Academic electronic medical record system usability testing - Coursework Example

? ACADEMIC ELECTRONIC MEDICAL RECORD SYSTEM USABILITY TESTING Academic Electronic Medical Record System Usability Testing Computerisation in every kind of industry has brought enough changes to increase work pacing, in any kind of business or service that the public utilises. However, despite the availability of methods in implementing computer-based methods in the upkeep of patient records, prescriptions, and other information, the health care field has been lagging behind in the use of electronic-based systems, and there is still a heavy reliance on paper-based or handwritten information storage and retrieval system (Garrido, et al., 2005; Menachemi & Collum, 2011; Moody, et al., 2004). Some researchers suggest that the main reasons for the backlog in new technology applications are the following: a large number of end-users (e.g. physicians, nurses, and other medical technical personnel) are still strong followers of traditional pen-and-paper methods of information retrieval and storage; high costs of implementation and maintenance of the systems; the usability of the programs are highly variable amongst the software developers and the end-users, with those not having enough computer technical know-hows end up not using the system to their advantage; the use of computer-based records interfere with the time allotted to interact with the patient; and because future nurses are not taught how to use electronic health records (EHR) as early as possible during their studying years (McBride, 2011; Master of Technical and Scientific Communication Program Students, 2004; Moody, et al., 2004; Natarajan, et al., 2010). Since it is expected that in the future there will be more nurses capable of including technology in their everyday work, this is a great opportunity to teach them how to use EHR during their study years so that they can have enough experiences on its use and that they will be comfortable enough to work with it when performing their tasks as professionals later on (Bonnel & Smith, 2010). For this to work, aside from teaching students how to use EHR, tests must be done to the EHR programs to asses for usability and standardisation of terms and protocols so that further improvements can also be made to the programs in the future. Common EHR Usage in Hospitals Using HER’s in hospitals provide improvements in health care delivery mainly due to the reduction of inaccuracies in patient health and medicine records. There is considerably less misinterpretation of information handled from the reduced use of handwriting which often leads to inaccuracies in patient records or from missing information due to illegibility (Garrido, et al., 2005; Simon, et al., 2007). But EHR is not limited to the storage and retrieval of patient health information, as it also functions as a database for other kinds of data such as drug dosage and actions, disease symptoms, and physician information which many identified users can access in order to synchronise patient medical information and history from (Wang, et al., 2008). At the same time, EHR can also function as an alarm or reminder notification system for regular users in their work duties, such as patient check-up times or administration of drugs, creation of electronic memos such as patient health progress, among others (Bonnel & Smith, 2010; Moody, et al., 2004; Simon, et al., 2007). This makes for the EHR's contribution in enhancing care delivery for end-users and other stakeholders, and it is expected that the number of agencies putting EHR in effect will also increase in proportion to the improvements made in the program user interfaces. Impact of Teaching EHR in Schools Due to the costs of EHR instalment and maintenance, it can be expected that the bulk of end-users of such programs would be large health facilities such as hospitals or other medical institutions, or individual practitioners tied to these facilities. This is mainly from the high volume of patients or clients that enter regularly or intermittently and have their health records kept for future references (Menachemi & Collum, 2011; Simon, et al., 2007). As such, it is equally important that many personnel in these institutions are able to use EHR's to their advantage. It can be safely assumed that many health care personnel take the opportunity to use EHR since the facility itself has it available for use, however due to the apprehensions of some users there is a gap between the implementation of the EHR and the number of its users, which prevent it from reaching its full potential in care delivery (Natarajan, et al., 2010). Many health personnel are capable of using EHR to some extent however those who do not are hesitant to do so due to their incomplete understanding or misconceptions in using computers to store and retrieve patient health and medical information. Most of these people are those who have been in service for a very long time and are quite comfortable in doing their work in the traditional paper-based way. With the passing of time, the number of personnel comfortable in the use of EHR and other related technologies is expected to increase, and academicians can fully take advantage of this situation in improving the reception of future generations of nurses and other healthcare personnel in using EHR (McBride, 2011). One possible step is by allowing them to experience the use of EHR while they are still students, since one of the perceived barriers in the use of advanced technologies is tied to the lack of understanding about the importance or relevance of the technology, as well as having an experience in its use (Bonnel & Smith, 2010; Moody, et al., 2004). If the students are able to experience the usability of EHR at the earliest time possible, they will likely integrate the use and incorporation of this technology not only during their training but also in their professional practices as well. EHR Usability in the Academic Settings Usability has been defined as the inherent characteristic of objects or tools that users find to be easy or convenient, making these things practical and frequently utilised (Brancato, 2010; Master of Technical and Scientific Communication Program Students, 2004). The implications of this statement is that as the ease of use or the convenience of these tools or objects increase, the usage of these tools by users also increase, hence the high usability of such objects. Likewise, if the tools or objects require complicated methods to operate, these will have lower usability since people more often than not prefer simple and easy-to-use tools frequently. In the case of EHR software or programs, high usability is important for user-acceptance and reliance, especially among personnel who may not have the convenience of sacrificing their work time in learning and using the application (McBride, 2011). This must also be taken into consideration when schools plan to teach students how to use EHR systems, especially since an initial low usability rate among students could intimidate and deter them from the use of other similar systems in the future, hence making the implementation of EHR to succeeding nurses even more difficult. EHR Usability Problems and some Possible Solutions In teaching the use of EHR in schools, several problems or issues might arise. To prevent this while increasing the reception of students to the use of EHR, they must first be presented with an introduction on the basic working principles and advantages of using an EHR in comparison with traditional paper-based methods of patient documentation (Bonnel & Smith, 2010). This is because the lack of understanding on the principles of EHR use could prevent the students from working with computer-based records, and could make them even more reluctant to its usage when current systems become upgraded or revised and they have the need to relearn how the system works all over again (McBride, 2011). However, if the students are taught to anticipate system upgrades as well as having a gist on the basic principles of EHR usage, they can be confident in the sense that no matter how much the program changes, they could still use the EHR properly and successfully every time. At the same time they also have the capacity to assess the usability of the program as well, and contribute to future improvements such as increased ease of use and efficiency. Other usability-specific problems could also arise in the process of teaching students how to use EHR within the academe. For one thing, acceptability and usability issues could arise if a program is unsuitable for the students due to the program’s lack of user-friendliness or if there are not enough simplifications that go along with it (Brancato, 2010). With the program or system’s high complexity and inconvenience as one of the major issues that could prevent the EHR from having a high usability rate, students will not only have a hard time adjusting their schedules to learn the program, but also see it as a hindrance to do their work efficiently and timely. To compensate for this, it is suggested that schools initiate EHR usage through utilisation of a modified EHR simulation program most suitable for the students’ level, so that they can easily use the program for practise on various hypothetical scenarios (Brancato, 2010; Kennedy, et al., 2009). Sufficient time for the learning curve must also be given so that the process of adapting the technology will not be rushed. This way, the students can become acquainted with how the system works and explore its various functions other than keep patient records, and in the process they may be able to learn ways on how to integrate the system into frequent use such as in decision-making, among others (Natarajan, et al., 2010). Another suggestion in teaching students how to use EHR’s in the academic settings is to implement or teach standard terminologies used in relation to EHR usage, so that while students learn how to use the EHR they are also introduced to other words that are often used in real-life hospital settings as well as in performing queries within the EHR database itself (Lundberg, et al., 2008). Also, by learning these terminologies, students can improve their abilities in searching for the most appropriate methods of aid, and along the way could also train their decision-making abilities and help decrease underuse, overuse, or misuse curative methods in clinical decision-making scenarios (Garrido, et al., 2005). It is easy to teach students how to use EHR to their advantage, and even easier to get their feedback in its use. However in terms of finding out whether the system is truly usable or not, incentives apart from additional points must be given so that the students can give their opinions or feedback as timely and as honestly as possible. This is because the lack of a non-academic incentive for usage or not having a chance to voice out their opinions in using EHR could prevent students from fully appreciating the technology, as they will only see it as a requirement to finish a course and not see it as a tool they can use for work improvement (Bonnel & Smith, 2010). In addition, without proper feedback from end-users such as the students, modifications to the system in order to become much more usable might not happen, and future students might become much more reluctant to its use. If this happens, teaching students how to use EHR will only be in vain. However, by getting feedback from each student in their EHR use, academicians not only keep track of the usage of the system, but they can also gather enough usable information which can be used to further improve the system’s usability among other users (Brancato, 2010). In the process this will also allow students to fully integrate EHR usage into their work since they are given an opportunity to both experience how it works, as well as having a chance to contribute to its improvement in terms of efficiency, effectiveness, and overall user satisfaction (Kennedy, et al., 2009). Electronic health records or EHR shows promises of improving health care services by reducing costs of record maintenance and improving efficiencies of users in terms of care provision (Menachemi & Collum, 2011). However, aside from the high costs of upkeep, the lack of enthusiasm in its use becomes a large hindrance in its acceptability among users (Moody, et al., 2004). This can be prevented in the future by allowing present-day students to experience its utility at the earliest possible time so that they can grow confident in its use (Bonnel & Smith, 2010). Academicians must take the opportunity to teach students how to use EHR through incentives such as additional points, chances for feedback, and improved usability, so that they have more confidence in using the system. Teaching students EHR may seem like a costly method of introducing them to modern methods of patient information storage and retrieval, but in the long run it can give them a great advantage in improving their abilities in health care delivery once they start working in their respective careers. References Brancato, C. (2010). Usability: Can best practices help develop meaningful users? Innovation 2010: On the Threshold of Meaningful Use. Government Health IT Conference. Bonnel, W., Smith, K. (2010). Teaching technologies in nursing & the health professions: beyond simulation and online courses. New York: Springer Publishing Company, LLC. Garrido, T., Jamieson, L., Zhou, Y., Liang, L., & Wiesenthal, A. (2005). Effect of electronic health records in ambulatory care: restrospective, serial, cross sectional study. British Medical Journal, 330(7491), 581. Kennedy, D., Pallikkathayil, L., & Warren, J. (2009). Using a modified electronic health record to develop nursing process skills. Journal of Nursing Education, 48 (2), 96-101. Lundberg, C., Brokel, J. M., Bulechek, G. M., Butcher, H. K., Martin, K. S., Moorhead, S., & ... Maas, M. L. (2008). Selecting a standardized terminology for the electronic health record that reveals the impact of nursing on patient care. Online Journal of Nursing Informatics, 12(2), 19p. McBride, A.B. (2011). The growth and development of nurse leaders. New York: Springer Publishing Company, LLC. Menachemi, N., & Collum, T. H. (2011). Benefits and drawbacks of electronic health record systems. Risk management and healthcare policy, 4, 47-55. Moody, L., Slocumb, E., Berg, B., & Jackson, D. (2004). Electronic health records documentation in nursing. CIN: Computers, Informatics, Nursing, 22(6), 337-344. Natarajan, K., Stein, D., Jain, S., & Elhadad, N. (2010). An analysis of clinical queries in an electronic health record search utility. International journal of medical informatics, 79(7), 515-522. Simon, S., Kaushal, R., Cleary, P., Jenter, C., Volk, L., Poon, E., Oray, E., Lo, H., Williams, D., & Bates, D. (2007). Correlates of electronic health record adoption in office practices: a statewide survey. Journal of the American Medical Informatics Association, 14, 110-117. Students in the Master of Technical and Scientific Communication Program. (2004). Usability testing: developing useful and usable products. Ohio: Miami University of Ohio. Wang, T. D., Plaisant, C., Quinn, A. J., Stanchak, R., Shneiderman, B., & Murphy, S. (2008). Aligning temporal data by sentinel events: discovering patterns in electronic health records. CHI 2008 Proceedings - Health and Wellness (pp. 457-466 ). Florence: ACM. Read More