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Determining the Impact of Usability Issues of Primary Care Physicians by Expertise When Using an Electronic Health Record

MUII Comprehensive Exam Announcement - Martina Clarke

In clinical practice, the function of health information technology (HIT) is growing and more physicians are adopting EHRs extensively because of the financial incentives promised by CMS. There is a shortage of physicians which is expected to top 125,000 by 2020–2025. With the healthcare reform underway, an increase in patients will induce a shortage of primary care providers which may reduce the time physicians’ spend with patients thereby increasing the duties of primary care physicians. Lack of usability considerations in the design of EHR systems creates potential human-computer interaction issues, including increased workflow complexity that will result in loss of productivity and decreased quality of patient care.

 My rationale for the proposed research is that maximizing physicians’ efficiency when using an EHR by improving physicians’ use of the EHR, would relieve a part of the time constraints physicians experience while treating patients. The specific objective of this study is to determine usability issues that affect primary care physicians’ workflow in an electronic health record as they complete specific tasks.

Quantitative and qualitative methods, including, lab-based usability tests, will be used to determine usability issues and the difference in performance among primary care physicians with varying expertise when using an EHR. Morae Manager will be used to conduct sub task analysis and calculate performance measures: task percent success, time on task, mouse clicks, and mouse movements.  Sequential pattern analysis will also be conducted to detect EHR features that tend to be accessed one after another in a consistent, consecutive order between novice and expert physicians. This will assist in identifying usability issues that may affect physician workflow. To record physicians’ visual attention patterns, a portable, remote eye-tracking device will be used. Markov chain will be used to estimate the probability of a physician moving from one EHR feature to the next to inform which EHR features should be close together on the EHR screen.

Published on 01/13/2015

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