scholarly journals The Effect of Electronic Health Record Usability Redesign on Annual Screening Rates in an Ambulatory Setting

2020 ◽  
Vol 11 (04) ◽  
pp. 580-588
Author(s):  
Robert P. Pierce ◽  
Bernie R. Eskridge ◽  
LeAnn Rehard ◽  
Brandi Ross ◽  
Margaret A. Day ◽  
...  
Keyword(s):  
Usability Testing ◽  
Error Rates ◽  
Drug Misuse ◽  
Ambulatory Setting ◽  
Interrupted Time Series Analysis ◽  
Improvement Project ◽  
System Usability Scale ◽  
Electronic Health ◽  
The Impact ◽  
User Centered

Abstract Objectives Improving the usability of electronic health records (EHR) continues to be a focus of clinicians, vendors, researchers, and regulatory bodies. To understand the impact of usability redesign of an existing, site-configurable feature, we evaluated the user interface (UI) used to screen for depression, alcohol and drug misuse, fall risk, and the existence of advance directive information in ambulatory settings. Methods As part of a quality improvement project, based on heuristic analysis, the existing UI was redesigned. Using an iterative, user-centered design process, several usability defects were corrected. Summative usability testing was performed as part of the product development and implementation cycle. Clinical quality measures reflecting rolling 12-month rates of screening were examined over 8 months prior to the implementation of the redesigned UI and 9 months after implementation. Results Summative usability testing demonstrated improvements in task time, error rates, and System Usability Scale scores. Interrupted time series analysis demonstrated significant improvements in all screening rates after implementation of the redesigned UI compared with the original implementation. Conclusion User-centered redesign of an existing site-specific UI may lead to significant improvements in measures of usability and quality of patient care.

scholarly journals Beyond Getting Rid of Stupid Stuff in the Electronic Health Record (Beyond-GROSS): Protocol for a User-Centered, Mixed-Method Intervention to Improve the Electronic Health Record System

10.2196/25148 ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. e25148
Author(s):  
Ahmed Umar Otokiti ◽  
Catherine K Craven ◽  
Avniel Shetreat-Klein ◽  
Stacey Cohen ◽  
Bruce Darrow
Keyword(s):  
Health Care ◽  
Data Analysis ◽  
Electronic Health Record ◽  
Health Record ◽  
User Centered Design ◽  
Pilot Phase ◽  
Direct Input ◽  
Electronic Health ◽  
The Impact ◽  
User Centered

Background Up to 60% of health care providers experience one or more symptoms of burnout. Perceived clinician burden resulting in burnout arises from factors such as electronic health record (EHR) usability or lack thereof, perceived loss of autonomy, and documentation burden leading to less clinical time with patients. Burnout can have detrimental effects on health care quality and contributes to increased medical errors, decreased patient satisfaction, substance use, workforce attrition, and suicide. Objective This project aims to improve the user-centered design of the EHR by obtaining direct input from clinicians about deficiencies. Fixing identified deficiencies via user-centered design has the potential to improve usability, thereby increasing satisfaction by reducing EHR-induced burnout. Methods Quantitative and qualitative data will be obtained from clinician EHR users. The input will be received through a form built in a REDCap database via a link embedded in the home page of the EHR. The REDCap data will be analyzed in 2 main dimensions, based on nature of the input, what section of the EHR is affected, and what is required to fix the issue(s). Identified issues will be escalated to relevant stakeholders responsible for rectifying the problems identified. Data analysis, project evaluation, and lessons learned from the evaluation will be incorporated in a Plan-Do-Study-Act (PDSA) manner every 4-6 weeks. Results The pilot phase of the study began in October 2020 in the Gastroenterology Division at Mount Sinai Hospital, New York City, NY, which includes 39 physicians and 15 nurses. The pilot is expected to run over a 4-6–month period. The results of the REDCap data analysis will be reported within 1 month of completing the pilot phase. We will analyze the nature of requests received and the impact of rectified issues on the clinician EHR user. We expect that the results will reveal which sections of the EHR have the highest deficiencies while also highlighting issues about workflow difficulties. Perceived impact of the project on provider engagement, patient safety, and workflow efficiency will also be captured by evaluation survey and other qualitative methods where possible. Conclusions The project aims to improve user-centered design of the EHR by soliciting direct input from clinician EHR users. The ultimate goal is to improve efficiency, reduce EHR inefficiencies with the possibility of improving staff engagement, and lessen EHR-induced clinician burnout. Our project implementation includes using informatics expertise to achieve the desired state of a learning health system as recommended by the National Academy of Medicine as we facilitate feedback loops and rapid cycles of improvement. International Registered Report Identifier (IRRID) PRR1-10.2196/25148

Resident Physician Experience and Duration of Electronic Health Record Use

2021 ◽  
Vol 12 (04) ◽  
pp. 721-728
Author(s):  
A. Jay Holmgren ◽  
Brenessa Lindeman ◽  
Eric W. Ford
Keyword(s):  
Care Delivery ◽  
Well Being ◽  
Early Career ◽  
Ambulatory Setting ◽  
Care Experience ◽  
Resident Physicians ◽  
Physician Time ◽  
After Hours ◽  
Electronic Health ◽  
The Impact

Abstract Background Electronic health records (EHRs) demand a significant amount of physician time for documentation, orders, and communication during care delivery. Resident physicians already work long hours as they gain experience and develop both clinical and socio-technical skills. Objectives Measure how much time resident physicians spend in the EHR during clinic hours and after-hours, and how EHR usage changes as they gain experience over a 12-month period. Methods Longitudinal descriptive study where participants were 622 resident physicians across postgraduate year cohorts (of 948 resident physicians at the institution, 65.6%) working in an ambulatory setting from July 2017 to June 2018. Time spent in the EHR per patient, patients records documented per day, and proportion of EHR time spent after-hours were the outcome, while the number of months of ambulatory care experience was the predictor. Results Resident physicians spent an average of 45.6 minutes in the EHR per patient, with 13.5% of that time spent after-hours. Over 12 months of ambulatory experience, resident physicians reduced their EHR time per patient and saw more patients per day, but the proportion of EHR time after-hours did not change. Conclusion Resident physicians spend a significant amount of time working in the EHR, both during and after clinic hours. While residents improve efficiency in reducing EHR time per patient, they do not reduce the proportion of EHR time spent after-hours. Concerns over the impact of EHRs on physician well-being should include recognition of the burden of EHR usage on early-career physicians.

scholarly journals Perancangan dan Pembuatan Aplikasi Pembelajaran Bahasa Jepang Untuk Pemula Dengan Metode User Centered Design Berbasis Android

Teknika ◽  
2017 ◽  
Vol 5 (1) ◽  
pp. 10-23
Author(s):  
Michael Agustav ◽  
Kathryn Widhiyanti ◽  
Edwin Meinardi Trianto
Keyword(s):  
Usability Testing ◽  
User Centered Design ◽  
Dynamic Design ◽  
The Impact ◽  
Bahasa Indonesia ◽  
User Centered

Seiring perkembangan zaman dimana perdagangan bebas Asia Pasifik mulai sering terjadi, maka penduduk Indonesia perlu mempelajari bahasa lain selain bahasa Indonesia. Bahasa Jepang perlu dipelajari karena mulai banyak investor asing dari negara Jepang di Indonesia. Oleh sebab itu dibuat aplikasi sederhana untuk membantu proses pembelajaran bahasa Jepang untuk pemula menggunakan metode User Centered Design. Dalam metode User Centered Design pada pembuatan aplikasi pembelajaran aplikasi pembelajaran bahasa Jepang untuk pemula ini dilakukan dengan membuat prototype pertama berupa hand-sketches prototype, kemudian dibuat prototype kedua berupa realisasi dari hasil handsketches, dan yang terakhir dibuat prototype ketiga berupa dynamic design prototype. Dari ketiga jenis prototype juga dilengkapi dengan evaluasi terhadap pengguna dan dilakukan perbaikan. Kemudian untuk pengujian telah dilakukan dua kali pengujian menggunakan metode dari usability testing yaitu completing a transaction dan evaluating the impact of subtle changes. Hasil dari kedua pengujian itu telah dianalisa dan dihitung, berdasarkan hasil analisa tersebut disimpulkan bahwa pada pengujian completing a transaction mendapatkan hasil 92,3% menunjukkan bahwa pengguna telah memahami fitur dan fungsi dari tombol yang telah disediakan pada aplikasi pembelajaran bahasa Jepang yang telah dibuat dan pada hasil pengujian evaluating the impact of subtle changes mendapatkan hasil 100% hasil tersebut menunjukkan bahwa pengguna telah dapat mempelajari bahasa Jepang dengan menggunakan aplikasi pembelajaran bahasa Jepang yang dibuat.

In pursuit of the holy grail: Improving C. difficile testing appropriateness with iterative electronic health record clinical decision support and targeted test restriction

2021 ◽  
pp. 1-8
Author(s):  
Norah S. Karlovich ◽  
Suchita Shah Sata ◽  
Brian Griffith ◽  
Ashley Coop ◽  
Ibukunoluwa C. Kalu ◽  
...  
Keyword(s):  
Decision Support ◽  
Electronic Health Record ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Health Record ◽  
Annual Change ◽  
Interrupted Time Series Analysis ◽  
Hospital System ◽  
Electronic Health ◽  
The Impact

Abstract Objective: To determine the impact of electronic health record (EHR)–based interventions and test restriction on Clostridioides difficile tests (CDTs) and hospital-onset C. difficile infection (HO-CDI). Design: Quasi-experimental study in 3 hospitals. Setting: 957-bed academic (hospital A), 354-bed (hospital B), and 175-bed (hospital C) academic-affiliated community hospitals. Interventions: Three EHR-based interventions were sequentially implemented: (1) alert when ordering a CDT if laxatives administered within 24 hours (January 2018); (2) cancellation of CDT orders after 24 hours (October 2018); (3) contextual rule-driven order questions requiring justification when laxative administered or lack of EHR documentation of diarrhea (July 2019). In February 2019, hospital C implemented a gatekeeper intervention requiring approval for all CDTs after hospital day 3. The impact of the interventions on C. difficile testing and HO-CDI rates was estimated using an interrupted time-series analysis. Results: C. difficile testing was already declining in the preintervention period (annual change in incidence rate [IR], 0.79; 95% CI, 0.72–0.87) and did not decrease further with the EHR interventions. The laxative alert was temporally associated with a trend reduction in HO-CDI (annual change in IR from baseline, 0.85; 95% CI, 0.75–0.96) at hospitals A and B. The gatekeeper intervention at hospital C was associated with level (IRR, 0.50; 95% CI, 0.42-0.60) and trend reductions in C. difficile testing (annual change in IR, 0.91; 95% CI, 0.85–0.98) and level (IRR 0.42; 95% CI, 0.22–0.81) and trend reductions in HO-CDI (annual change in IR, 0.68; 95% CI, 0.50–0.92) relative to the baseline period. Conclusions: Test restriction was more effective than EHR-based clinical decision support to reduce C. difficile testing in our 3-hospital system.

scholarly journals Hospitalization of mild cases of community-acquired pneumonia decreased more than severe ones during the COVID-19 epidemic

2021 ◽  
Author(s):  
Hiroyuki Nagano ◽  
Daisuke Takada ◽  
Jung-ho Shin ◽  
Tetsuji Morishita ◽  
Susumu Kunisawa ◽  
...  
Keyword(s):  
Claims Data ◽  
Health Care Systems ◽  
Interrupted Time Series ◽  
Community Acquired Pneumonia ◽  
Interrupted Time Series Analysis ◽  
Temporary Reduction ◽  
Improvement Project ◽  
The Past ◽  
Care Systems ◽  
The Impact

AbstractObjectiveThe epidemic of the coronavirus disease 2019 (COVID-19) has affected the entire health care systems. Our aim was to assess the impact of the COVID-19 epidemic on the number and severity of cases for community-acquired pneumonia (CAP) in Japan.MethodsUsing claims data from the Quality Indicator/Improvement Project (QIP) database, we included urgent cases of inpatients for CAP from August 1, 2018, to July 30, 2020. We compared the monthly ratio of inpatient cases from August 2018 to July 2019 and August 2019 to July 2020 as a year-over-year comparison. We also compared this ratio according to the severity score “A-DROP” and performed an interrupted time series analysis (ITS) to evaluate the impact of the COVID-19 epidemic on the monthly number of inpatient cases.ResultsA total of 67,900 inpatient cases for CAP in 262 hospitals were included. During the COVID-19 epidemic (defined as the period between March and July 2020), the number of inpatient cases for CAP drastically decreased during the epidemic compared with the same period in the past year (−48.1%), despite only a temporary reduction in the number of other urgent admissions. The number of inpatient cases decreased according to the severity of pneumonia. Milder cases showed a greater decrease in the year-over-year ratio than severe ones (mild −55.2%, moderate −45.8%, severe −39.4%, and extremely severe − 33.2%). The ITS analysis showed that the COVID-19 epidemic reduced the monthly number of inpatient cases for CAP significantly (estimated decrease: −1233 cases; 95% CI, −521 to −1955).ConclusionsOur study showed a significant reduction in the number of inpatient cases for CAP during the COVID-19 epidemic in Japan. The milder cases showed a greater decrease in the year-over-year ratio of the number of inpatient cases.

scholarly journals Penerapan UCD (User Centered Design) Pada Perancangan Sistem Informasi Manajemen Aset TI Berbasis Web di Bid TIK Kepolisian Daerah Kepulauan Riau

2020 ◽  
Vol 4 (1) ◽  
pp. 74-83
Author(s):  
Supardianto Supardianto ◽  
Arief Binsar Tampubolon
Keyword(s):  
Usability Testing ◽  
Black Box ◽  
User Centered Design ◽  
System Usability Scale ◽  
System Usability ◽  
Grade Scale ◽  
User Friendly ◽  
User Centered

Sulitnya melakukan penelurusan dan pengontrolan aset TI mengakibatkan kurang baiknya manajemen aset TI yang ada di Bid TIK sehingga kesulitan ketika diminta laporan-laporan mengenai aset TI yang dimiliki. Dalam penelitian ini, masalah-masalah ini dapat diselesaikan dengan membangun sistem informasi yang mampu mengelola aset TI di Bid TIK. Penelitian ini bertujuan untuk merancang dan membuat sistem informasi manajemen aset TI berbasis web dengan menerapkan UCD (user centered design) dengan pengujian usability serta pengembangan sistem infomasi dengan kuisioner dan usability testing. Pengujian black box dilakukan untuk memvalidasi fungsionalitas yang ditetapkan pada kebutuhan user saat wawancara. Hasil akhir dalam membangun sistem informasi ini adalah Berdasarkan Usability Testing dengan System Usability Scale, Sistem informasi manajemen aset TI ada pada range acceptable, untuk grade scale dengan hasil C sedangkan pada adjective ratings dengan hasil good yaitu sebesar 76. Maka dari itu, Sistem informasi manajemen aset TI berhasil membangun sistem yang user-friendly dengan tingkat usability yang baik. Berdasarkan hasil pengujian black box, didapatkan hasil bahwa seluruh kebutuhan fungsional dari sistem yang dibangun telah terpenuhi dan berjalan dengan baik. Sistem informasi manajemen aset TI yang dibuat sudah memenuhi komponen usability yg sudah diujikan sehingga sistem tersebut layak untuk di operasikan/digunakan oleh anggota Bid TIK Polda Kepulauan Riau.

scholarly journals Perancangan dan Pembuatan Game “Pembelajaran Bahasa Jepang Untuk Pemula” Metode User Centered Design Berbasis Android

2017 ◽  
Vol 2 (2) ◽  
pp. 137
Author(s):  
Michael Agustav ◽  
Kathryn Widhiyanti ◽  
Edwin Meinardi Trianto
Keyword(s):  
Design Method ◽  
Usability Testing ◽  
Test Method ◽  
Japanese Language ◽  
User Centered Design ◽  
Dynamic Design ◽  
Adobe Flash ◽  
Asian Pacific ◽  
The Impact ◽  
User Centered

With the growing rate of Asian Pacific free trading business in Indonesia, Indonesians need to be multilingual, rather than communicating only with mother language. Since recently there are quite number of investors come from Japan to Indonesia, Japanese language is fairly important to learn nowadays. And therefore this application is made to aid the process of learning Japanese for beginner by using the user centered design method. In this method the process includes making three prototypes. The first is called hand sketches prototype, then the second is the realization from the result of the first prototype, the third is called dynamic design prototype. These three prototypes are also combined with evaluation towards the user and debugging. There are two testing done, using the usability testing method which one of them includes “completing a transaction” and “evaluating the impact of subtle changes”. The result of the tests have been analyzed and according to the result it can be concluded that the test on completing a transaction shows that 92,3% of the users understood the features and buttons provided in the application, and as for the another test method which is “evaluating the impact of subtle changes” shows that 100% of the users are able to learn Japanese language with this application.Keywords: Android, Bahasa Jepang, User Centered Design, Usability Testing, Starling, Action Script 3, Adobe Flash Builder. AbstrakSeiring perkembangan jaman dimana perdagangan bebas Asia Pasifik mulai sering terjadi, maka penduduk Indonesia perlu mempelajari bahasa lain selain bahasa Indonesia. Bahasa Jepang perlu dipelajari karena mulai banyak investor asing dari negara Jepang di Indonesia. Oleh sebab itu dibuat aplikasi sederhana untuk membantu proses pembelajaran bahasa Jepang untuk pemula menggunakan metode user centered design. Dalam metode user centered design pada pembuatan aplikasi pembelajaran aplikasi pembelajaran bahasa Jepang untuk pemula ini dilakukan dengan membuat prototype pertama berupa hand-sketches prototype, kemudia dibuat  kedua berupa realisasi dari hasil hand-sketches, dan yang terakhir dibuat prototype ketiga berupa dynamic design prototype. Dari ketiga jenis prototype juga dilengkapi dengan evaluasi terhadap pengguna dan dilakukan perbaikan. Kemudian untuk pengujian telah dilakukan dua kali pengujian menggunakan metode dari usability testing yaitu completing a transaction dan evaluating the impact of subtle changes. Hasil dari kedua pengujian itu telah dianalisa dan dihitung, berdasarkan hasil analisa tersebut disimpulkan bahwa pada pengujian completing a transaction mendapatkan hasil 92,3% menunjukkan bahwa pengguna telah memahami fitur dan fungsi dari tombol yang telah disediakan pada aplikasi pembelajaran bahasa Jepang yang telah dibuat dan pada hasil pengujian evaluating the impact of subtle changes mendapatkan hasil 100% hasil tersebut menunjukkan bahwa pengguna telah dapat mempelajari bahasa Jepang dengan menggunakan aplikasi pembelajaran bahasa Jepang yang dibuat. Kata kunci: Android, Bahasa Jepang, User Centered Design, Usability Testing, Starling, Action Script 3, Adobe Flash Builder

scholarly journals Beyond Getting Rid of Stupid Stuff in the Electronic Health Record (Beyond-GROSS): Protocol for a User-Centered, Mixed-Method Intervention to Improve the Electronic Health Record System (Preprint)

2020 ◽  
Author(s):  
Ahmed Umar Otokiti ◽  
Catherine K Craven ◽  
Avniel Shetreat-Klein ◽  
Stacey Cohen ◽  
Bruce Darrow
Keyword(s):  
Health Care ◽  
Data Analysis ◽  
Electronic Health Record ◽  
Health Record ◽  
User Centered Design ◽  
Pilot Phase ◽  
Direct Input ◽  
Electronic Health ◽  
The Impact ◽  
User Centered

BACKGROUND Up to 60% of health care providers experience one or more symptoms of burnout. Perceived clinician burden resulting in burnout arises from factors such as electronic health record (EHR) usability or lack thereof, perceived loss of autonomy, and documentation burden leading to less clinical time with patients. Burnout can have detrimental effects on health care quality and contributes to increased medical errors, decreased patient satisfaction, substance use, workforce attrition, and suicide. OBJECTIVE This project aims to improve the user-centered design of the EHR by obtaining direct input from clinicians about deficiencies. Fixing identified deficiencies via user-centered design has the potential to improve usability, thereby increasing satisfaction by reducing EHR-induced burnout. METHODS Quantitative and qualitative data will be obtained from clinician EHR users. The input will be received through a form built in a REDCap database via a link embedded in the home page of the EHR. The REDCap data will be analyzed in 2 main dimensions, based on nature of the input, what section of the EHR is affected, and what is required to fix the issue(s). Identified issues will be escalated to relevant stakeholders responsible for rectifying the problems identified. Data analysis, project evaluation, and lessons learned from the evaluation will be incorporated in a Plan-Do-Study-Act (PDSA) manner every 4-6 weeks. RESULTS The pilot phase of the study began in October 2020 in the Gastroenterology Division at Mount Sinai Hospital, New York City, NY, which includes 39 physicians and 15 nurses. The pilot is expected to run over a 4-6–month period. The results of the REDCap data analysis will be reported within 1 month of completing the pilot phase. We will analyze the nature of requests received and the impact of rectified issues on the clinician EHR user. We expect that the results will reveal which sections of the EHR have the highest deficiencies while also highlighting issues about workflow difficulties. Perceived impact of the project on provider engagement, patient safety, and workflow efficiency will also be captured by evaluation survey and other qualitative methods where possible. CONCLUSIONS The project aims to improve user-centered design of the EHR by soliciting direct input from clinician EHR users. The ultimate goal is to improve efficiency, reduce EHR inefficiencies with the possibility of improving staff engagement, and lessen EHR-induced clinician burnout. Our project implementation includes using informatics expertise to achieve the desired state of a learning health system as recommended by the National Academy of Medicine as we facilitate feedback loops and rapid cycles of improvement. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/25148

scholarly journals Evaluasi dan Rekomendasi Usabilitas guna perbaikan E-Learning pada Perguruan Tinggi berdasarkan User Centered Design

2020 ◽  
Vol 6 (2) ◽  
pp. 67-76
Author(s):  
Hulwah Zahidah ◽  
Amalia Rahmah
Keyword(s):  
Usability Testing ◽  
User Acceptance ◽  
Acceptance Test ◽  
User Centered Design ◽  
User Research ◽  
System Usability Scale ◽  
System Usability ◽  
E Learning ◽  
Research Prototype ◽  
User Centered

STT Terpadu Nurul Fikri adalah salah satu instansi yang memanfaatkan teknologi dalam mengembangkan kegitan belajar mengajar dengan menggunakan e-learning sebagai media utamanya. Namun, kondisi eLen saat ini masih kurang mendukung pembelajaran mahasiswa, dibuktikan dengan tidak tersedianya beberapa fitur yang dibutuhkan oleh pengguna. Hal tersebut didukung dari hasil penyebaran kuesioner yang mengacu pada usability, bahwa eLen memiliki permasalahan. Dengan adanya permasalahan tersebut maka diperlukan peningkatan e-Len STT NF dengan membuat rancangan solusi desain berdasarkan kebutuhan pengguna menggunakan User Centered Design (UCD). Dari masalah yang sudah didapat akan dilakukan user research, lalu dilakukan pembuatan prototype yang mengacu pada hasil user research. Prototype yang telah dibuat akan diuji dengan menggunakan metode usability testing dan system usability scale. Hasil usability testing menyatakan bahwa prototype website eLen STT NF yang telah dilakukan berbasis UCD sudah cukup baik dan sudah sesuai dengan kebutuhan pengguna. Sementara itu, hasil System Usability Scale (SUS) menyatakan bahwa Skor SUS dari website eLen STT NF berbasis UCD adalah 78.61. Tahap selanjutnya, akan dilakukannya implementasi Moodle yang kemudian akan dilakukan  pengujian kembali dengan menggunakan User Acceptance Test (UAT). Kemudian hasil dari UAT menyatakan bahwa implementasi eLen STT NF sudah cukup baik didapat dari jumlah nilai rata-rata pengujian berdasarkan 14 pertanyaan sebesar 83,57%.

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