Clinicians’ user experience with health information exchange technologies during simulated medication reconciliation
Background: Health information exchange (HIE), the electronic sharing of medical records between health care institutions, may increase patient safety. However, reported barriers to clinicians’ use of HIE include poor system usability and information quality. Through simulated medication reconciliat...
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Elsevier
2025-06-01
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| Series: | Human Factors in Healthcare |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772501424000101 |
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| author | Himalaya Patel April Savoy Steven L. Sanchez Morgan Traylor Khoa A. Nguyen Kenneth S. Boockvar Vincent S. Fan Emily R. Locke Bryan Gibson Amanda S. Mixon Susan H. Byerly David A. Haggstrom Teresa M. Damush Michael Weiner Alissa L. Russ-Jara |
| author_facet | Himalaya Patel April Savoy Steven L. Sanchez Morgan Traylor Khoa A. Nguyen Kenneth S. Boockvar Vincent S. Fan Emily R. Locke Bryan Gibson Amanda S. Mixon Susan H. Byerly David A. Haggstrom Teresa M. Damush Michael Weiner Alissa L. Russ-Jara |
| author_sort | Himalaya Patel |
| collection | DOAJ |
| description | Background: Health information exchange (HIE), the electronic sharing of medical records between health care institutions, may increase patient safety. However, reported barriers to clinicians’ use of HIE include poor system usability and information quality. Through simulated medication reconciliation tasks, our objective was to characterize clinicians’ user experience with HIE technologies, and to identify requirements for future HIE technologies from clinicians’ current use patterns. Methods: Our simulation-based observational study included three successive generations of HIE technologies used in the U.S. Department of Veterans Affairs (VA) health care system: Computerized Patient Record System (CPRS); VistA Web; and Joint Longitudinal Viewer (JLV). While using a think-aloud technique, participants attempted two randomly assigned, time-limited medication reconciliation tasks using any of these technologies. Tasks followed from clinical scenarios that varied on the types of cues about HIE data availability. After tasks, participants used the UMUX-Lite instrument to rate each technology's ease of use and utility (each range 1–7; 7=strongly agree). To identify design-related barriers, we coded and interpreted usability and content problems that participants encountered. To ease coding, we used problem frequency to indicate severity. Results: Forty-four clinicians, spanning 21 specialties, participated from four VA medical centers: 23 physicians, 11 nurse practitioners, and 10 pharmacists. Overall, participant-rated ease of use and utility (M [SD]) were 4.0 (1.7)—a point-estimate grade of D (“Fair”)—and 4.0 (1.6), respectively. Participants spent 71 % of task time in CPRS, which also ranked highest in ease of use and utility (ps < .001). Across technologies, frequent user-experience problems included unclear screen layout (35 [80 % of] participants), difficult navigation (35 [80 %]), and task-irrelevant data (34 [77 %]). Notable features included preformatted reports; table sorting methods; data-availability indicators; and filters for data sources, time periods, and keywords. Conclusion: To improve clinicians’ user experience and ease transitions to newer platforms, HIE technologies should 1) communicate data scope, 2) minimize clinicians’ navigation steps, 3) summarize retrieved data, and 4) offer searching, sorting, and filtering. These strategies may increase HIE's usefulness for clinicians when reconciling patients’ medications. |
| format | Article |
| id | doaj-art-ae9f98d845a64e2182c8f927f4741691 |
| institution | Kabale University |
| issn | 2772-5014 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
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| series | Human Factors in Healthcare |
| spelling | doaj-art-ae9f98d845a64e2182c8f927f47416912025-01-29T05:02:45ZengElsevierHuman Factors in Healthcare2772-50142025-06-017100073Clinicians’ user experience with health information exchange technologies during simulated medication reconciliationHimalaya Patel0April Savoy1Steven L. Sanchez2Morgan Traylor3Khoa A. Nguyen4Kenneth S. Boockvar5Vincent S. Fan6Emily R. Locke7Bryan Gibson8Amanda S. Mixon9Susan H. Byerly10David A. Haggstrom11Teresa M. Damush12Michael Weiner13Alissa L. Russ-Jara14Center for Health Information and Communication, U.S. Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Service (CIN 13-416), Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States of America; Corresponding author.Center for Health Information and Communication, U.S. Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Service (CIN 13-416), Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States of America; Purdue School of Engineering and Technology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States of America; Center for Health Services Research, Regenstrief Institute, Inc., Indianapolis, IN, United States of AmericaCenter for Health Information and Communication, U.S. Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Service (CIN 13-416), Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States of AmericaCenter for Health Information and Communication, U.S. Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Service (CIN 13-416), Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States of AmericaCenter for Health Information and Communication, U.S. Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Service (CIN 13-416), Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States of America; Department of Pharmacotherapy & Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, United States of AmericaGeriatrics Research, Education, and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, United States of America; Department of Geriatrics & Palliative Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, United States of AmericaVA Puget Sound Health Care System, Seattle, WA, United States of America; University of Washington, Seattle, WA, United States of AmericaVA Puget Sound Health Care System, Seattle, WA, United States of AmericaCenter for Informatics, Decision-Enhancement and Analytic Sciences, VA Health Services Research and Development, George E. Wahlen VA Medical Center, Salt Lake City, UT, United States of America; Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States of AmericaGeriatric Research, Education, and Clinical Center, VA Tennessee Valley Healthcare System, Nashville, TN, United States of America; Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States of AmericaGeriatric Research, Education, and Clinical Center, VA Tennessee Valley Healthcare System, Nashville, TN, United States of America; Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States of AmericaCenter for Health Information and Communication, U.S. Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Service (CIN 13-416), Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States of America; Center for Health Services Research, Regenstrief Institute, Inc., Indianapolis, IN, United States of America; School of Medicine, Indiana University, Indianapolis, IN, United States of AmericaCenter for Health Information and Communication, U.S. Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Service (CIN 13-416), Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States of America; Center for Health Services Research, Regenstrief Institute, Inc., Indianapolis, IN, United States of America; School of Medicine, Indiana University, Indianapolis, IN, United States of AmericaCenter for Health Information and Communication, U.S. Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Service (CIN 13-416), Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States of America; Center for Health Services Research, Regenstrief Institute, Inc., Indianapolis, IN, United States of America; School of Medicine, Indiana University, Indianapolis, IN, United States of AmericaCenter for Health Information and Communication, U.S. Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Service (CIN 13-416), Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States of America; Center for Health Services Research, Regenstrief Institute, Inc., Indianapolis, IN, United States of America; Department of Pharmacy Practice and Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, IN, United States of AmericaBackground: Health information exchange (HIE), the electronic sharing of medical records between health care institutions, may increase patient safety. However, reported barriers to clinicians’ use of HIE include poor system usability and information quality. Through simulated medication reconciliation tasks, our objective was to characterize clinicians’ user experience with HIE technologies, and to identify requirements for future HIE technologies from clinicians’ current use patterns. Methods: Our simulation-based observational study included three successive generations of HIE technologies used in the U.S. Department of Veterans Affairs (VA) health care system: Computerized Patient Record System (CPRS); VistA Web; and Joint Longitudinal Viewer (JLV). While using a think-aloud technique, participants attempted two randomly assigned, time-limited medication reconciliation tasks using any of these technologies. Tasks followed from clinical scenarios that varied on the types of cues about HIE data availability. After tasks, participants used the UMUX-Lite instrument to rate each technology's ease of use and utility (each range 1–7; 7=strongly agree). To identify design-related barriers, we coded and interpreted usability and content problems that participants encountered. To ease coding, we used problem frequency to indicate severity. Results: Forty-four clinicians, spanning 21 specialties, participated from four VA medical centers: 23 physicians, 11 nurse practitioners, and 10 pharmacists. Overall, participant-rated ease of use and utility (M [SD]) were 4.0 (1.7)—a point-estimate grade of D (“Fair”)—and 4.0 (1.6), respectively. Participants spent 71 % of task time in CPRS, which also ranked highest in ease of use and utility (ps < .001). Across technologies, frequent user-experience problems included unclear screen layout (35 [80 % of] participants), difficult navigation (35 [80 %]), and task-irrelevant data (34 [77 %]). Notable features included preformatted reports; table sorting methods; data-availability indicators; and filters for data sources, time periods, and keywords. Conclusion: To improve clinicians’ user experience and ease transitions to newer platforms, HIE technologies should 1) communicate data scope, 2) minimize clinicians’ navigation steps, 3) summarize retrieved data, and 4) offer searching, sorting, and filtering. These strategies may increase HIE's usefulness for clinicians when reconciling patients’ medications.http://www.sciencedirect.com/science/article/pii/S2772501424000101Electronic health recordsHealth information exchangeMedication reconciliationNurse practitionersPharmacistsPhysicians |
| spellingShingle | Himalaya Patel April Savoy Steven L. Sanchez Morgan Traylor Khoa A. Nguyen Kenneth S. Boockvar Vincent S. Fan Emily R. Locke Bryan Gibson Amanda S. Mixon Susan H. Byerly David A. Haggstrom Teresa M. Damush Michael Weiner Alissa L. Russ-Jara Clinicians’ user experience with health information exchange technologies during simulated medication reconciliation Human Factors in Healthcare Electronic health records Health information exchange Medication reconciliation Nurse practitioners Pharmacists Physicians |
| title | Clinicians’ user experience with health information exchange technologies during simulated medication reconciliation |
| title_full | Clinicians’ user experience with health information exchange technologies during simulated medication reconciliation |
| title_fullStr | Clinicians’ user experience with health information exchange technologies during simulated medication reconciliation |
| title_full_unstemmed | Clinicians’ user experience with health information exchange technologies during simulated medication reconciliation |
| title_short | Clinicians’ user experience with health information exchange technologies during simulated medication reconciliation |
| title_sort | clinicians user experience with health information exchange technologies during simulated medication reconciliation |
| topic | Electronic health records Health information exchange Medication reconciliation Nurse practitioners Pharmacists Physicians |
| url | http://www.sciencedirect.com/science/article/pii/S2772501424000101 |
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