The Electronic Health Record in Ophthalmology: Usability Evaluation Tools for Health Care Professionals

Area of Science:

• Ophthalmology
• Health Informatics
• Human-Computer Interaction

Background:

• Electronic health records (EHRs) are increasingly adopted in ophthalmology.
• Implementation challenges often lead to healthcare professional (HCP) dissatisfaction.
• User-centered design (UCD) principles can mitigate these issues by prioritizing user needs.

Purpose of the Study:

• To describe practical qualitative methodologies for HCP engagement in ophthalmology EHR design, implementation, and evaluation.
• To provide guidance on applying UCD principles effectively in ophthalmology EHR development.
• To address the lack of standardized best practices for HCP involvement in EHR UCD.

Main Methods:

• A review of current qualitative usability methodologies was performed by ophthalmologists with health informatics expertise.
• Qualitative methods for user-centered design and summative testing were identified and categorized.
• Focus on practical, low-fidelity tools suitable for clinical settings.

Main Results:

• Identified qualitative methodologies for EHR evaluation, including shadowing, autoethnography, interviews, and questionnaires for UCD.
• Included tools for summative testing such as card sorting, retrospective think-aloud protocols, wireframing, screenshot testing, and heat maps.
• Highlighted high-yield, low-fidelity tools that effectively engage HCPs in the EHR lifecycle.

Conclusions:

• Practical, low-fidelity qualitative tools can successfully engage HCPs in ophthalmology EHR design, implementation, and evaluation.
• These methods are accessible to HCPs without specialized usability training.
• Clinical centers can implement these techniques without substantial technical infrastructure.