Usability Guidance for Improving the User Interface and Adoption of Online Personal Health Records

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User Centric conducted an independent comparative usability study of two existing online personal health record applications, Google Health and Microsoft HealthVault. Based on this usability study, User Centric has identified several trends and best practices to be included in a working model for PHR interfaces that facilitates user adoption.
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    UsabilityGuidanceforImprovingtheUserInterfaceandAdoptionofOnlinePersonalHealthRecords   KirstenPeters,M.S.MichaelNiebling,M.S.CassandraSlimmer,B.S.ThomasGreen,M.S.JaysonM.Webb,Ph.D.RobertSchumacher,Ph.D.  UserCentric,Inc.February2009 UserCentric,Inc.2TransAmPlazaDr.-Suite100OakbrookTerrace,IL60181+1.630.320.3900www.UserCentric.com ©Copyright2009–UserCentric,Inc.      Version 1.1 © Copyright 2009 – User Centric, Inc. 2 RevisionHistory: Version1.0:InitialreleaseFeb2,2009Version1.1:Section4.4:AddedFactorAnalysistoUSEsurveydata.Feb24,2009Sections4.3-4.5:Correctedstatisticalreportingandclarifiedsomeofthelanguagetoreduceconfusionsomereadershavereported.Therewerenoresultingmaterialchangestofindingsorconclusions. Note :InconversationswiththeteamfromMicrosoftatthe2009TEPRConferenceinPalmSprings,UserCentricbecameawarethatMicrosoftdoesnotclaimorpromotethatHealthVaultisaPHR perse  .MicrosoftconsidersHealthVaultarobustdataplatformwithwhichthird-partyPHRsandothermedicalinformationsourcesinteract.Nevertheless,manyintheindustryandmediaconsiderHealthVault’suserinterfacetobeaPHRandoneworthyofevaluationandcomparison.   TechnicalContact: RobertSchumacher,Ph.D.2TransAmPlazaDr.-Suite100OakbrookTerrace,IL60181+1.630.320.3900rschumacher@usercentric.com   Version 1.1 © Copyright 2009 – User Centric, Inc. 3 UsabilityGuidanceforImprovingtheUserInterfaceandAdoptionofOnlinePersonalHealthRecords  1.Abstract DuringDecember2008andJanuary2009,theuserexperienceresearchfirmUserCentricconductedanindependentcomparativeusabilitystudyoftwoexistingonlinepersonalhealthrecordapplications,GoogleHealthandMicrosoftHealthVault.(NeitherGooglenorMicrosoftcommissionedorparticipatedinthisstudyinanymanner.)Duringthisstudy,30participantscompletedkeytasksusingeachPHRapplicationandprovidedqualitativefeedback,ratingsandpreferencedataonfivespecificdimensions:Overallusability,utility(usefulnessoffeatures),security,privacyandtrust.ParticipantsperformeduptoseventasksonbothGoogleHealthandMicrosoftHealthVault,whichincludedthreetasksthatexploredeachapplication’suniquefeatures.Midwaythroughthestudy,athirdPHRapplication,MyMedicalRecords.com,wasaddedtogatheradditionalqualitativedata.ThemajorityofstudyparticipantsfoundPHRstobeusefulandstatedthattheyhadaninterestinbuildingtheirownPHRsafterthestudy.Overall,participantsindicatedthattheyfoundGoogleHealthmoreusablebecausenavigationanddataentryofhealthinformationwaseasierthanontheotherapplications.ParticipantssaidthattheGoogleHealthapplicationutilizedmorefamiliarmedicalterminologyandprovidedapersistenthealthinformationprofilesummary.Basedonananalysisofthestudydata,UserCentrichasidentifiedthefollowingtrends: Usability Overall,participantslikedhowtheGoogleHealthinterfaceallowedthemtoquicklyentermedicalinformation.Thelefthandnavigation,tabs,andprofilesummaryallcontributedtoafairlysmoothuserexperiencefordataentry,whichisacriticalPHRtask.However,therewasstillroomforimprovement.Participantshadtroubleattachingdatestohealthinformation,figuringoutwheretostart,andfindingwheretheycouldaddanotherfamilymember.Ingeneral,participantshadmoretroublewiththeMicrosoftHealthVaultinterface.Themosttroublesomeelementsweretheconfusingnavigation,thepresentationofalltermsinmedicaljargon,andtheinconsistencybetweendifferentdataentryelements.However,reactiontoMicrosoftHealthVaultwasnotcompletelynegative–eventhoughtheystruggledtoentertheirhealthinformation,severalparticipantsstillreactedfavorablytotheveryhighlevelofdetailthesystemallowedthemtoenter.Inaddition,participantslikedtheabilitytoadddetailstoanitemimmediatelyafteraddingtheitemitself.ThisrepresentedanefficientflowthatGoogleHealthdidnotprovide. Utility ParticipantsfoundPHRstobefairlydesirablebytheendofthestudy.ThePHRs’baselinefunctionalitywasappealing,andbothGoogleHealthandMicrosoftHealthVaulteachhadafewwell-receivedexclusivefeatures.   Version 1.1 © Copyright 2009 – User Centric, Inc. 4 GoogleHealth’spreferenceonthisdimensionislikelyduetotwofactors.First,participantssometimesseemedtoconfuseutilitywithusability,eventhoughresearchersspecificallyaskedabout“usefulnessoffeatures.”This,alongwithGoogleHealth’sbettereaseofuse,wouldexplainashiftinparticipants’utilitypreference.Second,GoogleHealthincludedthehighlydesirabledruginteractionfeature,whichwasrankedmostappealingoutofallthefeaturesinthepost-testquestionnaire.ThiswastheonlyoutstandingfeatureamongthesixPHR-exclusivefeatures,soitmayalsohaveboostedtheperceptionofGoogleHealth’sutility. Security,PrivacyandTrust ThekeycontributorstoMicrosoftHealthVault’smorefrequentpreferenceonsecurity,privacyandtrustwereastrongbrandimage,professional-lookingvisualdesignandahigherperceivedinformationcontent.However,eventhoughparticipantsmorecommonlypreferredMicrosoftHealthVaultforthesedimensions,whenratingthetwoPHRstheyscoredGoogleHealthalmostequallyashighly.GoogleHealth’shighratingislikelyduetoitsbrandreputationanditsup-frontpresentationofthetermsofuseandlegalagreements.Oneimportantnegative,though,wasGoogle’sstrongpositioninginthesearchande-maildomains;itislikelythatthiscontributedtoMicrosoftHealthVault’soverallpreferencehere. Overall UserCentric’scomparativestudyfoundthatneitherGoogleHealthnorMicrosoftHealthVaultwereperfectapplications;eachhadflawsintheuserexperiencewhichwereseentoreduceparticipants’willingnesstoadoptPHRtechnology.However,participantspreferredGoogleHealthoverMicrosoftHealthVaultonthewhole,mainlyduetoGoogleHealth’sgreatereaseofuse.Althoughfeatures,security,privacyandtrustcertainlydidinfluenceparticipants’overallevaluations,itiscriticaltonotethattheirmajordifficultieswithbothapplications-andtheirstrongestcriticisms-wererelatedtotheuserexperience.Improvementstotheuserexperiencethereforerepresentthelargestopportunityforimprovingthepatient’sexperiencewithaPHR.Basedonthisusabilitystudy,UserCentrichasidentifiedseveralbestpracticestobeincludedinaworkingmodelforPHRinterfacesthatfacilitatesuseradoption.
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