Int J Med Inform - Assessing performance of an Electronic Health Record (EHR) using Cognitive Task Analysis.

Tópicos

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Resumo

CKGROUND: Many Electronic Health Record (EHR) systems fail to provide user-friendly interfaces due to the lack of systematic consideration of human-centered computing issues. Such interfaces can be improved to provide easy to use, easy to learn, and error-resistant EHR systems to the users.OBJECTIVE: To evaluate the usability of an EHR system and suggest areas of improvement in the user interface.METHODS: The user interface of the AHLTA (Armed Forces Health Longitudinal Technology Application) was analyzed using the Cognitive Task Analysis (CTA) method called GOMS (Goals, Operators, Methods, and Selection rules) and an associated technique called KLM (Keystroke Level Model). The GOMS method was used to evaluate the AHLTA user interface by classifying each step of a given task into Mental (Internal) or Physical (External) operators. This analysis was performed by two analysts independently and the inter-rater reliability was computed to verify the reliability of the GOMS method. Further evaluation was performed using KLM to estimate the execution time required to perform the given task through application of its standard set of operators.RESULTS: The results are based on the analysis of 14 prototypical tasks performed by AHLTA users. The results show that on average a user needs to go through 106 steps to complete a task. To perform all 14 tasks, they would spend about 22 min (independent of system response time) for data entry, of which 11 min are spent on more effortful mental operators. The inter-rater reliability analysis performed for all 14 tasks was 0.8 (kappa), indicating good reliability of the method.CONCLUSION: This paper empirically reveals and identifies the following finding related to the performance of AHLTA: (1) large number of average total steps to complete common tasks, (2) high average execution time and (3) large percentage of mental operators. The user interface can be improved by reducing (a) the total number of steps and (b) the percentage of mental effort, required for the tasks.

Resumo Limpo

ckground mani electron health record ehr system fail provid userfriend interfac due lack systemat consider humancent comput issu interfac can improv provid easi use easi learn errorresist ehr system usersobject evalu usabl ehr system suggest area improv user interfacemethod user interfac ahlta arm forc health longitudin technolog applic analyz use cognit task analysi cta method call gom goal oper method select rule associ techniqu call klm keystrok level model gom method use evalu ahlta user interfac classifi step given task mental intern physic extern oper analysi perform two analyst independ interrat reliabl comput verifi reliabl gom method evalu perform use klm estim execut time requir perform given task applic standard set operatorsresult result base analysi prototyp task perform ahlta user result show averag user need go step complet task perform task spend min independ system respons time data entri min spent effort mental oper interrat reliabl analysi perform task kappa indic good reliabl methodconclus paper empir reveal identifi follow find relat perform ahlta larg number averag total step complet common task high averag execut time larg percentag mental oper user interfac can improv reduc total number step b percentag mental effort requir task

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