ERCIM News No.29 - April 1997

Towards Improved Usability of Health Care Information Systems

by Pentti Kolari

Usability is today an important issue in all types of computer-based artifacts, not least in healthcare information systems. In healthcare, the artifact is typically used in connection with direct health professional - patient encounter. In this context, it is of utmost importance that the artifact acts as a tool and not becomes an object in itself fading the actual object out. User-centred design and usability assessment are approaches aiming at this goal. VTT Information Technology, in cooperation with Finn-Medi Research Ltd and three Finnish SMEs developing healthcare information systems, carried out a prestudy to find out how these companies address usability in their product development processes and how this is reflected in their products.

Differentiation of the roles of the producer and user of artifacts, characteristic to our society, is the fundamental reason for many of the problems in their use. There are, at least in large organizations, many mediating roles, like seller and buyer, between the producer and user of the artifact so that the producer and user do not necessarily ever meet. To improve the situation, the connection between the producer and user has to be somehow restored. This is what user-centred design and usability assessment are about.

It is sometimes argued that the development of new enabling technologies, like virtual reality or speech recognition, will solve usability problems. However, this is not necessarily the whole truth. Deeper understanding of human activity and the role of artifacts as part of it is needed, too. This means that we have to work at least on these two fronts. And we have also to keep in mind that there may not be easy solutions to all problems. Many things were desirable but which are possible is another question. Although much can be done to improve the usability of computer-based artifacts, it may be impossible to design every artifact so that its use is immediately obvious for everyone without training or consulting the user's guide.

Finn-Medi Research Ltd (the umbrella organization for Finn-Medi Health Care Technology Centre of Expertise), in cooperation with three Finnish SMEs developing healthcare information systems, commissioned VTT Information Technology to carry out a prestudy to find out how these companies address usability in their product development processes and how this is reflected in their products. The prestudy was started with a short introduction to usability. To assess the processes we interviewed the key persons of the companies. To evaluate the products we carried out a heuristic evaluation to one product of each company.

Our prestudy showed that in these companies there are direct connections between the producers and users of the products. Users are deeply involved in the design of the products and their feedback is a major source in further development of the products. In this sense, the principles of user-centred design are realized. However, user interface design principles published in the research literature or draft standards (like ISO 9241) are not used consciously. Usability assessments are not either carried out systematically.

When comparing the usability of graphical and character-based user interfaces it turned out that usability is a problem particularly in graphical user interfaces. This is understandable because the possibilities in graphical user interfaces are much wider and the application areas of products having graphical user interfaces are often less mature.

Based on the promising results of the prestudy, we will continue our cooperation with the companies in improving their procuct development processes to better address usability issues.

Please contact:
Pentti Kolari ­ VTT Information Technology
Tel: +358 3 316 3353

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