End-User Participation In Healthcare IT

In recent times, electronic healthcare systems have become the norm. Many hospitals and private clinics around the world use electronic devices to register and record patient data. While this is a substantial change in the right direction, a lot of improvement is needed to make these systems user-friendly for physicians, the primary users of healthcare IT. This article will highlight and recap some of the research in this field.

A study was conducted in Finland by Susanna Martikainen, Johanna Vitanen, Mikko Korpela, and Tinja Laaveri which analyzed the experience of doctors while using healthcare records. The study included a third of the entire working population of physicians in Finland. A questionnaire was used to deduce whether or not physicians were willing to participate in IT development in the healthcare setting and whether this participation was of any benefit.

What do Physicians Think About Electronic Health Record (EHR) Systems?

The questionnaire asked doctors about their experience regarding the use of EHR systems. It was found that Finnish doctors are far from satisfied with EHRs as they are time-consuming and are not user-friendly. Similarly, a survey of 10,000 American doctors showed that 86% said the wrong chart had been used for a patient in their practice at least once in the past year, and 44% reported that a patient’s medicine administration record (MAR) had not been updated.

Most healthcare IT is not designed in collaboration with the end-user - click to tweet this

The reason for this dissatisfaction and misuse may be because healthcare systems are not designed in collaboration with the end-user i.e. the physicians who will be using the interface. Even if medical professionals are consulted, the methods are usually questionnaires and surveys. Participatory methods, which provide much deeper insights and give UX professionals a way to empathize with the user, are far rarer. So, are physicians interested in being a part of participatory user research? Let's take a look at one large-scale study from 2011.

Study Regarding User Participation In Healthcare IT Development In Finland

The study we will recap here was part of a larger survey that involved different aspects of healthcare IT systems including patient admission, discharge, billing, daily progress notes, MARs, among others. The systems that the end-users (hospital staff) were using on a daily basis.

The questionnaire, designed by multi-disciplinary researchers, contained three main sets of questions. The first set was in the form of a Likert scale with five points, from 'strongly agree' to 'strongly disagree'. These questions investigated doctors’ likelihood of giving feedback about the IT system to developers, and the developers’ responses. The second contained multiple choice questions about the doctors’ participation in IT development. The third was an open-ended question regarding the views of the doctors about future of healthcare IT development.

Results of the Research

The results of the first question were mostly negative. 47.4% of physicians said they were not aware of whom to contact if they wanted to give feedback about their healthcare IT and 43.7% felt that the management in their hospital was not deeply concerned about the user experience regarding healthcare IT. According to 66.8% physicians, even when given feedback, software companies did not heed them, and 77.6% felt that any changes (if changes were made) were never delivered on time. Also, doctors in emergency settings were more dissatisfied than those in management positions.

47.4% of physicians said they were not aware of whom to contact if they wanted to give feedback about their healthcare IT - click to tweet this

The responses to the second question were more favorable when compared to the first. Only 17.3% of doctors were not interested at all in contributing to healthcare IT development. 52% said they would happily give feedback to a colleague who could collaborate with software developers while many doctors chose other options like giving feedback directly to software developers (37.6%) and contacting developers via email (29.5%).

The response regarding the third question was more or less similar from all participants. They felt that IT developers do not bother to contact and ask the users about their exact needs and how the system could be improved. Doctors felt like there were not enough physicians involved in IT development process and hence the systems were designed without proper know-how of what would best benefit the doctors. They also thought that the current software was not very user-friendly and needed a lot of improvement.

Conclusion and Final Thoughts

This study had a very large sample size so it can safely be said that the results should be considered indispensable. This research proved, for one thing, that end-user participation is vital the design and development of successful healthcare solutions. Users, such as physicians, are extremely interested in participating in user research. The fact that doctors are currently dissatisfied with their IT systems makes it even more relevant that they are invited to be directly involved in creating the experiences behind health software.

Further reading