Literature Review on Usability Testing on Academic Electronic Medical Record Systems - Coursework Example

?Literature Review on Usability Testing on Academic Electronic Medical Record Systems Although developments and advancements in technology nowadays are aggressively being adopted for better service in the medical practice, usability of academic medical record systems is still a challenge. The biggest challenge is that the errors are normally occurring in the process of using electronic medical records systems by novice users. The resulting of the errors in the process means that there is a miscommunication between the inexperienced healthcare professionals and the patient, leading to poor or inappropriate administration of health services to the patient (ISO/IEC, 2011). This can be disastrous for patients to the extent of causing avoidable deaths. Users of electronic medical systems are practitioners in the medical field and users of academic medical record systems are those who are being prepared through learning to become qualified and full users of electronic medical records systems. As a result, earlier application usability testing on academic medical records stands to eliminate or minimize errors associated with usability of electronic medical record systems. Implementing usability testing on academic medical records systems creates an environment whereby the health care services practitioners understand electronic medical systems earlier and are adequately prepared for the challenge (s) before them. Academic electronic medical records systems do not have much coverage as relate to usability testing but there is an abundance of literature on usability of electronic medical records systems. An academic application of electronic medical records system is very important in enhancing the knowledge and skills of the medical student for the actual task ahead. Amidst all of the debate revolving around product functions, features, and which product is appropriate for which practice setting, one very important aspect that require to be examined is usability. Usability of a product depends on the combination of its functionality, features, visual appeal as well as the usefulness (Emanuel, et al., 2008). A product must be oriented to the context it applies, and it must take into account the characteristics of its users. Generally, electronic medical records are used for handling medical information vital for patient care and enhance the efficiency as well as accessibility of that information. The same purpose is maintained in academic electronic medical records systems only that it will incorporate those training to become actual users in the future. The importance of testing for usability of academic medical records (EMR) system Studies on the importance of testing usability of an EMR system, involves examining the role of usability testing as concerns evaluation of an EMR system, identification issues with usability by both beginners and more experienced system users, and effect on efficiency and satisfaction of its users (Corrao, Robinson, Swiernik, & Naeim, 2010). Academic practitioner literatures are confronted with both failed and successful implementations of EMR system. Setting up of EMR systems is always accompanied by technical, economic, organizational and cultural challenges. These studies conclude that apart from reviewing content and features of an EMR system, usability testing has the potential of improving chances of an EMR design being integrated with current workflow and process of business in a clear, transparent and efficient manner. In these studies 90% and above of issues and recommendations for rectification identified by beginners have been found to be credible. However, an interesting finding is that a majority of the users experienced in using previously implemented systems that have not been subject to amplified usability testing, had a higher level of dissatisfaction with efficiency as well as overall functionality but higher general satisfaction than expected. This underscores the importance of testing usability in academic EMR systems. Literature on academic EMR systems, suggest that there should be capacity of change readiness impacted on students and health organization, especially learning institutions’ health systems to alleviate the challenges emerging in effective EMR implementation (Ranganathan & Afnan, 2012). Improving EMR system's usability Studies to this effect have sought to improve patient safety and the quality of health care, through enhancing the usability of EMR systems (Blackford, et al., 2012). Generally, issues to this effect lie in four areas of concern: human factors in health information technology research, industry issues, health information technology policy and clinical-end-user of EMR software. Errors related to the usability of an EMR system may be known or unknown to the user. The errors that are unknown to the user may not have a huge impact on the delivery of services by the user but will impact on the overall outcome. The variation in the final outcome may come by because in some instances a user is expected to use two EMR systems, which may have different terminologies and particular design intended for particular results. Any deviation in use because of the assumption that use of a particular EMR system is standard could result in a huge divergence from the intended result. Most of the recent studies define safe and effective use of EMR system as an asset resulting from the careful integration of multiple factors in an extensive socio-technical framework, including consideration and coordination across requirements assessment, usability and engineering of human factors, application design, training, monitoring, implementation, and feedback to developers of application (Shneiderman, 2011). There is a substantial usage of electronic books gaining momentum as compared to print books in the medical field. Print is keeping a level usage pattern whereas electronic usage is steadily increasing. Generally, medical texts experience high demand in medical libraries. Electronic versions of medical information can replace the print versions especially of texts in reverse situations. This indicates that as a way of improving EMR system medical libraries and other medical facilities need to enhance their academic EMR systems as demand is going high in an effort to mitigate related challenges. Use an EMR system in cognition task Studies have been carried out to identify the related EMR use and its influence on communication between patients and doctors. Generally an EMR system has comprehensive, organized and readable data that have reduced the need by physicians to rely on memory and the problems of reading handwritings (Shachak, Hadas-Dayagi, Ziv, & Reis, 2009). Interns have indicated that they use e-information to support their clinical care. Thus, EMR reduces the cognitive load connected with clinical tasks. EMR use automation ability contributes to efficiency, but at times results in errors, like the choice of the wrong medication, or data input into the incorrect chart of the patient. Use of academic EMR has been found to interfere with patient-doctor communication. A major way of overcoming this difficulty involved separating the use of academic EMR from the time consumed communication with patients. Enhanced student physicians’ communication and computer mastery has also assisted. It has been concluded that there is a fine balance amidst the risks and benefits of academic EMR use (Buntin, Burke, Hoaglin, & Blumenthal, 2011). Automation ability, particularly in combination with interruptions, has emerged as a major cognitive factor that contributes to errors. Generally, EMR use has been found to have a negative impact that can be partly addressed by enhancing the spatial organization of facilities of student physicians and by improving computer and communication skills of student physicians. Usability testing in academic EMR system As indicated above academic EMR system is now gaining weight following issues that have been identified in extensive coverage of EMR systems. Usability is described as including nine attributes: naturalness, simplicity, consistency, effective use of language, forgiveness and feedback, effective information presentation, efficient interactions, minimization of cognitive load, and preservation of context (Belden, Grayson, & Barnes, 2009). Zhang and Walji (2011), offer a more comprehensive as well as evidence-based view on usability, where usability describes how usable, useful, and satisfying a system stands for the users it is intended to achieve goals through carrying out certain sequences of tasks. These are objective measurable dimensions regarding usability. EMR systems having better usability basing on these dimensions should have no or fewer negative patient consequences (Zhang & Walji, 2011). Efficiency as well as consistency has to be measured objectively. Testing usability of academic EMR in undergraduate education Literatures on academic EMR system indicate that there is a radical transformation in the nursing education and nursing profession towards meeting the lately evolving expectations of employees in the nursing field (Lowry, et al., 2012). The principal idea behind this is that EMR and informatics must be used for preparing nursing graduates for practicing the profession. EMR is now being adopted by professional organizations in clinical practice. Academic EMR are totally functional systems via which students can navigate document and technology as well as plan patient care within a computer-generated format. The academic EMR system permits students to apply knowledge and skills gained during their educational experience and assists in the development of relevant critical thinking skills. In this regard, competences have been set up for novice nurse and must serve as a guide to educators of nurses as they develop the nursing curriculum (Forrey, Pedersen, & Schneider, 2007). Nursing faculty has been recognized as the main barrier to academic EMR integration into the nursing curriculum (Shachak, Hadas-Dayagi, Ziv, & Reis, 2009) As the implementation of the academic EMR is encouraged, testing its usability is encouraged through the principles of accreditation of the nursing programs in education institutions, especially on adoption and enhancing use of technology to enhance clinical practice (Belden, Grayson, & Barnes, 2009). However, the full potential of testing usability in academic EMR needs further emphasis to be achieved (Lowry, et al., 2012). In a nutshell testing usability of the academic EMR system is valuable and to be effective, it must function with a high level of flexibility and efficiency. These should take into considerations concerns raised by interns in the field and cognitive science principles. Generally, testing usability of academic EMR system must be enhanced as an effort towards improving utility of academic EMR systems. References Belden, L. J., Grayson, R., & Barnes, J. (2009). Defining and Testing EMR Usability: Principles and Proposed Methods of EMR Usability Evaluation and Rating. Washington: Heal Information and Management Systems Society (HIMSS). Blackford, M., Bloomrosen, M., Dente, A. M., Hashmat, B., Koppel, R., Overhage, M. J., . . . Zhang, J. (2012). Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA. J AM Med Iform Assoc, 1458-62. Buntin, M., Burke, M., Hoaglin, M., & Blumenthal, D. (2011). The benefits of health information technology: a review of the recent literature shows predominantly positive results. Health Affairs, 464-471. Corrao, J. N., Robinson, G. A., Swiernik, A. M., & Naeim, A. (2010). Importance of Testing for Usability When selecting and Implementing an Electronic Health or Medical Record System. J Oncol Pract, 120-124. Emanuel, L., Berwick, D., Conway, J., Combes, J., Hatlie, M., Leape, L., . . . Walton. (2008). Advances in patient safety: new directions and alternative approaches. Rockville, MD: Agency for Healthcare Research and Quality. Forrey, R., Pedersen, C., & Schneider, P. (2007). interrater agreement with a standard scheme for classifying medication errors. . American journal of Health-System Pharmacy, 175-181. ISO/IEC. (2011). Systems and software engineering-Software product Quality requirements and Evaluation (SQuoRE) -Software product quality and system quality in use model. New York: ISO. Lowry, Z. S., Quinn, T. M., Ramaiah, M., Schumacher, M. R., Patterson, S. E., Zhang, J., . . . Abbott, P. (2012). Technical Evaluation, Testing, and Validation of the Usability of Electronic Health Records. NISTR 7804, 40-70. Shachak, A., Hadas-Dayagi, M., Ziv, A., & Reis, M. (2009). Primary care Physicians' Use of an electronic Medical Record System: A cognitive Task Analysis. J Gen Intern Med, 341-348. Shneiderman, B. (2011). Tragic Errors: usability and electronic health records. Interactions, 60-3. Zhang, J., & Walji, M. (2011). TuRF: Towards a unified framework of EHR usability. Journal of Biomedical informatics, 1056-67. Read More