreal, CA.

  • Zhang J, Johnson TR, Patel VL, Paige DL and Kubose T (2003) Using usability heuristics to evaluate patient safety of medical devices. Journal of Biomedical Informatics 36 (1–2), 23–30.

    Article  Google Scholar 

  • Zhang J and Walji MF (2011) TURF: toward a unified framework of EHR usability. Journal of Biomedical Informatics 44 (6), 1056–1067.

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank Shelley Rusincovitch and the Duke Health Technology Solutions Management Team for their help and support. This publication was made possible by Grant Number UL1RR024128 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NCRR or Duke University.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ryan J Shaw.

Additional information

Disclaimer: None of the authors has any conflicts of interest to declare.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shaw, R., Horvath, M., Leonard, D. et al. Developing a user-friendly interface for a self-service healthcare research portal: cost-effective usability testing. Health Syst 4, 151–158 (2015). https://doi.org/10.1057/hs.2014.26

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1057/hs.2014.26

Keywords

Navigation