National survey of user-reported usability of electronic medical record software in ophthalmology in Germany.

Digitalization Electronic medical record Medical informatics National survey Usability

Journal

Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie

ISSN: 1435-702X

Titre abrégé: Graefes Arch Clin Exp Ophthalmol

Pays: Germany

ID NLM: 8205248

Informations de publication

Date de publication:
Nov 2023

Historique:

received: 10 04 2023

accepted: 01 06 2023

revised: 01 06 2023

pubmed: 28 6 2023

medline: 28 6 2023

entrez: 28 6 2023

Statut: ppublish

Résumé

A nationwide, comparative survey of the physician-reported usability of electronic medical record (EMR) software used by ophthalmologists in Germany using the System Usability Scale (SUS) as a standardized metric. A cross-sectional survey of members of the German Ophthalmological Society (DOG) and professional association of ophthalmologists (BVA) was conducted in May 2022. All 7788 physician members of both societies were invited to participate in an anonymous online-survey by individualized links. User-reported usability of the participants main software used for electronic medical recordkeeping was assessed using the SUS (range 0-100). A total of 881 participants with 51 different EMRs completed the entire questionnaire. Mean EMR-SUS score was 65.7 (SD ± 23.5). Significant differences in mean SUS of several EMR programs were observed with a range of 31.5 to 87.2 in programs with 10 or more responses. 31.8% of all main program SUS ratings were below 50 points. Female gender was associated with 4.02 higher SUS score (95% CI 0.46-7.59). Main program SUS was positively correlated with overall work-related satisfaction and work environment SUS but negatively correlated with the number of programs in the work environment. The SUS of the entire digital work environment including all programs used daily was closely correlated with the main EMR SUS, but not the number of programs used. Our survey revealed a fragmented pattern of EMR use by ophthalmologists in Germany with many competing software products and widely diverging mean System Usability Scale scores. A considerable share of ophthalmologists report EMR usability below what is commonly considered acceptable.

Identifiants

DOI: 10.1007/s00417-023-06139-5 PMID: 37378879

pubmed: 37378879

doi: 10.1007/s00417-023-06139-5

pii: 10.1007/s00417-023-06139-5

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

3325-3334

Informations de copyright

Références

Krauth C, Brümmer A, Bucholtz N, Amelung VE (2012) Bedarfsplanung in der Augenheilkunde. Gesundheits- und Sozialpolitik 66:44–51

doi: 10.5771/1611-5821-2012-3-44

Read-Brown S, Hribar MR, Reznick LG et al (2017) Time requirements for electronic health record use in an academic ophthalmology center. JAMA Ophthalmol 135:1250. https://doi.org/10.1001/jamaophthalmol.2017.4187

doi: 10.1001/jamaophthalmol.2017.4187 pubmed: 29049512 pmcid: 5710390

Dirghangi AJ, Ericksen C, Falk L (2020) The impact of EMR usability on ophthalmology practice patterns. Invest Ophthalmol Vis Sci 61:5112

Carayon P, Hoonakker P (2019) Human factors and usability for health information technology: old and new challenges. Yearb Med Inform 28:071–077. https://doi.org/10.1055/s-0039-1677907

doi: 10.1055/s-0039-1677907

Ratwani RM, Reider J, Singh H (2019) A decade of health information technology usability challenges and the path forward. JAMA 321:743–744. https://doi.org/10.1001/jama.2019.0161

doi: 10.1001/jama.2019.0161 pubmed: 30715133

Abran A, Khelifi A, Suryn W, Seffah A (2003) Usability meanings and interpretations in ISO standards. Softw Qual J 11:325–338. https://doi.org/10.1023/A:1025869312943

doi: 10.1023/A:1025869312943

Bundschuh BB, Majeed RW, Bürkle T et al (2011) Quality of human-computer interaction - results of a national usability survey of hospital-IT in Germany. BMC Med Inform Decis Mak 11:69. https://doi.org/10.1186/1472-6947-11-69

doi: 10.1186/1472-6947-11-69 pubmed: 22070880 pmcid: 3229438

Kaipio J, Lääveri T, Hyppönen H et al (2017) Usability problems do not heal by themselves: national survey on physicians’ experiences with EHRs in Finland. Int J Med Inform 97:266–281. https://doi.org/10.1016/j.ijmedinf.2016.10.010

doi: 10.1016/j.ijmedinf.2016.10.010 pubmed: 27919385

Gomes KM, Ratwani RM (2019) Evaluating improvements and shortcomings in clinician satisfaction with electronic health record usability. JAMA Netw Open 2. https://doi.org/10.1001/jamanetworkopen.2019.16651

Melnick ER, Dyrbye LN, Sinsky CA et al (2020) The association between perceived electronic health record usability and professional burnout among US physicians. Mayo Clin Proc 95:476–487. https://doi.org/10.1016/j.mayocp.2019.09.024

doi: 10.1016/j.mayocp.2019.09.024 pubmed: 31735343

Li C, Parpia C, Sriharan A, Keefe DT (2022) Electronic medical record-related burnout in healthcare providers: a scoping review of outcomes and interventions. BMJ Open 12. https://doi.org/10.1136/bmjopen-2022-060865

Hartel MJ, Staub LP, Röder C, Eggli S (2011) High incidence of medication documentation errors in a Swiss university hospital due to the handwritten prescription process. BMC Health Serv Res 11:199. https://doi.org/10.1186/1472-6963-11-199

doi: 10.1186/1472-6963-11-199 pubmed: 21851620 pmcid: 3180357

Shneiderman B (2011) Tragic errors: usability and electronic health records. Interactions 18:60–63. https://doi.org/10.1145/2029976.2029992

doi: 10.1145/2029976.2029992

Hautamäki E, Kinnunen U-M, Palojoki S (2017) Health information systems´ usability-related use errors in patient safety incidents. FinJeHeW 9:6. https://doi.org/10.23996/fjhw.60763

doi: 10.23996/fjhw.60763

KBV (2022) Arztgruppe_Augenaerzte Praxissysteme KBV Top 20 .pdf. https://www.kbv.de/media/sp/Arztgruppe_Augenaerzte.pdf . Accessed 29 Jan 2023

Brooke J (1996) SUS: a “quick and dirty” usability scale. In: Jordan PW, Thomas B, Weerdmeester BA, McClelland IL (eds) Usability evaluation in industry. Taylor & Francis, London, pp 189–194

Rummel, B (2013) System Usability Scale – jetzt auch auf Deutsch. | SAP Blogs. https://blogs.sap.com/2016/02/01/system-usability-scale-jetzt-auch-auf-deutsch/ . Accessed 29 Jan 2023

Lewis JR, Sauro J (2009) The factor structure of the system usability scale. In: Kurosu M (ed) Human Centered Design. Springer, Berlin, Heidelberg, pp 94–103

doi: 10.1007/978-3-642-02806-9_12

Lewis JR (2018) The System Usability Scale: past, present, and future. Int J Hum Comput Interact 34:577–590. https://doi.org/10.1080/10447318.2018.1455307

doi: 10.1080/10447318.2018.1455307

Lorah JA (2020) Interpretation of main effects in the presence of non-significant interaction effects. The Quantitative Methods for. Psychology 16:33–45. https://doi.org/10.20982/tqmp.16.1.p033

doi: 10.20982/tqmp.16.1.p033

Nohl-Deryk P, Brinkmann J, Gerlach F et al (2018) Hürden bei der Digitalisierung der Medizin in Deutschland – eine Expertenbefragung. Gesundheitswesen 80:939–945. https://doi.org/10.1055/s-0043-121010

doi: 10.1055/s-0043-121010 pubmed: 29301149

KBV (2023) Verzeichnis zertifizierter Software - Übersichtsmatrix. In: kbv.de. https://update.kbv.de/ita-update/Service-Informationen/Zulassungsverzeichnisse/KBV_ITA_SIEX_Verzeichnis_Zert_Software.pdf . Accessed 31 May 2023

Ammenwerth E, Rigby M (2016) Evidence-based health informatics: promoting safety and efficiency through scientific methods and ethical policy. IOS Press

Kaipio J, Kuusisto A, Hyppönen H et al (2020) Physicians’ and nurses’ experiences on EHR usability: comparison between the professional groups by employment sector and system brand. Int J Med Inform 134. https://doi.org/10.1016/j.ijmedinf.2019.104018

Lloyd S, Long K, Oshni Alvandi A et al (2021) A national survey of EMR usability: comparisons between medical and nursing professions in the hospital and primary care sectors in Australia and Finland. Int J Med Inform 154. https://doi.org/10.1016/j.ijmedinf.2021.104535

Bangor A, Kortum PT, Miller JT (2008) An empirical evaluation of the System Usability Scale. Int J Hum Comput Interact 24:574–594. https://doi.org/10.1080/10447310802205776

doi: 10.1080/10447310802205776

Kortum PT, Bangor A (2013) Usability ratings for everyday products measured with the System Usability Scale. Int J Hum Comput Interact 29:67–76. https://doi.org/10.1080/10447318.2012.681221

doi: 10.1080/10447318.2012.681221

Lærum H, Faxvaag A (2004) Task-oriented evaluation of electronic medical records systems: development and validation of a questionnaire for physicians. BMC Med Inform Decis Mak 4:1. https://doi.org/10.1186/1472-6947-4-1

doi: 10.1186/1472-6947-4-1 pubmed: 15018620 pmcid: 356923

Belden JL, Grayson R, Barnes J (2009) Defining and testing EMR usability: principles and proposed methods of EMR usability evaluation and rating. Healthcare Information and Management Systems Society (HIMSS). https://www.himss.org/sites/hde/files/FileDownloads/HIMSS_DefiningandTestingEMRUsability.pdf . Accessed 17 June 2023

Simon A (2020) Usability of electronic patient record systems: Instrument validation study conducted for hospitals in Germany. Health Informatics J 26:1969–1982. https://doi.org/10.1177/1460458219895910

doi: 10.1177/1460458219895910 pubmed: 31912755

Zahabi M, Kaber DB, Swangnetr M (2015) Usability and safety in electronic medical records interface design: a review of recent literature and guideline formulation. Hum Factors 57:805–834. https://doi.org/10.1177/0018720815576827

doi: 10.1177/0018720815576827 pubmed: 25850118

Shanafelt TD, Dyrbye LN, Sinsky C et al (2016) Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction. Mayo Clin Proc 91:836–848. https://doi.org/10.1016/j.mayocp.2016.05.007

doi: 10.1016/j.mayocp.2016.05.007 pubmed: 27313121

Khairat S, Coleman C, Ottmar P et al (2019) Physicians’ gender and their use of electronic health records: findings from a mixed-methods usability study. J Am Med Inform Assoc 26:1505–1514. https://doi.org/10.1093/jamia/ocz126

doi: 10.1093/jamia/ocz126 pubmed: 31504578 pmcid: 7647147

Rangraz Jeddi F, Nabovati E, Bigham R, Khajouei R (2020) Usability evaluation of a comprehensive national health information system: relationship of quality components to users’ characteristics. Int J Med Inform 133. https://doi.org/10.1016/j.ijmedinf.2019.104026

Barkow L, Meincke O, Ulrich H, Ingenerf J (2021) Fit for purpose: analyzing the German archiving and exchange interface for medical practice management systems. Stud Health Technol Inform 278:80–85. https://doi.org/10.3233/SHTI210054

doi: 10.3233/SHTI210054 pubmed: 34042879

Bethlehem J (2010) Selection bias in web surveys. Int Stat Rev 78:161–188. https://doi.org/10.1111/j.1751-5823.2010.00112.x

doi: 10.1111/j.1751-5823.2010.00112.x

Hu N, Zhang J, Pavlou PA (2009) Overcoming the J-shaped distribution of product reviews. Commun ACM 52:144–147. https://doi.org/10.1145/1562764.1562800

doi: 10.1145/1562764.1562800

Munz H (2021) Vertragsarztstatistik 2020: Weiblich, angestellt, in Teilzeit. In: Deutsches Ärzteblatt. https://www.aerzteblatt.de/archiv/218868/Vertragsarztstatistik-2020-Weiblich-angestellt-in-Teilzeit . Accessed 5 Feb 2023

KBV (2022) Gesundheitsdaten - Niedergelassene Ärztinnen und Ärzte werden immer älter. https://gesundheitsdaten.kbv.de/cms/html/16397.php . Accessed 5 Feb 2023

Howe JL, Adams KT, Hettinger AZ, Ratwani RM (2018) Electronic health record usability issues and potential contribution to patient harm. JAMA 319:1276. https://doi.org/10.1001/jama.2018.1171

doi: 10.1001/jama.2018.1171 pubmed: 29584833 pmcid: 5885839

Ratwani RM, Savage E, Will A et al (2018) Identifying electronic health record usability and safety challenges in pediatric settings. Health Affairs 37:1752–1759. https://doi.org/10.1377/hlthaff.2018.0699

doi: 10.1377/hlthaff.2018.0699 pubmed: 30395517

Adams KT, Pruitt Z, Kazi S et al (2021) Identifying health information technology usability issues contributing to medication errors across medication process stages. J Patient Saf 17:e988–e994. https://doi.org/10.1097/PTS.0000000000000868

doi: 10.1097/PTS.0000000000000868 pubmed: 34009868

Asan O, Smith P D, Montague E (2014) More screen time, less face time - implications for EHR design. J Eval Clin Pract 20:896–901. https://doi.org/10.1111/jep.12182

doi: 10.1111/jep.12182 pubmed: 24835678 pmcid: 4237676

Gardner RL, Cooper E, Haskell J et al (2018) Physician stress and burnout: the impact of health information technology. J Am Med Inform Assoc 26:106–114. https://doi.org/10.1093/jamia/ocy145

doi: 10.1093/jamia/ocy145 pmcid: 7647171

Heponiemi T, Hyppönen H, Vehko T et al (2017) Finnish physicians’ stress related to information systems keeps increasing: a longitudinal three-wave survey study. BMC Med Inform Decis Mak 17:147. https://doi.org/10.1186/s12911-017-0545-y

doi: 10.1186/s12911-017-0545-y pubmed: 29041971 pmcid: 5646125