Page 103 - ITU KALEIDOSCOPE, ATLANTA 2019

ICT for Health: Networks, standards and innovation

simplify communication interfaces and improve the quality the coordinators kept their eyes on the participants during
of patient care [18, 19]. Another critical issue of the clinical the entire user study. In this study, we only focused on the
information systems is the difficulty of use, which is one of the task execution time, but future studies should evaluate task
dissatisfaction factors expressed by healthcare professionals success rate, error rate, and user satisfaction since these are
[20]. Specifically, the complex interfaces and the lack of also important usability measures.
intuitiveness causes usability problems. However, this issue
has not been treated as necessary as the data exchange
standards [21]. 8. CONCLUSION

In the evaluation report of Electrical Medical Record (EMR), In this paper, we have examined the usability issues of an
Belden et al. said that “Usability is one of the major factors – existing LIS and proposed a new, responsive user interface
to resolve them.
We were interested in the extent to
possibly the most important factor – hindering widespread which the proposed interface could improve usability in
adoption of EMRs. Usability has a strong, often direct heterogeneous environments. Results indicated an average
relationship with clinical productivity, error rate, user fatigue
and user satisfaction ... [22].” Although there have been improvement of about 30% across various metrics. Based on
some efforts to resolve the usability issues such as the Health the results, we highlighted the current status of computing
Information Technology for Economic and Clinical Health environments and user needs in the near future. Additionally,
(HITECH) Act in 2009 and an incentive program by the U.S. we discussed several factors which can improve the quality
Centers for Medicare & Medicaid Services, the improvement of laboratory information systems and recommend adding
of the usability has still been slow [21]. As shown in usability specifications to international standards.
our study, we were able to improve the usability by up to
34% by applying a responsive, simple, open-source website REFERENCES
framework to the existing LIS. It should not be a challenging [1] I. E. Asangansi, O. O. Adejoro, O. Farriab, and
task in terms of cost and development effort. We highly O. Makinde, “Computer use among doctors in
encourage that international standards organizations dealing africa:survey of trainees in a nigerian teaching hospital,”
with health informatics should pay attention to the usability Journal of Health Informatics in Developing Countries,
standards for laboratory information systems as they include vol. 2, no. 1, pp. 10–13, 2008.
diverse devices, platforms, and browsers, as important as they
did for medical record interoperability. [2] M. Shekar and K. Otto, “Information and
communication technologies for health in africa,”
Since the International Organization for Standardization The World Bank Group, Tech. Rep., 01 2014. [Online].
(ISO) proposed the definition of usability (ISO 9241-11) Available: http://documents.worldbank.org/curated/en/
and its metrics (ISO/IEC 9126-4), a few usability models 553151468009030957/ICTs-for-health-in-Africa
and evaluation techniques have been studied in the hospital
information system domain [23, 24]. Among them, [3] C. L. Ventola, “Mobile devices and apps for health
a prime example would be the empirical guideline for care professionals: uses and benefits,” P T, vol. 39,
safety-related usability of EHR (NISTIR 7804-1) proposed no. 5, pp. 356–364, May 2014, 24883008[pmid].
by the National Institute of Standards and Technology (NIST) [Online]. Available: https://www.ncbi.nlm.nih.gov/
[25]. The guidelines described three critical implications – pubmed/24883008
1) Consistently present patient identification in a reserved [4] S. Wallace, M. Clark, and J. White, “‘it’s on my
area to prevent wrong-patient errors, 2) Provide visual cues iphone’: attitudes to the use of mobile computing
to minimize the risk of entering information and writing devices in medical education, a mixed-methods study,”
orders in the wrong patient’s chart, and 3) Support efficient BMJ Open, vol. 2, no. 4, 2012. [Online]. Available:
and easy identification of incorrect items in lists of grouped https://bmjopen.bmj.com/content/2/4/e001099
information by presenting clear, well-organized evidence.
Similar to the standardization efforts in NIST, more practical [5] P. Adedeji, O. Irinoye, R. Ikono, and A. Komolafe,
and applicable standards are needed for safer and effective “Factors influencing the use of electronic health records
hospital information systems. among nurses in a teaching hospital in nigeria,”
Journal of Health Informatics in Developing Countries,
vol. 12, no. 2, pp. 1–20, 2018. [Online]. Available:
7. LIMITATIONS http://www.jhidc.org/index.php/jhidc/article/view/174
We were in the US, and our target users were in Africa. [6] M. Jones, G. Marsden, N. Mohd-Nasir, K. Boone, and
We opted to use log data for the analyses, which meant that G. Buchanan, “Improving web interaction on small
we were not able to observe participants’ behavior in person displays,” in Proceedings of the Eighth International
while they completed the tasks. Thus, it was challenging Conference on World Wide Web, ser. WWW ’99.
to understand unexpected behaviors such as inactive mouse New York, NY, USA: Elsevier North-Holland,
cursors and random delays in typing. While we did our Inc., 1999, pp. 1129–1137. [Online]. Available:
best to train the administrators, we cannot guarantee that all http://dl.acm.org/citation.cfm?id=313234.313014

– 83 –