Working with Health IT Systems Fundamentals of Usability in HIT Systems—What Does it Matter?...

Working with Health IT Systems

Fundamentals of Usability in HIT Systems—What Does it Matter?

Lecture a

This material (Comp7_Unit 5a) was developed by Johns Hopkins University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC00013.


Learning Objectives—Lecture a

2Health IT Workforce Curriculum Version 3.0/Spring 2012

Working with Health IT Systems Fundamentals of Usability—What Does it Matter?

Lecture a

• Define usability and its relationship to HIT systems.

• Explain the impact of HIT usability on user satisfaction, adoption, and workarounds including error rates and unintended consequences.

• Provide alternatives to HIT usability bottlenecks.

Usability Defined

• “The extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context of use.” (ISO 9241-11)

(Ergonomic Requirements for Office Work with Visual Display Terminals (VDTs) – Part 11 Guidance on Usability. ISO/IEC 9241)

• Usability is the study of the ease with which people can employ a particular tool or other human-made object to achieve a particular goal.



Lecture a

Jakob Nielsen

• Usability—a quality attribute that assesses how easy user interfaces are to use

• 5 6 Components:– Learnability– Efficiency– Memorability– Errors– Satisfaction– Utility

http://www.usability.gov/basics



Lecture a

User-Centered Design



Lecture a

User-Centered DesignISO 13407:Human-Centered Design

Process



Lecture a

User Centered Design



Lecture a

Iteration in Design

“If you dislike change, you're going to dislike irrelevance even more”

Eric Shinseki: 7th US Secretary of Veterans Affairs



Lecture a

Usability in HIT

• Understanding the user base– Mobile workers– Highly disruptive & stressful situations– Cognitive overload– Restriction of physical space–portability

important– Time compression– Frequent turnover (patients & providers)– Workarounds are common



Lecture a


Summary—Lecture a• Consequences of poor usability• Six quality attributes of usability• ISO’s User-Centered Design• Challenges of clinical computing and how

usability relates• Knowing the principles, designing with the user

in mind & testing designs are critical



Lecture a


References—Lecture aReferences• Ergonomic Requirements for Office Work with Visual Display Terminals (VDTs) – Part 11 Guidance on Usability.

ISO/IEC 9241.• Jakob Nielson: useit.com: Jakob Nielsen's Website. Available from: http://www.useit.com/• Koppel, R. P., Wetterneck, T. M., Telles, J. L., & Karsh, B.-T. (2008). Workarounds to Barcode Medication

Administration Systems: Their Occurrences, Causes, and Threats to Patient Safety. Journal of the American Medical Informatics Association, 408-421.

• National Review Online, "Marines Turned Soldiers” December 10, 2001. 4 Star General Eric Shinseki, U.S. Secretary of Veterans Affairs. Available from: http://old.nationalreview.com/comment/comment-owens121001.shtml

• National Transportation Safety Board Executive Summary of its final report into the Denver crash. January 26, 1999. Available from: http://www.avweb.com/other/ntsb9905.html

• Nielsen, Jakob. Definition of Usability. Available from: http://www.useit.com/alertbox/20030825.html



Lecture a


References—Lecture a Images• Slide 2: Door Alarm. Available from: http://www.flickr.com/photos/brettlider/5615190034/sizes/m/in/photostream/

Attribution—Share Alike 2.0 Generic (CC BY-SA 2.0) Brett L.'s Photostream.• Slide 4: Man in Front of PC Screen, Face in Hands. Courtesy Federal Drug Administration(FDA). Available from:

http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/psn/printer.cfm?id=497• Slide 5: Image 1—Notification window: "This is a generic notification box. You should not be seeing this box.”

Image 2—Error message : Error opening this file. Courtesy Dr. Patricia Abbott • Slide 6: User-centered Design. Adapted from ISO standard 13407 by Dr. Patricia Abbott• Slide 7 : Image 1—The Six Iterative Steps of User-Centered Design.

Image 2—Older Asian Woman. Courtesy Mark Blatt, M.D. (HIMSS Presentation; MCA; 2009)

• Slide 8: Eric Shinseki: 7th US Secretary of Veterans Affairs. Courtesy Veterans Administration. Available from: http://www1.va.gov/opa/bios/

• Slide 9: Doctors and Medics in a Makeshift Field Hospital During a Mass-Casualty Exercise on Fort Bragg, N.C.

Courtesy US Army. Available from: http://Army.mil.images



Lecture a

Working with Health IT Systems Fundamentals of Usability in HIT Systems—What Does it Matter?...

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