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Multicenter Study
. 2011 Sep-Oct;18(5):711-6.
doi: 10.1136/amiajnl-2011-000281. Epub 2011 May 27.

User perspectives on the usability of a regional health information exchange

Cynthia S Gadd  1 , Yun-Xian Ho, Cather Marie Cala, Dana Blakemore, Qingxia Chen, Mark E Frisse, Kevin B Johnson
Affiliations
Multicenter Study

User perspectives on the usability of a regional health information exchange

Cynthia S Gadd et al. J Am Med Inform Assoc. 2011 Sep-Oct.

Abstract

Objective: We assessed the usability of a health information exchange (HIE) in a densely populated metropolitan region. This grant-funded HIE had been deployed rapidly to address the imminent needs of the patient population and the need to draw wider participation from regional entities.

Design: We conducted a cross-sectional survey of individuals given access to the HIE at participating organizations and examined some of the usability and usage factors related to the technology acceptance model.

Measurements: We probed user perceptions using the Questionnaire for User Interaction Satisfaction, an author-generated Trust scale, and user characteristic questions (eg, age, weekly system usage time).

Results: Overall, users viewed the system favorably (ratings for all usability items were greater than neutral (one-sample Wilcoxon test, p<0.0014, Bonferroni-corrected for 35 tests). System usage was regressed on usability, trust, and demographic and user characteristic factors. Three usability factors were positively predictive of system usage: overall reactions (p<0 0.01), learning (p<0.05), and system functionality (p<0.01). Although trust is an important component in collaborative relationships, we did not find that user trust of other participating healthcare entities was significantly predictive of usage. An analysis of respondents' comments revealed ways to improve the HIE.

Conclusion: We used a rapid deployment model to develop an HIE and found that perceptions of system usability were positive. We also found that system usage was predicted well by some aspects of usability. Results from this study suggest that a rapid development approach may serve as a viable model for developing usable HIEs serving communities with limited resources.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
Technology acceptance model (TAM) adapted to illustrate the relationship between system usage and usability (using QUIS variables), usefulness, trust, and socio-demographic variables. Shaded boxes indicate our variables of interest.
Figure 2
Figure 2
Screenshots of the health information exchange interface for a test patient: Clinical History (top) and Encounters (bottom).
See this image and copyright information in PMC

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