Article Describes Design and Implementation of a VA Hospital-Based Usability Laboratory for Health Information Technology
Usability evaluations can identify design features of health information technology (HIT) that pose a risk for patient harm. In addition, usability evaluations and subsequent HIT redesigns have many potential benefits, including enhanced patient safety, reduced HIT training and support costs, and increased work efficiency and provider satisfaction. Nonetheless, usability evaluations of HIT are not commonly performed. VA has emerged as an early leader in establishing usability laboratories to inform the design of HIT, including its electronic health record. This article describes the HSR&D Human-Computer Interaction & Simulation Laboratory, housed within one VAMC, which was intended to provide research-level findings about HIT design and was developed to investigate the usability of HIT toward transforming VA's health information system. Investigators provide insight about the Laboratory's design and implementation, and the use of a usability laboratory in the healthcare setting.
The HSR&D Human-Computer Interaction & Simulation Laboratory supports rapid prototyping, formal usability testing, and analysis tools to assess existing technologies, alternative designs, and potential future technologies. In addition, the layout of the laboratory can be altered to simulate a variety of healthcare environments. Although the Laboratory has maintained a research focus, it has become increasingly integrated with VA operations, both within the VAMC and on a national level (e.g., using data collected in the Laboratory to develop design recommendations for HIT that is used nationally across VA). Through the partnership with hospital operations, researchers have become more familiar with HIT development and implementation challenges, and this knowledge informs their scientific efforts. Moreover, clinical application specialists have become champions for usability testing, and efforts are underway to provide basic usability knowledge for VA clinical application support personnel across the U.S. The information and insights presented in this article also may assist other healthcare organizations that want to invest in usability resources to improve HIT.
There is evidence of growing enthusiasm and efforts to implement human-computer interaction and usability laboratories in VA to aid with HIT development and evaluation. These types of laboratories offer many potential benefits. Implementing and sustaining these laboratories may require start-up funds for laboratory development and additional workforce personnel with human factors, human-computer interaction, and/or usability evaluation expertise.
This study was funded by HSR&D (PPO 09-298), and Dr. Saleem was supported by an HSR&D Career Development Award (CDA 09-024). Drs. Russ, Weiner, and Saleem, and Mr. Russell are part of HSR&D's Center of Excellence on Implementing Evidence-Based Practice, Indianapolis, IN.
Russ A, Weiner M, Russell S, Baker D, Fahner J, and Saleem J. The Design and Implementation of a Usability Lab for a Hospital Setting: Insights from a VA Laboratory for Health Information Technology. The Joint Commission Journal on Quality and Patient Safety December 2012;38(12):531-40.