Scenario 3: Medications
Description
Our prototype demonstrates access to a medications list that includes both current and past medications plus the ability for patient to edit/add/reconcile medications including the addition of supplements. Any patient reported changes trigger a notification and review by the practice. In addition, all medications are linked to National Library of Medicine/Medline Plus patient education content.
Advantages over Current PHR/Patient Portals
Our approach is superior in both accessibility and functionality. First, we were unable to identify a PHR/patient portal that presented medications in an accessible format. Second, while some PHR/patient portals provide some of the functionality represented in our prototype, none apply as comprehensive approach, combining patient reporting with practice notifications, past and current medications, and patient education content.
Usability Test Scenario Description
Background:
Imagine that you saw a specialist who is not connected to your online system. The specialist discovered your Vitamin D levels were very low and recommended you start taking 5000 IU of Vitamin D every day. You buy Vitamin D, 5000 IU per pill, over the counter and take one pill a day. A month's supply costs you about $8.00. You want to make sure your taking Vitamin D is part of your medical record and included with other drugs you are currently taking.
Goal:
Use the system to do the following:
- Enter your Vitamin D information so it is listed with all the other drugs you are currently taking.
- Use the system to list all the medications you used to take.
Usability Test Results
Objective Results:
| Task Completion: | 75% (4 participants failed to complete the task) |
|---|---|
| Usability Error: | 25% (4 participants encountered non-critical errors) |
| Accessibility Error: | 19% (3 participants encountered non-critical errors) |
| Time on Task: | Mean 5:08 (Minimum 2:15, Maximum 11:15) |
Subjective Results:
| Strongly disagree | Disagree | Some. disagree | Neutral | Some. agree | Agree | Strongly Agree | % Agree | |
|---|---|---|---|---|---|---|---|---|
| This scenario presented a task(s) important to my healthcare | 1 | 4 | 11 | 100% | ||||
| The system was easy to use | 1 | 1 | 8 | 6 | 94% | |||
| The system was accessible | 1 | 10 | 5 | 94% | ||||
| The system provided useful features and information | 1 | 1 | 1 | 3 | 10 | 94% | ||
| The system requires no changes or improvements | 2 | 2 | 1 | 2 | 2 | 3 | 4 | 69% |
| The system would be useful to me in managing my own health care | 2 | 1 | 1 | 12 | 100% | |||
| Overall I am satisfied with the system | 1 | 2 | 3 | 10 | 94% |
Participant Comments:
- I just lived this. I had to tell my doctor I was taking an iron supplement.
- Keep my complaints in perspective. Most systems are crappy and I expect to struggle.
- This needs signed content for people who are deaf and can't read English.
- I wouldn't bother entering this.
- This is very handy.
Discussion and Recommendations:
Four participants encountered critical errors and failed to complete this task. Participant #1 was a screen reader user and encountered difficulties throughout the entire test due to screen reader accessibility code resulting in being overwhelmed and confused with repetitive descriptions. Due to the severity of these issues, the accessibility code was modified after her experience and results with the remaining 3 screen reader user participants were improved. Participant #6 self-identified as having a cognitive disability and seemed to have difficulty in understanding and recalling scenario objectives. Participant #7 did not self-identify as having a cognitive impairment, but also had difficulty in understanding and recalling scenario objectives. As a result both of these participants could not complete this task (and almost all others) without assistance. Participant #10 was a screen reader user whose critical error involved not being able to comprehend/navigate the medications table. Two other screen reader participants did not encounter this error and issues here may be due to issues with older versions of JAWS (v11) and/or browser.