Usability of information systems: Experiences of outpatient physicians, outpatient nurses, and open care social welfare professionals from three large cross-sectional surveys in Finland.

BACKGROUND: Many European countries are integrating healthcare and social welfare services; some also include joint information systems (ISs) in this process. Despite this, large national survey studies examining and comparing the experiences of the major professional groups regarding the usability of their health (HISs) and client information systems (CISs) are lacking. METHODS: We combined the responses from three national cross-sectional surveys conducted among physicians and nurses in 2017, and social welfare professionals (SWPs) in 2019 in Finland. We selected the responses of 1,826 physicians and 774 nurses working in outpatient clinics in specialized and primary care, and 669 social workers and other SWPs working in open services. The questionnaires were adjusted from a validated instrument. In this study, we analyzed 11 usability-related statements. RESULTS: The healthcare professionals (HPs) were more critical of the stability and responsiveness of their ISs than the SWPs (27-48% vs 58-65% agreed). The physicians were most dissatisfied with IS support for routine tasks (24-26% agreed). Less than half of all respondents agreed with statements concerning the ease of documentation, arrangement of fields, and terminology. While the HPs were satisfied with IS support for collaboration and information exchange between professionals in the same organization, all professional groups were dissatisfied with cross-organizational support and communication with patients and clients. Almost half of the HPs considered that HISs improve the quality of care, but 80% of the SWPs disagreed that CISs help improve the quality of services. CONCLUSIONS: Overall, the physicians, nurses, and SWPs were dissatisfied with the usability of their HISs and CISs. Based on our findings, ISs should be further developed to support routine tasks, inter- and cross-organizational collaboration, and information exchange. ISs for the integration of care and services should be designed to accommodate various professional groups' different work contexts and needs.

Social welfare professionals willing to participate in client information system development - Results from a large cross-sectional survey.

Human-centered design methods should be implemented throughout the client information system (CIS) development process to understand social welfare professionals' needs, tasks, and contexts of use. The aim of this study was to examine Finnish social welfare professionals' experiences of participating in CIS development.A national cross-sectional web-based survey on the CIS experiences of social welfare professionals (1145 respondents) was conducted in Finland in spring 2019. This study focused on statements concerning the experiences of end users with CIS development and participation. The results are reported by professional and age groups.Half (50%) of the 1145 respondents had participated in CIS development. Half (56%) knew to whom and how to send feedback to software developers, but most (87%) indicated that changes and corrections were not made according to suggestions and quickly enough. The most preferred methods of participation were telling a person in charge of information systems development about usage problems (53%) and showing developers on site how professionals work (34%); 19% were not interested in participating.Social welfare professionals are willing to participate in CIS development, but vendors and social welfare provider organizations are underutilizing this resource. Social welfare informaticists are needed to interpret the needs of end users to software developers.

Challenges and Best Practices in Ethical Review of Human and Organizational Factors Studies in Health Technology: a Synthesis of Testimonies.

OBJECTIVE: Human and Organizational Factors (HOF) studies in health technology involve human beings and thus require Institutional Review Board (IRB) approval. Yet HOF studies have specific constraints and methods that may not fit standard regulations and IRB practices. Gaining IRB approval may pose difficulties for HOF researchers. This paper aims to provide a first overview of HOF study challenges to get IRB review by exploring differences and best practices across different countries. METHODS: HOF researchers were contacted by email to provide a testimony about their experience with IRB review and approval. Testimonies were thematically analyzed and synthesized to identify and discuss shared themes. RESULTS: Researchers from seven European countries, Argentina, Canada, Australia, and the United States answered the call. Four themes emerged that indicate shared challenges in legislation, IRB inefficiencies and inconsistencies, general regulation and costs, and lack of HOF study knowledge by IRB members. We propose a model for IRB review of HOF studies based on best practices. CONCLUSION: International criteria are needed that define low and high-risk HOF studies, to allow identification of studies that can undergo an expedited (or exempted) process from those that need full IRB review. Enhancing IRB processes in such a way would be beneficial to the conduct of HOF studies. Greater knowledge and promotion of HOF methods and evidence-based HOF study designs may support the evolving discipline. Based on these insights, training and guidance to IRB members may be developed to support them in ensuring that appropriate ethical issues for HOF studies are considered.

Usability Analysis of Contending Electronic Health Record Systems.

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study.

A Framework for Usability Evaluation in EHR Procurement.

Usability should be considered already by the procuring organizations when selecting future systems. In this paper, we present a framework for usability evaluation during electronic health record (EHR) system procurement. We describe the objectives of the evaluation, the procedure, selected usability attributes and the evaluation methods to measure them. We also present the emphasis usability had in the selection process. We do not elaborate on the details of the results, the application of methods or gathering of data. Instead we focus on the components of the framework to inform and give an example to other similar procurement projects.

End-Users' Voice in EHR Selection: Development of a Usability Questionnaire for Demonstrations in Procurement (DPUQ).

This paper describes the development of a questionnaire for evaluating usability during EHR system procurement (DPUQ). Established usability questionnaires can be used to gather user feedback after using the systems. However, during procurement, experimenting with real system use is practical only with a limited number of system candidates. There is a need for less resource-demanding usability evaluation in the early stages of procurement in cases with several vendors. DPUQ has been designed for usability evaluation by end-users during special scenario-based vendor demonstrations. The questionnaire includes three sets of questions to be used during and after the vendor demonstration. DPUQ delivers specific usability scores and can be used to compare system candidates in procurement complementing other evaluation methods.