Usability Evaluation Methods Used in Electronic Discharge Summaries: Literature Review

Abstract

Background: With the widespread adoption of digital health records, including electronic discharge summaries (eDS), it is important to assess their usability in order to understand whether they meet the needs of the end-users. While there are established approaches for evaluating the usability of electronic health records, there is a lack of knowledge regarding suitable evaluation methods specifically for eDS.Objective: This review aims to identify the usability evaluation approaches employed in eDS. Methods:We conducted a comprehensive search of PubMed, CINAHL, Web of Science, ACM Digital Library, Medline, and ProQuest databases from their inception until July 2023. The study information was extracted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We included studies that assessed the usability of eDS, and systems used to display eDS.Results: A total of twelve records, including eleven studies and one thesis, met the inclusion criteria. The included studies employed qualitative, quantitative, or mixed methods approaches and reported the use of various usability evaluation methods. Heuristic evaluation was the most employed method to assess the usability of eDS systems (n=7), followed by the think-aloud approach (n=5) and laboratory testing (n=3). These methods were used either individually or in combination with usability questionnaires (n=3) and qualitative semi-structured interviews (n=4) for evaluating eDS usability issues. The evaluation processes incorporated usability metrics such as user performance, satisfaction, efficiency, and impact rating.Conclusions: There are limited number of studies focusing on usability evaluations of eDS. The identified studies utilised expertbased and/or user-centred approaches, which can be employed either individually or in combination to identify usability issues. However, further research is needed to develop specific evaluation methods tailored to the unique characteristics of discharge summaries and to explore additional usability metrics to enhance the evaluation process.