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BMC Medical Informatics and Decision Making
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Open Access 01-12-2024 | Research

Evaluating the usability of Iran’s national comprehensive health information system: a think-aloud study to uncover usability problems in the recording of childcare data

Authors: Razieh Farrahi, Ehsan Nabovati, Reyhane Bigham, Fateme Rangraz Jeddi

Published in: BMC Medical Informatics and Decision Making | Issue 1/2024

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Abstract

Introduction

Health information systems play a crucial role in the delivery of efficient and effective healthcare. Poor usability is one of the reasons for their lack of acceptance and low usage by users. The aim of this study was to identify the usability problems of a national comprehensive health information system using the concurrent think-aloud method in the recording of childcare data.

Methods

A descriptive cross-sectional study was conducted in the health centers of Kashan University of Medical Sciences, Iran, in 2020. Ten healthcare providers as system's users were purposively selected to evaluate the system. To identify problems, a concurrent think-aloud evaluation was conducted. Two administrators of the system designed scenarios for ten childcare data recording tasks. By analysing the recorded files, usability problems were identified. The severity of the problems was then determined with the help of the users and problems were assigned to usability attributes based on their impact on the user.

Results

A total of 68 unique problems were identified in the system, of which 47.1% were rated as catastrophic problems. The participants assigned 47 problems (69%) to the user satisfaction attribute and 45 problems (66%) to the efficiency attribute; they also did not assign any problems to the effectiveness attribute.

Conclusion

The problems identified in the national comprehensive health information system using the think-aloud method were rated as major and catastrophic, which indicates poor usability of this system. Therefore, resolving the system problems will help increase user satisfaction and system efficiency, allowing more time to be spent on patient care and parent's education as well as improving overall quality of care.
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Literature
1.
Alolayyan MN, Alyahya MS, Alalawin AH, Shoukat A, Nusairat FT. Health information technology and hospital performance the role of health information quality in teaching hospitals. Heliyon. 2020;6(10):e05040.CrossRefPubMedPubMedCentral
2.
3.
Jeddi FR, Farrahi R, Chopannejad S. Usability of Electronic Death Registration System: A Case Study of Heuristic Evaluation. Int Arch Health Sci. 2021;8(4):243–8.CrossRef
4.
Keshvari M, Yusefi AR, Homauni A, Omidifar R, Nobakht S. Barriers for the Using of Information Systems in Hospitals: A Qualitative Study. Shiraz E-Med J. 2018;19(8):e66180.CrossRef
5.
Khajouei R, Farahani F. A combination of two methods for evaluating the usability of a hospital information system. BMC Med Inform Decis Mak. 2020;20(1):84.CrossRefPubMedPubMedCentral
6.
Middleton B, Bloomrosen M, Dente MA, Hashmat B, Koppel R, Overhage JM, Payne TH, Rosenbloom ST, Weaver C, Zhang J. Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA. J Am Med Inform Assoc. 2013;20(e1):e2–8.CrossRefPubMedPubMedCentral
7.
8.
Bigham R. Usability evaluating of an integrated health information system with user-based and expert methods. M.S. Thesis. Kashan: Kashan University of Medical Sciences; 2018.
9.
Rangraz Jeddi F, Nabovati E, Bigham R, Khajouei R. Usability evaluation of a comprehensive national health information system: relationship of quality components to users’ characteristics. Int J Med Informatics. 2020;133:104026.CrossRef
10.
Fan M, Lin J, Chung C, Truong KN. Concurrent think-aloud verbalizations and usability problems. ACM Trans Comput Human Interac (TOCHI). 2019;26(5):1–35.CrossRef
11.
Fan M, Shi S, Truong KN: Practices and challenges of using think-aloud protocols in industry: An international survey. J Usability Stud. 2020;15(2):85–102.
12.
Virzi RA. Refining the test phase of usability evaluation: How many subjects is enough? Hum Factors. 1992;34(4):457–68.CrossRef
13.
Nielsen J. Estimating the number of subjects needed for a thinking aloud test. Int J Hum Comput Stud. 1994;41(3):385–97.CrossRef
14.
Faulkner L. Beyond the five-user assumption: Benefits of increased sample sizes in usability testing. Behav Res Methods Instrum Comput. 2003;35:379–83.CrossRefPubMed
15.
Jääskeläinen R. Think-aloud protocol. Handbook Translation Stud. 2010;1:371–4.CrossRef
16.
17.
Sadeqi Jabali M, Nabovati E, Farzandipour M, Farrahi SR, Abbasi R. Evaluation of the usability of admission and medical record information system: A heuristic evaluation. J Health Biomed Informatics. 2019;6(2):80–9.
18.
Mazaheri Habibi M, Khajouei R, Eslami S, Jangi M, Ghalibaf A, Zangouei S. Usability testing of bed information management system: A think-aloud method. J Adv Pharmaceutical Technol Res. 2018;9(4):153–7.CrossRef
19.
Georgsson M, Staggers N. An evaluation of patients’ experienced usability of a diabetes mHealth system using a multi-method approach. J Biomed Inform. 2016;59:115–29.CrossRefPubMed
20.
Joe J, Chaudhuri S, Le T, Thompson H, Demiris G. The use of think-aloud and instant data analysis in evaluation research: Exemplar and lessons learned. J Biomed Inform. 2015;56:284–91.CrossRefPubMedPubMedCentral
21.
Zahiri Esfahani M, Khajouei R, Baneshi MR. Augmentation of the think aloud method with users’ perspectives for the selection of a picture archiving and communication system. J Biomed Inform. 2018;80:43–51.CrossRefPubMed
22.
Shi Q. An empirical study of thinking aloud usability testing from a cultural perspective. Frederiksberg: Samfundslitteratur; 2010.
23.
Rieber H, Frontzek A, Fischer M. Periprosthetic joint infection associated with Mycoplasma hominis after transurethral instrumentation in an immunocompetent patient. Unusual or underestimated? A case report and review of the literature. Int J Infec Dis. 2019;82:86–8.CrossRef
24.
Farrahi R, Jeddi FR, Nabovati E, Jabali MS, Khajouei R. The relationship between user interface problems of an admission, discharge and transfer module and usability features: a usability testing method. BMC Med Inform Decis Mak. 2019;19(1):172.CrossRefPubMedPubMedCentral
25.
Luz R, Mussi CC, Dutra A, Chaves LC. Implementation of large-scale health information systems. Revista de Gestão. 2021;28(2):106–32.CrossRef
26.
Singh H, Ash JS, Sittig DF. Safety assurance factors for electronic health record resilience (SAFER): study protocol. BMC Med inform Decis Mak. 2013;13:46.
27.
Hu HJ, Yen J, Guan SS: A study on the interface usability of B2C hypermarket E-commerce website. In: 2008 IEEE Asia-Pacific Services Computing Conference: 2008 IEEE; 2008: 1202–1207.
28.
Farzandipour M, Nabovati E, Tadayon H, Jabali MS. Identification and classification of usability problems in a nursing information system: a heuristic evaluation. CIN Comput Inform Nurs. 2022;40(2):121–30.
Metadata
Title
Evaluating the usability of Iran’s national comprehensive health information system: a think-aloud study to uncover usability problems in the recording of childcare data
Authors
Razieh Farrahi
Ehsan Nabovati
Reyhane Bigham
Fateme Rangraz Jeddi
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2024
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-024-02746-2

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