Usability evaluation of an integrated electronic medication management system implemented in an oncology setting using the unified theory of acceptance and use of technology

Racha Dabliz,Jonathan Penm,Rosemary Burke,Angus Ritchie,Simon K Poon

doi:10.1186/s12911-020-01348-y

Abstract

BackgroundMedication management processes in an Oncology setting are complex and difficult to examine in isolation from interrelated processes and contextual factors. This qualitative study aims to evaluate the usability of an Electronic Medication Management System (EMMS) implemented in a specialised oncology unit using the Unified Theory of Acceptance and Use of Technology (UTAUT) framework.MethodsThe study was conducted in a 12-bed outpatient Oncology unit of a major teaching hospital 6 months following implementation of a commercial EMMS. In-depth semi-structured interviews were conducted with doctors, nurses and pharmacists using the system to assess usability. The UTAUT framework was used to analyse the results, which facilitated evaluation of interrelated aspects and provided a structured summary of user experience and usability factors.ResultsDirect cross-comparison between user groups illustrated that doctors and pharmacists were generally satisfied with the facilitating conditions (hardware and training), but had divergent perceptions of performance (automation, standardised protocols and communication and documented) and effort (mental and temporal demand) expectancy. In counterpoint, nurses were generally satisfied across all constructs.Prior experience using an alternative EMMS influenced performance and effort expectancy and was related to early dissatisfaction with the EMMS. Furthermore, whilst not originally designed for the healthcare setting, the flexibility of the UTAUT allowed for translation to the hospital environment.ConclusionNurses demonstrated overall satisfaction with the EMMS, whilst doctors and pharmacists perceived usability problems, particularly related to restricted automaticity and system complexity, which hindered perceived EMMS success. The study demonstrates the feasibility and utility of the UTAUT framework to evaluate usability of an EMMS for multiple user groups in the Oncology setting.

Highlights

Medication management processes in an Oncology setting are complex and difficult to examine in isolation from interrelated processes and contextual factors
In light of the complexity of the medication process and the difficultly of examining it in isolation from other interrelated processes and contextual factors, this study aims to evaluate the usability of an Electronic Medication Management System (EMMS) in the Oncology setting from the perspective of nurses, doctors and pharmacists using the UTAUT model
Interviews generated extensive data relating to usability and acceptability of the EMMS

Summary

Introduction

Medication management processes in an Oncology setting are complex and difficult to examine in isolation from interrelated processes and contextual factors This qualitative study aims to evaluate the usability of an Electronic Medication Management System (EMMS) implemented in a specialised oncology unit using the Unified Theory of Acceptance and Use of Technology (UTAUT) framework. Studies of EMMS implementations in the oncology setting have found that critical success factors include; the design and usability of the EMMS [3], standardization of chemotherapy protocols [3,4,5,6], seamless integration with other health information systems and user workflows [2,3,4,5, 7,8,9,10,11], effective training and support [4, 12], support from leadership [4, 12, 13], collaborative project management [13], and effective ongoing maintenance and support [9, 13, 14]. Several theories that measure individual and organizational acceptance and success have been designed and validated [20]

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