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Healthcare
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Evaluation of the Usability of Healthcare Systems
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Evaluation of the Usability of Healthcare Systems

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Health Assessments".

Deadline for manuscript submissions: closed (29 February 2024) | Viewed by 17136

Special Issue Editors

Prof. Dr. Andre Kushniruk

E-Mail Website
Guest Editor
School of Health Information Science, University of Victoria, Victoria, BC V8P 5C2, Canada
Interests: usability of health information systems; human factors in healthcare; clinical informatics; health informatics; consumer informatics; decision support systems; healthcare decision making; AI in healthcare; evaluation methods; healthcare system design
Prof. Dr. Elizabeth Borycki

E-Mail Website
Guest Editor
School of Health Information Science, University of Victoria, Victoria, BC V8P 5C2, Canada
Interests: human factors; usability; safety; clinical informatics; nursing informatics; health informatics

Special Issue Information

Dear Colleagues,

A wide range of healthcare information systems are being deployed worldwide, ranging from electronic health records to clinical decision support, emerging applications of AI as well as many patient-facing applications. However, a variety of issues and challenges remain regarding the usability of many of these systems and applications in healthcare. There continue to be reports of systems that are deemed unusable by the end users, that have been perceived as adding to workload (rather than reducing it) and that may inadvertently lead to unsafe healthcare. Usability and user experience are now recognized as being critical areas for evaluation in order to improve adoption, efficiency and user satisfaction of healthcare systems. The evaluation of usability and user experience has become an essential component in deploying healthcare systems that are effective, safe and that will ultimately be adopted by end users. Along these lines, there is a need for scientific approaches for evaluating the usability of healthcare information systems. Central to this is the development of evaluation methods and approaches that can practically inform design (and redesign) of healthcare systems. Methods and approaches vary from in-depth qualitative usability testing approaches, to ethnography and remote analysis of users, to automated analysis of both health providers and patients involved in virtual healthcare.

In this special issue we invite a range of papers that consider advances in the evaluation of the usability of healthcare systems. New research papers, short communications, perspectives articles and reviews are all welcome in this special issue. The issue aims to bring together work that critically examines approaches to the evaluation of usability and user experience from multiple perspectives. This includes work in the area of human factors, applications of usability engineering and design science, as well as regulatory issues related to evaluation and certification of healthcare information systems. In this issue we invite submissions that provide insight into advancing research, practice and methodology for evaluating the usability of healthcare information systems.

We look forward to receiving your contributions.

Prof. Dr. Andre Kushniruk
Prof. Dr. Elizabeth Borycki
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • usability of healthcare systems
  • user experience in healthcare
  • human-computer interaction (HCI) in healthcare
  • human factors engineering for healthcare
  • system evaluation in healthcare
  • usability engineering applied in healthcare
  • usability testing of healthcare systems

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Published Papers (6 papers)

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Research

15 pages, 1801 KiB  
Article
Usability Evaluation Ecological Validity: Is More Always Better?
by Romaric Marcilly, Helen Monkman, Sylvia Pelayo and Blake J. Lesselroth
Healthcare 2024, 12(14), 1417; https://doi.org/10.3390/healthcare12141417 - 16 Jul 2024
Cited by 1 | Viewed by 781
Abstract
Background: The ecological validity associated with usability testing of health information technologies (HITs) can affect test results and the predictability of real-world performance. It is, therefore, necessary to identify conditions with the greatest effect on validity. Method: We conducted a comparative analysis of [...] Read more.
Background: The ecological validity associated with usability testing of health information technologies (HITs) can affect test results and the predictability of real-world performance. It is, therefore, necessary to identify conditions with the greatest effect on validity. Method: We conducted a comparative analysis of two usability testing conditions. We tested a HIT designed for anesthesiologists to detect pain signals and compared two fidelity levels of ecological validity. We measured the difference in the number and type of use errors identified between high and low-fidelity experimental conditions. Results: We identified the same error types in both test conditions, although the number of errors varied as a function of the condition. The difference in total error counts was relatively modest and not consistent across levels of severity. Conclusions: Increasing ecological validity does not invariably increase the ability to detect use errors. Our findings suggest that low-fidelity tests are an efficient way to identify and mitigate usability issues affecting ease of use, effectiveness, and safety. We believe early low-fidelity testing is an efficient but underused way to maximize the value of usability testing. Full article
(This article belongs to the Special Issue Evaluation of the Usability of Healthcare Systems)
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14 pages, 271 KiB  
Article
Personalizing Digital Health: Adapting Health Technology Systems to Meet the Needs of Different Older Populations
by Jennifer Jimenez, Alberto del Rio, Arianna N. Berman and Miriam Grande
Healthcare 2023, 11(15), 2140; https://doi.org/10.3390/healthcare11152140 - 26 Jul 2023
Cited by 8 | Viewed by 1894
Abstract
The ageing of the population is growing significantly and will challenge healthcare systems. Chronic diseases in the older population require a change in service delivery, and new technologies can be a key element in ensuring the viability and sustainability of these systems. However, [...] Read more.
The ageing of the population is growing significantly and will challenge healthcare systems. Chronic diseases in the older population require a change in service delivery, and new technologies can be a key element in ensuring the viability and sustainability of these systems. However, the generation gap and the physical and cognitive decline commonly associated with the older generation are barriers to the transition to these models of care. Despite this, there has been a trend towards digital healthcare, which has many potential benefits for the older population. Numerous studies have assessed the acceptability of new technologies for older people in healthcare. These studies highlight the importance of perceived usefulness, compatibility, ease of use and personalisation of the technology. Personalisation is necessary to ensure that the system is useful for users, and different characteristics such as country of origin, gender, age, or comfort with the technology should be taken into account. A person-centred approach in the development of new health technology systems is essential to ensure that applications can be better tailored to the needs of different ageing populations. Many organisations have dedicated time and resources to ensure a person-centred approach in the development of new health technology systems, and putting the individual first is the best way forward in digital health. This article presents the work carried out in this regard in the framework of the European TeNDER project together with an analysis of the results obtained in terms of satisfaction, usefulness, and usability from end-users. The dynamic and continuous process carried out throughout the TeNDER project translates the needs reported by users, as far as personalisation of interactions is concerned. All end-users held a positive opinion about the usability and usefulness of the system. Full article
(This article belongs to the Special Issue Evaluation of the Usability of Healthcare Systems)
22 pages, 1188 KiB  
Article
Framework for Guiding the Development of High-Quality Conversational Agents in Healthcare
by Kerstin Denecke
Healthcare 2023, 11(8), 1061; https://doi.org/10.3390/healthcare11081061 - 7 Apr 2023
Cited by 7 | Viewed by 2805
Abstract
Evaluating conversational agents (CAs) that are supposed to be applied in healthcare settings and ensuring their quality is essential to avoid patient harm and ensure efficacy of the CA-delivered intervention. However, a guideline for a standardized quality assessment of health CAs is still [...] Read more.
Evaluating conversational agents (CAs) that are supposed to be applied in healthcare settings and ensuring their quality is essential to avoid patient harm and ensure efficacy of the CA-delivered intervention. However, a guideline for a standardized quality assessment of health CAs is still missing. The objective of this work is to describe a framework that provides guidance for development and evaluation of health CAs. In previous work, consensus on categories for evaluating health CAs has been found. In this work, we identify concrete metrics, heuristics, and checklists for these evaluation categories to form a framework. We focus on a specific type of health CA, namely rule-based systems that are based on written input and output, have a simple personality without any kind of embodiment. First, we identified relevant metrics, heuristics, and checklists to be linked to the evaluation categories through a literature search. Second, five experts judged the metrics regarding their relevance to be considered within evaluation and development of health CAs. The final framework considers nine aspects from a general perspective, five aspects from a response understanding perspective, one aspect from a response generation perspective, and three aspects from an aesthetics perspective. Existing tools and heuristics specifically designed for evaluating CAs were linked to these evaluation aspects (e.g., Bot usability scale, design heuristics for CAs); tools related to mHealth evaluation were adapted when necessary (e.g., aspects from the ISO technical specification for mHealth Apps). The resulting framework comprises aspects to be considered not only as part of a system evaluation, but already during the development. In particular, aspects related to accessibility or security have to be addressed in the design phase (e.g., which input and output options are provided to ensure accessibility?) and have to be verified after the implementation phase. As a next step, transfer of the framework to other types of health CAs has to be studied. The framework has to be validated by applying it during health CA design and development. Full article
(This article belongs to the Special Issue Evaluation of the Usability of Healthcare Systems)
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28 pages, 2003 KiB  
Article
Threat Assessment and Risk Analysis (TARA) for Interoperable Medical Devices in the Operating Room Inspired by the Automotive Industry
by Andreas Puder, Jacqueline Henle and Eric Sax
Healthcare 2023, 11(6), 872; https://doi.org/10.3390/healthcare11060872 - 16 Mar 2023
Cited by 6 | Viewed by 5958
Abstract
Prevailing trends in the automotive and medical device industry, such as life cycle overarching configurability, connectivity, and automation, require an adaption of development processes, especially regarding the security and safety thereof. The changing requirements imply that interfaces are more exposed to the outside [...] Read more.
Prevailing trends in the automotive and medical device industry, such as life cycle overarching configurability, connectivity, and automation, require an adaption of development processes, especially regarding the security and safety thereof. The changing requirements imply that interfaces are more exposed to the outside world, making them more vulnerable to cyberattacks or data leaks. Consequently, not only do development processes need to be revised but also cybersecurity countermeasures and a focus on safety, as well as privacy, have become vital. While vehicles are especially exposed to cybersecurity and safety risks, the medical devices industry faces similar issues. In the automotive industry, proposals and draft regulations exist for security-related risk assessment processes. The medical device industry, which has less experience in these topics and is more heterogeneous, may benefit from drawing inspiration from these efforts. We examined and compared current standards, processes, and methods in both the automotive and medical industries. Based on the requirements regarding safety and security for risk analysis in the medical device industry, we propose the adoption of methods already established in the automotive industry. Furthermore, we present an example based on an interoperable Operating Room table (OR table). Full article
(This article belongs to the Special Issue Evaluation of the Usability of Healthcare Systems)
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12 pages, 926 KiB  
Article
The Burden of Alcohol-Related Emergency Department Visits in a Hospital of a Large European City
by Hanna Cholerzyńska, Wiktoria Zasada, Tomasz Kłosiewicz, Patryk Konieczka and Mateusz Mazur
Healthcare 2023, 11(6), 786; https://doi.org/10.3390/healthcare11060786 - 7 Mar 2023
Cited by 2 | Viewed by 1853
Abstract
(1) Alcohol consumption contributes to the development of numerous diseases and is a big organizational burden on emergency departments (EDs). (2) We examined data on alcohol-related ED admissions in Poznan, Poland between 1 April 2019 and 31 March 2022. A total of 2290 [...] Read more.
(1) Alcohol consumption contributes to the development of numerous diseases and is a big organizational burden on emergency departments (EDs). (2) We examined data on alcohol-related ED admissions in Poznan, Poland between 1 April 2019 and 31 March 2022. A total of 2290 patients’ records were collected and analysed. The main goal was to determine the impact that these visits had on the functioning of the ED and the hospital. (3) The alcohol-related admission rate was significantly higher in males (78.95% vs. 21.05%), and the median blood alcohol concentration (BAC) level was 2.60 (1.78–3.38) ‰. Most of the visits took place at weekends and in the evening. Patients with higher BAC tended to stay longer in the ED, but had a lower chance of being admitted. A majority of patients required radiology and laboratory testing, 20.44% needed psychiatric examination, and 19.69% suffered trauma, mainly to the head. (4) Injuries and mental problems were the most common medical emergencies. This study presents trends in alcohol-related ED attendances, examines reasons for visits, and makes an attempt to assess overall burden on EDs. Full article
(This article belongs to the Special Issue Evaluation of the Usability of Healthcare Systems)
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16 pages, 641 KiB  
Article
Co-Creation in Health 4.0 as a New Solution for a New Era
by Norbert Laurisz, Marek Ćwiklicki, Michał Żabiński, Rossella Canestrino and Pierpaolo Magliocca
Healthcare 2023, 11(3), 363; https://doi.org/10.3390/healthcare11030363 - 27 Jan 2023
Cited by 4 | Viewed by 2728
Abstract
Previous research on co-creation in healthcare indicates that the use of co-creation in the design process of health solutions influences their greater acceptance and adaptation, resulting in greater efficiency of health services and higher usability of implemented health solutions. Analysis of adaptation and [...] Read more.
Previous research on co-creation in healthcare indicates that the use of co-creation in the design process of health solutions influences their greater acceptance and adaptation, resulting in greater efficiency of health services and higher usability of implemented health solutions. Analysis of adaptation and acceptance of new technologies reveals the problem of misunderstanding and the need for more trust in modern tools implemented in the healthcare system. The remedy may be the use of co-creation in the process of developing modern medical products and services. This article’s main purpose is to explore the co-creation process in Health 4.0, which is understood as the development of healthcare through the application of methods and tools of the Fourth Industrial Revolution. The literature review provided insights for an analytical framework—the co-creation matrix. We analyzed the case of the Italian medical platform Paginemediche.it to reveal the actors’ engagement in co-creation. The results demonstrated different levels of engagement in improving the efficiency of implementing medical and technological solutions. Both theoretical and practical analysis proved that the co-creation matrix helps more precisely define the scale and scope of co-creation in Health 4.0. Full article
(This article belongs to the Special Issue Evaluation of the Usability of Healthcare Systems)
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