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. 2016 Jun 15;7(2):502-15.
doi: 10.4338/ACI-2015-10-RA-0129. eCollection 2016.

Usability Testing of Two Ambulatory EHR Navigators

Gretchen Hultman  1 , Jenna Marquard  2 , Elliot Arsoniadis  3 , Pamela Mink  4 , Rubina Rizvi  1 , Tim Ramer  5 , Saif Khairat  6 , Keri Fickau  7 , Genevieve B Melton  8
Affiliations

Usability Testing of Two Ambulatory EHR Navigators

Gretchen Hultman et al. Appl Clin Inform. .

Abstract

Background: Despite widespread electronic health record (EHR) adoption, poor EHR system usability continues to be a significant barrier to effective system use for end users. One key to addressing usability problems is to employ user testing and user-centered design.

Objectives: To understand if redesigning an EHR-based navigation tool with clinician input improved user performance and satisfaction.

Methods: A usability evaluation was conducted to compare two versions of a redesigned ambulatory navigator. Participants completed tasks for five patient cases using the navigators, while employing a think-aloud protocol. The tasks were based on Meaningful Use (MU) requirements.

Results: The version of navigator did not affect perceived workload, and time to complete tasks was longer in the redesigned navigator. A relatively small portion of navigator content was used to complete the MU-related tasks, though navigation patterns were highly variable across participants for both navigators. Preferences for EHR navigation structures appeared to be individualized.

Conclusions: This study demonstrates the importance of EHR usability assessments to evaluate group and individual performance of different interfaces and preferences for each design.

Keywords: Electronic health record; meaningful use; usability.

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Conflict of interest statement

Conflicts of Interest

The authors declare that they have no conflicts of interest in this research.

Figures

Fig. 1
Fig. 1
Screenshot of a portion of the original ambulatory navigator (© 2015 Epic Systems Corporation. Used with permission).
Fig. 2
Fig. 2
Screenshot of new navigator “Intake” activity and reduced buttons on far left (© 2015 Epic Systems Corporation. Used with permission)
Fig. 3
Fig. 3
Average time to complete each patient case scenario
Fig. 4
Fig. 4
Average time to complete each Meaningful Use task
Fig. 5
Fig. 5
Perceived workload for each patient case scenario
Fig. 6
Fig. 6
Old navigator pathways. Light grey text signifies links only available by default in the new navigator menu. The second column (Activities) contains buttons in the far left column on the screen. The first column shows options after one of the optional Activities buttons is clicked. The third column shows links after one of the navigator buttons is clicked (i.e., Visit Navigator, Intake, or Charting). The far right column shows links that appear after a link within the visit navigator is selected. Arrows show pathways between buttons and links, with darker arrows signifying that more participants navigated via those pathways.
Fig. 7
Fig. 7
New navigator pathways. Light grey text signifies links only available by default in the new navigator menu. The second column (Activities) contains buttons in the far left column on the screen. The first column shows options after one of the optional Activities buttons is clicked. The third column shows links after one of the navigator buttons is clicked (i.e., Intake or Charting). The far right column shows links that appear after a link within the visit navigator is selected. Arrows show pathways between buttons and links, with darker arrows signifying that more participants navigated via those pathways.
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