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June 9, 2010Usability Methodsto Improve EMRsJaney Barnes, PhDUser-View, Inc.Raleigh, NCJeff Belden, MD Family &Community MedicineUniversity of Missouri1
Conflict of Interest DisclosureJaney Barnes, PhDContracted Research:  AllscriptsPatagonia HealthDuke Health Systems2
Conflict of Interest DisclosureJeff Belden, MD Dr. Belden is on faculty at University of Missouri - Columbia, and an EMR usability consultant with the Tiger Institute, a technology collaborative between the University of Missouri and Cerner Corporation.Dr. Belden has no financial interest.3
Session ObjectivesDescribe stages of software development in which usability methods can be most effective.List and describe usability methods applicable to each stage of EMR development.Analyze the cost/benefit of implementing usability methods within a user-centered design process.4
Software Development Process5
Waterfall modelof software development6
7Waterfall
“Agile” modelof software development8
9Agile
Usability methods work for both10
don’t forget the buyer’s sideof usability11
12AgileWaterfallSelectionImplementation
Want to be a change-agent?13
Usability methods to improve EMRs
User Centered Design Process15
16Incorporating User Centered Designin Software Development ProcessPrototyping
Card sorting
Concept exploration
Usability Testing
and testing
Keep testing
Requirements
User stories
Summative testing
Affinity Diagramming
Personas
Use case scenarios
User acceptance testing
Incorporating feedback
Maintain design intenta few words about usability when  selecting & implementing17
Software Selection ActivitiesUsability Methods of InterestSite visit for:User surveys of current users like you
Performance testing
Observe one of their experienced (but not an ace) users
Do clinical scenario test with real data
Define target measures
Set goals18
Implementation ActivitiesUsability Methods of InterestTask analysis & user observationCard sorting (picking categories, nomenclature)Design guidelines & Style guidesPaper prototypingHave clinician create documents for several patients19
Usability methods to improve EMRs
DiscoveryActivitiesContextual inquiryAffinity diagrammingPersonasUse case scenariosFor each method we presentGoalof the method
Details for planning& executingeach method
Best timing the software development schedule
How to deliver impactto the product21
Contextual InquiryPersona22
Goalsunderstand the user’s:
tasks
workflows
environment
description of a specific person (a target user). Details make them real.23Contextual InquiryPersona
Contextual InquiryPersonaPlanning ExecutionObserve users onsiteBe a fly on the wallBefore, during & afterHalf day…or longer!Take photos of environment.  Watch.  Observe.  Learn.
Make notes.
Stand, sit, to side, in middle.
Stay out of way
Collect any artifacts. Contextual InquiryPersonaTimingEarly
Requirements gathering
Before sprint planning
Before “iteration 1”Having ImpactBy watching, observing, learning26Contextual InquiryUse Case Scenarios
27Contextual InquiryUse Case ScenariosGoalsUnderstand the user’s:
tasks
workflows
environment
Specify how users carry out their tasks in a specified context.28Contextual InquiryUse Case ScenariosPlanning ExecutionObserve users onsiteBe a fly on the wallBefore, during & afterHalf day…or longer!Take photos of environment. Watch.  Observe.  Learn.
Make notes.
Stand, sit, to side, in middle.
Stay out of way
Collect any artifacts. 29Contextual InquiryUse Case ScenariosTimingEarly
Requirements gathering
Before sprint planning
Before “iteration 1”Having ImpactBy watching, observing, learning30Contextual InquiryHow long should this take?
31Contextual InquiryHow long should we plan?PlanTeach team to observe
Not sell, or teach, or fix
Have tools ready32Contextual InquiryHow long should we stay to observe?It dependsHow varied are user groups?How familiar are you with territory?Stay until you see patterns emerge
33Contextual InquiryHow long to compile findings?Compile intoPersonasUse case scenariosWork flowsTask flows
Usability methods to improve EMRs
Definition ActivitiesRequirements User StoriesGoal
Planning
Execution
Timing
Impact35
Requirements gatheringGoalIdentify usability requirements that can be tested laterFor each chosen task and user type estimate:acceptable task time & optimum target
how to score effectiveness - agreeing what errors user might make
the effectiveness target
the satisfaction target.36
Requirements gatheringPlanningExecutionArrange workshop with users, developers.Review tasksFor each task & user type estimateTask time & optimum goal
How to score effectiveness
Effectiveness target
Satisfaction TargetDecide on usability requirements among:Understandability
Learnability
Operability
AttractivenessRecruiting physicians is challenging.37
Requirements gatheringTimingEarlyImpactShows importance of usability early on
Provides concrete objectives & testable criteria for usability38
User Stories39
User StoriesGoalMore approachable than a formalized use case
Slim, give high-level requirements

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Usability methods to improve EMRs

Editor's Notes

  • #84: Note to Janey - if you conduct the wrong activity for the specific research question = trouble