Usability of Healthcare Information Technology: Barrier to the Exchange of Health Information in the Two-Sided E-Health Market?

Abstract Health information technology promises to modernize and streamline healthcare and to connect up different users and stakeholders in the e-health market. Systems such as electronic health records, decision support systems and personal health records are promising and are becoming widely deployed worldwide. However, in addition to successes there have been a growing number of failed projects and a range of issues have been identified, many related to the adoption and usability of systems in this complex domain. This chapter discusses the importance of understanding user needs and human-computer interaction in designing effective systems that can bring together patients and citizens with health professionals from both sides of the two-sided e-health market. Personal health records and patient portals represent platforms that will allow for integration of interoperable information across systems and time. However, their design must be based on an understanding of different user needs and requirements. To support this, formalisms such as the user-task-context matrix can be applied to help specify and explicitly model user requirements. In addition, a range of methods emerging from usability engineering need to be applied to ensure systems and their user interfaces meet the needs of a growing range of end-users of health IT systems such as PHRs and patient portals. The chapter explores some of the barriers and challenges in attempting to bring together users across the e-health market using information technology.

[1]  Andre Kushniruk,et al.  Identifying and preventing technology-induced error using simulations: application of usability engineering techniques. , 2005, Healthcare quarterly.

[2]  R. Kaushal,et al.  Association between use of a health information exchange system and hospital admissions , 2014, Applied Clinical Informatics.

[3]  Eric C. Pan,et al.  The Department of Veterans Affairs' (VA) implementation of the Virtual Lifetime Electronic Record (VLER): Findings and lessons learned from Health Information Exchange at 12 sites , 2014, Int. J. Medical Informatics.

[4]  Romaric Marcilly,et al.  Medication related computerized decision support system (CDSS): make it a clinicians' partner! , 2011, Studies in health technology and informatics.

[5]  David W. Bates,et al.  White Paper: Personal Health Records: Definitions, Benefits, and Strategies for Overcoming Barriers to Adoption , 2006, J. Am. Medical Informatics Assoc..

[6]  Taya Irizarry,et al.  Patient Portals and Patient Engagement: A State of the Science Review , 2015, Journal of medical Internet research.

[7]  Vimla L. Patel,et al.  The patient clinical information system (PatCIS): technical solutions for and experience with giving patients access to their electronic medical records , 2002, Int. J. Medical Informatics.

[8]  Vimla L. Patel,et al.  Using usability heuristics to evaluate patient safety of medical devices , 2003, J. Biomed. Informatics.

[9]  J. Vest.  Health information exchange: national and international approaches. , 2012, Advances in health care management.

[10]  Vimla L. Patel,et al.  Cognitive and usability engineering methods for the evaluation of clinical information systems , 2004, J. Biomed. Informatics.

[11]  Peter Elkin,et al.  The Human Factors Engineering Approach to Biomedical Informatics Projects: State of the Art, Results, Benefits and Challenges , 2007, Yearbook of Medical Informatics.

[12]  Elizabeth M. Borycki,et al.  Low-Cost Rapid Usability Testing for Health Information Systems: Is it Worth the Effort? , 2012, MIE.

[13]  Andre Kushniruk,et al.  Increasing the safety of healthcare information systems through improved procurement: toward a framework for selection of safe healthcare systems. , 2010, Healthcare quarterly.

[14]  Emily S. Patterson,et al.  Integrating Electronic Health Records into Clinical Workflow , 2014 .

[15]  Golam Sorwar,et al.  Current status, challenges and outlook of e-health record systems in Australia , 2014 .

[16]  Ashley Edwards,et al.  Barriers to cross--institutional health information exchange: a literature review. , 2010, Journal of healthcare information management : JHIM.

[17]  T. Greenhalgh,et al.  Adoption, non-adoption, and abandonment of a personal electronic health record: case study of HealthSpace , 2010, BMJ : British Medical Journal.

[18]  André Kushniruk,et al.  A Framework for User Involvement and Context in the Design and Development of Safe e-Health Systems , 2012, MIE.

[19]  Ross Koppel,et al.  Re-examining health IT policy: what will it take to derive value from our investment? , 2015, J. Am. Medical Informatics Assoc..

[20]  Elizabeth M Borycki,et al.  Low-cost rapid usability engineering: designing and customizing usable healthcare information systems. , 2006, Healthcare quarterly.

[21]  Arthur L Kellermann,et al.  What it will take to achieve the as-yet-unfulfilled promises of health information technology. , 2013, Health affairs.

[22]  Andre Kushniruk,et al.  Enhancing the Effectiveness of Consumer-Focused Health Information Technology Systems Through eHealth Literacy: A Framework for Understanding Users' Needs , 2015, JMIR human factors.

[23]  Kenneth D. Mandl,et al.  Viewpoint Paper: Early Experiences with Personal Health Records , 2008, J. Am. Medical Informatics Assoc..