Abstract
To increase the quality of the health care services and, at the same time, to control their costs, the use of Electronic Health Records (EHR) has substantially increased during the last years. Usability of EHR systems is a key factor to increase their efficiency. The SClínico is an EHR system widely used in public hospitals and primary care centres of the Portuguese National Health Service and the present article reports the assessment of its usability. This usability assessment consisted in three stages: in the first stage, an exploratory assessment was carried out, while in the second stage a quantitative assessment was performed using a validated usability assessment instrument, and, finally, in the third stage a focus group involving clinicians and usability experts was conducted. The results showed that SClínico presents important usability issues and, therefore, recommendations are suggested to overcome the identified issues.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
SPMS: Serviços Partilhados do Ministério da Saúde - SPMS - SClinico Hospitalar. http://spms.min-saude.pt/product/sclinicohospitalar/. Accessed 17 July 2017
SPMS: Serviços Partilhados do Ministério da Saúde - SPMS - SClinico Cuidados Primários. http://spms.min-saude.pt/product/sclinicocsp/. Accessed 17 July 2017
Zahabi, M., Kaber, D.B., Swangnetr, M.: Usability and safety in electronic medical records interface design: a review of recent literature and guideline formulation. Hum. Factors 57, 805–834 (2015). https://doi.org/10.1177/0018720815576827
Bhutkar, G., Konkani, A., Katre, D., Ray, G.G.: A review: healthcare usability evaluation methods. Biomed. Instrum. Technol. Suppl. 45–53 (2013). https://doi.org/10.2345/0899-8205-47.s2.45
Pavão, J., et al.: SClinico: usability study. In: Proceedings of the 11th International Joint Conference on Biomedical Engineering Systems and Technologies, pp. 48–56. SCITEPRESS - Science and Technology Publications (2018)
Rouleau, G., Gagnon, M.-P., Côté, J.: Impacts of information and communication technologies on nursing care: an overview of systematic reviews (protocol). Syst Rev. 4, 75 (2015). https://doi.org/10.1186/s13643-015-0062-y
Furukawa, M.F., King, J., Patel, V., Hsiao, C.-J., Adler-Milstein, J., Jha, A.K.: Despite substantial progress in EHR adoption, health information exchange and patient engagement remain low in office settings. Health Aff. 33, 1672–1679 (2014). https://doi.org/10.1377/hlthaff.2014.0445
Marin, H.D.F.: Sistemas de informação em saúde: considerações gerais. J. Health Inform. 2, 20–24 (2010). https://doi.org/10.1590/S0102-311X2012000800014
Marquié, J.-C.C., Tucker, P., Folkard, S., Gentil, C., Ansiau, D.: Chronic effects of shift work on cognition: findings from the VISAT longitudinal study. Occup Env. Med. 72, 258–264 (2015). https://doi.org/10.1136/oemed-2013-101993
Mair, F.S., May, C., O’Donnell, C., Finch, T., Sullivan, F., Murray, E.: Factors that promote or inhibit the implementation of e-health systems: an explanatory systematic review. Bull. World Health Organ. 90, 357–364 (2012). https://doi.org/10.2471/BLT.11.099424
Kruse, C.S., Kothman, K., Anerobi, K., Abanaka, L.: Adoption factors of the electronic health record: a systematic review. JMIR Med. Inform. 4, e19 (2016). https://doi.org/10.2196/medinform.5525
Kruse, C.S., Kristof, C., Jones, B., Mitchell, E., Martinez, A.: Barriers to electronic health record adoption: a systematic literature review. J. Med. Syst. 40, 252 (2016). https://doi.org/10.1007/s10916-016-0628-9
Adler-Milstein, J., Holmgren, A.J., Kralovec, P., Worzala, C., Searcy, T., Patel, V.: Electronic health record adoption in US hospitals: the emergence of a digital “advanced use” divide. J. Am. Med. Inform. Assoc. 24, 1142–1148 (2017). https://doi.org/10.1093/jamia/ocx080
ISO/IEC 9241-14: ISO/IEC 9241-14: 1998 (E) Ergonomic requirements for office work with visual display terminals (VDT)s – Part 14 Menu dialogue (1998). https://www.iso.org/obp/ui/#iso:std:16886:en
American Medical Association: Improving Care: Priorities to Improve Electronic Health Record Usability (2014)
Feng, R.-C., Chang, P.: Usability of the clinical care classification system for representing nursing practice according to specialty. Comput. Inform. Nurs. 33, 448–455 (2015)
Villa, L.B., Cabezas, I.: A review on usability features for designing electronic health records. In: 2014 IEEE 16th International Conference on e-Health Networking, Applications and Services, HealthCom 2014, pp. 49–54 (2015)
Choi, M., Lee, H.S., Park, J.H.: Usability of academic electronic medical record application for nursing students’ clinical practicum. Health Inf. Res. 21, 191–195 (2015). https://doi.org/10.4258/hir.2015.21.3.191
Czaja, S.J., Zarcadoolas, C., Vaughon, W.L., Lee, C.C., Rockoff, M.L., Levy, J.: The usability of electronic personal health record systems for an underserved adult population. Hum. Factors 57, 491–506 (2015). https://doi.org/10.1177/0018720814549238
Clarke, M.A., Belden, J.L., Kim, M.S.: Determining differences in user performance between expert and novice primary care doctors when using an electronic health record (EHR). J Eval Clin Pr. 20, 1153–1161 (2014). https://doi.org/10.1111/jep.12277
Johnston, D., Crowle, P.K.: EHR usability toolkit: a background report on usability and electronic health records. Agency for Healthcare Research and Quality, Rockville (2011)
Zhang, J., Walji, M. (eds.): Better EHR: Usability, Workflow and Cognitive Support in Electronic Health Records. National Center for Cognitive Informatics & Decision Making in Healthcare (2014). ISBN: 978-0-692-26296-2
Saitwal, H., Feng, X., Walji, M., Patel, V., Zhang, J.: Assessing performance of an electronic health record (EHR) using cognitive task analysis. Int J Med Inf. 79, 501–506 (2010). https://doi.org/10.1016/j.ijmedinf.2010.04.001
Edwards, P.J., Moloney, K.P., Jacko, J.A., Sainfort, F.: Evaluating usability of a commercial electronic health record: a case study. Int. J. Hum Comput Stud. 66, 718–728 (2008). https://doi.org/10.1016/j.ijhcs.2008.06.002
Middleton, B., et al.: Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA. J. Am. Med. Inform. Assoc. 20, e2–e8 (2013). https://doi.org/10.1136/amiajnl-2012-001458
Lowry, S.Z., et al.: Technical Evaluation, Testing, and Validation of the Usability of Electronic Health Records (2012)
Martins, A.I.., Queirós, A.., Silva, A.G.., Rocha, N.P.: Usability evaluation methods: a systematic review. In: Human Factors in Software Development and Design, pp. 250–273 (2014)
Rosa, A., Martins, A., Costa, V., Queiros, A., Silva, A., Rocha, N.: European Portuguese validation of the post-study system usability questionnaire (PSSUQ). In: 2015 10th Iberian Conference on Information Systems and Technologies (CISTI), pp. 1–5 (2015)
Lewis, J.: Psychometric evaluation of the PSSUQ using data from five years of usability studies. Int. J. Hum. Comput. Interact. 14, 463–488 (2002). https://doi.org/10.1207/S15327590IJHC143&4_11
Covêlo, M.: Interface para Aplicação Informática de Suporte Clínico em Ambiente Hospitalar (2016). http://hdl.handle.net/10348/5694
Wilkinson, S.: A practical guide to research methods. In: Smith, J. (ed.) Qualitative Psychology: A Practical Guide to Research Methods. SAGE Publications (2003)
Caplan, S.: Using focus group methodology for ergonomic design. Ergonomics 33, 527–533 (1990). https://doi.org/10.1080/00140139008927160
World Medical Association: Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects (2013)
International Epidemiological Association: Good Epidemiological Practice (GEP). IEA Guidelines for Proper Conduct in Epidemiologic Research. http://ieaweb.org/good-epidemiological-practice-gep/. Accessed 13 June 2018
Pavão, J., et al.: Usability study of SClinico. In: 2016 11th Iberian Conference on Information Systems and Technologies (CISTI), pp. 1–6 (2016)
Yan, R.: Icon design study in computer interface. Procedia Eng. 15, 3134–3138 (2011). https://doi.org/10.1016/J.PROENG.2011.08.588
Elam, K.: Grid Systems: Principles of Organizing Type. Princeton Architectural Press, New York (2004)
Lupton, E., Phillips, J.C.: Graphic Design: The New Basics. Princeton Architectural Press, New York (2008)
Hansen, D., Shneiderman, B., Smith, M.A.: Analyzing Social Media Networks with NodeXL: Insights from a Connected World (2010)
Behler, R.: Military Healthcare System (MHS) GENESIS Initial Operational test and Evaluation (IOT&E) Report (2018). https://www.nextgov.com/media/gbc/docs/pdfs_edit/051118letterng.pdf. Accessed 17 July 2018
Acknowledgments
The authors thank the administration board of CHTMAD for all the support provided, as well as all the clinicians of this hospital center who have accepted to participate in the study reported in this article.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this paper
Cite this paper
Pavão, J. et al. (2019). Considerations on the Usability of SClínico. In: Cliquet Jr., A., et al. Biomedical Engineering Systems and Technologies. BIOSTEC 2018. Communications in Computer and Information Science, vol 1024. Springer, Cham. https://doi.org/10.1007/978-3-030-29196-9_14
Download citation
DOI: https://doi.org/10.1007/978-3-030-29196-9_14
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-29195-2
Online ISBN: 978-3-030-29196-9
eBook Packages: Computer ScienceComputer Science (R0)