Scenario 5: Lab Results
Description
Our prototype demonstrates a clinician-patient interaction focused approach by combining information often delegated to separate EMR/PHR locations (messages, medications, labs, etc.) into a comprehensive message. An additional component is the delivery of patient education content. We feel this type of communication is quite feasible. Since many clinicians already work from EMR templates to quickly create structured notes, orders and more, we feel the same approach could be applied to patient communication.
Advantages over Current PHR/Patient Portals
All patient portal and PHR systems we reviewed compartmentalize information as it appears to patient charts used by clinicians. Our approach supports clinician-patient communication by combining all relevant information.
Usability Test Scenario Description: Scenario 5a
Background:
Imagine you saw your primary care doctor a few days ago. You told your doctor that you feel tired all the time and have been gaining weight, even though you sleep eight hours a night and have been carefully managing your diet.
Your doctor told you she wanted to test you for hypothyroidism, a common treatable condition where the thyroid gland is not producing enough of a hormone that regulates your metabolism. They drew some blood for the test and told you the results would be in within a few days.
A few days later you receive an automated message by email and/or text informing you of a new message regarding your test results.
Goal:
Use the system to do the following:
- Locate and read the message from your doctor's office.
- Identify your diagnosis and any new prescriptions or instructions.
- Use the system to learn more about your diagnosis and medication.
Usability Test Scenario Description: Scenario 5b
Background:
Imagine you saw your primary care doctor a few days ago. He had some blood drawn to check your cholesterol levels and told you the results would be in within a few days.
A few days later you receive an automated message by email and/or text informing you of a new message regarding your test results.
Goal:
Use the system to do the following:
- Locate and read the message from your doctor's office.
- Identify your diagnosis and any new prescriptions or instructions.
- Use the system to learn more about your diagnosis and medication.
Usability Test Results
Objective Results:
| Task Completion: | 88% (2 participants failed to complete the task) |
|---|---|
| Usability Error: | 31% (5 participants encountered non-critical errors) |
| Accessibility Error: | 13% (2 participants encountered non-critical errors) |
| Time on Task: | Mean 4:57 (Minimum 2:27, Maximum 14:21) |
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 | 2 | 3 | 11 | 88% | ||||
| The system was accessible | 1 | 6 | 9 | 94% | ||||
| The system provided useful features and information | 1 | 3 | 12 | 94% | ||||
| The system requires no changes or improvements | 2 | 2 | 8 | 4 | 88% | |||
| The system would be useful to me in managing my own health care | 1 | 4 | 11 | 100% | ||||
| Overall I am satisfied with the system | 1 | 7 | 8 | 94% |
Participant Comments:
- Medline Plus is a good source of information.
- This I really like.
- I read about all my medical tests, so having this right from the nurse is great.
- If I personalize this to myself and my care it would be awesome and very useful.
- The education links were too complex for deaf people with literacy issues.
- ASL materials are very important for people who are deaf and have low literacy.
- When they send me my lab results it is just a bunch of numbers.
Discussion and Recommendations:
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. The low objective ratings were primarily from the first two participants who were deaf who repeatedly commented on the lack of education content in American Sign Language for people who are deaf and have low literacy with English.