Abstract
BackgroundElectronic medical record (EMR) systems hold the exciting promise of accurate, real-time access to patient health care data and great potential to improve the quality of patient care through decision support to clinicians. This review evaluated the usability of EMR systems implemented in sub-Saharan Africa based on a usability evaluation criterion developed by the Healthcare Information and Management Systems Society (HIMSS).ObjectiveThis review aimed to evaluate EMR system implementations in sub-Saharan Africa against a well-defined evaluation methodology and assess their usability based on a defined set of metrics. In addition, the review aimed to identify the extent to which usability has been an enabling or hindering factor in the implementation of EMR systems in sub-Saharan Africa.MethodsFive key metrics for evaluating EMR system usability were developed based on the methodology proposed by HIMSS. These were efficiency, effectiveness, ease of learning, cognitive load, and user satisfaction. A 5-point rating system was developed for the review. EMR systems in 19 reviewed publications were scored based on this rating system. It awarded 5 points per metric to any EMR system that was identified as excellent, 4 points for good, 3 points for fair, 2 points for poor, and 1 point for bad. In addition, each of the 5 key metrics carried a maximum weighted score of 20. The percentage scores for each metric were then computed from the weighted scores from which the final overall usability score was derived.ResultsIn possibly contributing to the usability of implemented EMR systems, ease of learning obtained the highest percentage score of 71% (SD 1.09) followed by cognitive load in second place with a score of 68% (SD 1.62). Effectiveness followed closely in third place at 67% (SD 1.47) and efficiency was in fourth place at 64% (SD 1.04). User satisfaction came in last at 63% (SD 1.70). The overall usability score for all systems was calculated to be 66%.ConclusionsThe usability of EMR systems implemented in sub-Saharan Africa has been good with ease of learning possibly being the biggest positive contributor to this rating. Cognitive load and effectiveness have also possibly positively influenced the usability of EMR systems, whereas efficiency and user satisfaction have perhaps contributed least to positively influencing EMR system usability.
Highlights
BackgroundThe free dictionary defines an electronic medical record (EMR) as a repository for active notations about a patient’s health; it is a computerized database that typically includes demographic, medical, laboratory, radiographic, drug, and other information about a patient [1]
This literature review assessed Electronic medical record (EMR) systems implemented in a sub-Saharan African context, using the evaluation methods and metrics proposed by Healthcare Information and Management Systems Society (HIMSS)
This literature review of the usability of EMR systems in sub-Saharan Africa used an evaluation methodology and usability metrics proposed by HIMSS to evaluate the implemented systems through a mixed-methods approach
Summary
BackgroundThe free dictionary defines an electronic medical record (EMR) as a repository for active notations about a patient’s health; it is a computerized database that typically includes demographic, medical, laboratory, radiographic, drug, and other information about a patient [1]. This review evaluated the usability of EMR systems implemented in sub-Saharan Africa based on a usability evaluation criterion developed by the Healthcare Information and Management Systems Society (HIMSS). Objective: This review aimed to evaluate EMR system implementations in sub-Saharan Africa against a well-defined evaluation methodology and assess their usability based on a defined set of metrics. These were efficiency, effectiveness, ease of learning, cognitive load, and user satisfaction. Conclusions: The usability of EMR systems implemented in sub-Saharan Africa has been good with ease of learning possibly being the biggest positive contributor to this rating. Cognitive load and effectiveness have possibly positively influenced the usability of EMR systems, whereas efficiency and user satisfaction have perhaps contributed least to positively influencing EMR system usability
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