Developing the National Usability-Focused Health Information System Scale for Physicians: Validation Study

Area of Science:

• Health Informatics
• Human-Computer Interaction
• Medical Systems Engineering

Background:

• Usability issues in health information systems (HISs) are recognized but lack validated measurement tools.
• Existing research highlights the need for reliable questionnaires to assess HIS usability from end-user perspectives.
• Monitoring HIS usability is crucial for improving healthcare delivery and physician experience.

Purpose of the Study:

• To develop and validate the National Usability-Focused HIS-Scale (NuHISS) for measuring HIS usability.
• To assess the validity and reliability of the NuHISS among a national sample of Finnish physicians.
• To provide a tool for ongoing monitoring of HIS usability and end-user satisfaction.

Main Methods:

• Utilized cross-sectional data from Finnish physicians in 2014 and 2017.
• Employed exploratory and confirmatory factor analyses (structural equation modeling) to test structural validity.
• Assessed concurrent validity using self-reported overall electronic health record system quality.

Main Results:

• A 7-factor solution for the NuHISS demonstrated good fit in both datasets (C²=2136.14, P<.001 in 2014; C²=2109.83, P<.001 in 2017).
• Structural equation modeling confirmed acceptable fit (CFI=0.92/0.91, RMSEA=0.048/0.049).
• The 7 factors included technical quality, information quality, feedback, ease of use, benefits, internal collaboration, and cross-organizational collaboration, all associated with overall system quality.

Conclusions:

• The NuHISS is a valid and useful tool for measuring HIS usability among physicians.
• It enables large-scale, long-term monitoring of HIS development and usability.
• Further assessment against national health policy goals and inclusion of additional relevant items are recommended.