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Benchmarking usability of patient portals in Estonia, Finland, Norway, and Sweden
Department of Computer Science, Aalto University, Espoo, Finland.
Department of Computer Science, Aalto University, Espoo, Finland.
Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.
E-Medicine Centre, Department of Health Technologies, Tallinn University of Technology, Estonia.
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2024 (English)In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 181, article id 105302Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Poor usability is a barrier to widespread adoption of electronic health records (EHR). Providing good usability is especially challenging in the health care context, as there is a wide variety of patient users. Usability benchmarking is an approach for improving usability by evaluating and comparing the strength and weaknesses of systems. The main purpose of this study is to benchmark usability of patient portals across countries. METHODS: A mixed-methods survey approach was applied to benchmark the national patient portals offering patient access to EHR in Estonia, Finland, Norway, and Sweden. These Nordic countries have similar public healthcare systems, and they are pioneers in offering patients access to EHR for several years. In a survey of 29,334 patients, both patients' quantitative ratings of usability and their qualitative descriptions of very positive and very negative peak experiences of portal use were collected. RESULTS: The usability scores ranged from good to fair level of usability. The narratives of very positive and very negative experiences included the benefits of the patient portals and experienced usability issues. The regression analysis of results showed that very positive and negative experiences of patient portal use explain 19-35% of the variation of usability scores in the four countries. The percentage of patients who reported very positive or very negative experiences in each country was unrelated to the usability scores across countries. CONCLUSIONS: The survey approach could be used to evaluate usability with a wide variety of users and it supported learning from comparison across the countries. The combination of quantitative and qualitative data provided an approximation of the level of the perceived usability, and identified usability issues to be improved and useful features that patients appreciate. Further work is needed to improve the comparability of the varied samples across countries. 

Place, publisher, year, edition, pages
Elsevier, 2024. Vol. 181, article id 105302
Keywords [en]
Cross-national, Electronic health records, ORA, PAEHR, Online record access, Patient portal, Patient-accessible electronic health records, Survey, Usability benchmarking, Benchmarking, Estonia, Finland, Humans, Norway, Patient Portals, Sweden, electronic health record, human, medical record
National Category
Human Computer Interaction Computer and Information Sciences Information Systems, Social aspects Information Systems
Research subject
Information Systems
Identifiers
URN: urn:nbn:se:his:diva-23491DOI: 10.1016/j.ijmedinf.2023.105302ISI: 001126157900001PubMedID: 38011806Scopus ID: 2-s2.0-85180006899OAI: oai:DiVA.org:his-23491DiVA, id: diva2:1822847
Funder
NordForsk, 100477Forte, Swedish Research Council for Health, Working Life and Welfare, 2020-01229Academy of Finland, 352501Academy of Finland, 352503
Note

CC BY 4.0 DEED

Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.

Corresponding author at: Department of Computer Science, Aalto University, Konemiehentie 2, Espoo FI-00076, Finland. E-mail address: sari.kujala@aalto.fi (S. Kujala).

This work was supported by NordForsk through the funding to Nordic eHealth for Patients: Benchmarking and Developing for the Future, NORDeHEALTH, (Project #100477), the Swedish Research Council for Health, Working Life and Welfare (FORTE) through the funding to Beyond Implementation of eHealth (Project #2020-01229), the Strategic Research Council at the Academy of Finland (Project #352501 and #352503), and the Norwegian Centre for E-health Research.

Available from: 2023-12-28 Created: 2023-12-28 Last updated: 2024-04-15Bibliographically approved

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