Electronic personal health record (PHR) systems, which offer patients the ability to access, manage, and share their own health information, are intended to help them become more active participants in their own care. Although PHRs are proliferating in clinical practices and health-care organizations, not much attention has been given to the human factors issues associated with the use of these systems, especially for vulnerable populations.
A new study published in Human Factors: The Journal of the Human Factors and Ergonomics Society used a human factors approach to identify PHRs'demands on users and evaluated the ability of adults of lower socioeconomic status and low health literacy to use a select sample of these systems to perform common health-management activities.
"Given the increased proliferation of PHRs within the health-care arena, it is critical that diverse health consumer populations are able to effectively use these systems. This is particularly important for vulnerable and underserved populations who already experience health disparities," said lead author Sara J. Czaja, Ph.D., Leonard M. Miller Professor of Psychiatry and Behavioral Sciences and scientific director of the Center on Aging at the University of Miami Miller School of Medicine.
In the study, "The Usability of Electronic Personal Health Record Systems for an Underserved Adult Population," Czaja and colleagues tested 54 adults ranging in age from 22 to 62 years who had low education, income levels, and health literacy. Participants used the three currently available electronic PHR systems and were asked to find information about medication management, health maintenance and preventive care, communication and appointment settings, and lab or test results.
Despite their enthusiasm for using the tool to access their personal health information, the participants had difficulty performing tasks; specifically, those related to correctly interpreting the labels and links when searching for a category of information, interpreting data for lab or test results, and using health maintenance data for disease screenings. In short, findings indicated that the use of current PHRs may be difficult for many health consumers.
Applying human factors engineering principles and methods to improve PHR systems could benefit all users, no matter their level of skill and experience. Areas for improvement include reducing the literacy, numeracy, and cognitive demands of these systems and enhancing ease of navigation. In addition, designers of electronic PHRs should consult existing applicable human factors guidelines related to interface and Web design and rules pertaining to the use of clear and simple language in health-care communications.
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