Abstract
Clinical information systems in the National Health Service do not need to conform to any explicit usability requirements. Poor usability can increase the mental workload experienced by clinicians and cause fatigue, increase error rates and impact the overall patient safety. Mental workload can be used as a measure of usability. To assess the subjective cognitive workload experienced by general practitioners (GPs) with their systems. To raise awareness of the importance of usability in system design among users, designers, developers and policymakers. We used a modified version of the NASA Task Load Index, adapted for web. We developed a set of common clinical scenarios and computer tasks on an online survey. We emailed the study link to 199 clinical commissioning groups and 1,646 GP practices in England. Sixty-seven responders completed the survey. The respondents had spent an average of 17 years in general practice, had experience of using a mean of 1.5 GP computer systems and had used their current system for a mean time of 6.7 years. The mental workload score was not different among systems. There were significant differences among the task scores, but these differences were not specific to particular systems. The overall score and task scores were related to the length of experience with their present system. Four tasks imposed a higher mental workload on GPs: 'repeat prescribing', 'find episode', 'drug management' and 'overview records'. Further usability studies on GP systems should focus on these tasks. Users, policymakers, designers and developers should remain aware of the importance of usability in system design.What does this study add?• Current GP systems in England do not need to conform to explicit usability requirements. Poor usability can increase the mental workload of clinicians and lead to errors.• Some clinical computer tasks incur more cognitive workload than others and should be considered carefully during the design of a system.• GPs did not report overall very high levels of subjective cognitive workload when undertaking common clinical tasks with their systems.• Further usability studies on GP systems should focus on the tasks incurring higher cognitive workload.• Users, policymakers, and designers and developers should remain aware of the importance of usability in system design.
Highlights
IntroductionModern computer information systems have a proven record in supporting information management tasks in healthcare.[1,2] clinical information systems lacking usable designs may increase the mental workload imposed on their users and negatively impact on patient safety.[3,4,5] Today, with the nearly universal computerization of general practice in the UK,[6] general practitioners (GPs) are faced with the challenge of working with computer systems that could be potentially adding to their cognitive workload.[7]GP Systems of Choice (GPSoC) in England (Table 1) do not have to conform to any specified usability requirements, there have been initiatives to promote usability supported by the National Health Service (NHS), including the Microsoft Health Common User Interface.[8]
general practitioners (GPs) Systems of Choice (GPSoC) in England (Table 1) do not have to conform to any specified usability requirements, there have been initiatives to promote usability supported by the National Health Service (NHS), including the Microsoft Health Common User Interface.[8]
This study looks to identify where potential usability issues with current existing GP systems in the NHS in England may exist, by exploring the subjective cognitive workload experienced by GPs when they carry out common clinical tasks with their computer systems
Summary
Modern computer information systems have a proven record in supporting information management tasks in healthcare.[1,2] clinical information systems lacking usable designs may increase the mental workload imposed on their users and negatively impact on patient safety.[3,4,5] Today, with the nearly universal computerization of general practice in the UK,[6] general practitioners (GPs) are faced with the challenge of working with computer systems that could be potentially adding to their cognitive workload.[7]GP Systems of Choice (GPSoC) in England (Table 1) do not have to conform to any specified usability requirements, there have been initiatives to promote usability supported by the National Health Service (NHS), including the Microsoft Health Common User Interface.[8]. Modern computer information systems have a proven record in supporting information management tasks in healthcare.[1,2] clinical information systems lacking usable designs may increase the mental workload imposed on their users and negatively impact on patient safety.[3,4,5] Today, with the nearly universal computerization of general practice in the UK,[6] general practitioners (GPs) are faced with the challenge of working with computer systems that could be potentially adding to their cognitive workload.[7]. It largely relates to the quality of the information design and s ystem navigability, and has a lot to do with user interfaces.[10,11] Usability is a very important aspect in system design[12] and may impact user satisfaction, user fatigue, clinical productivity, error rates, and overall patient safety. Poor usability can increase the mental workload experienced by clinicians and cause fatigue, increase error rates and impact the overall patient safety. Policymakers, designers and developers should remain aware of the importance of usability in system design
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