Abstract
Objectives Although electronic patient portals are offered by most health care organizations,
poor usability and poor fit to patient needs may pose barriers to adoption. We collaborated
with an academic hospital to conduct iterative user evaluation of a newly deployed
portal designed to deliver inpatient data upon hospital discharge.
Methods Three evaluators applied heuristic usability evaluation and conducted 23 individual
user testing sessions with patients with chronic disease or managing the care of family
members with chronic disease. Evaluation and development/improvement were conducted
iteratively. User testing and analysis of qualitative data were both conducted from
the perspective of a task-technology fit framework, to assess the degree of fit between
the portal and patient work.
Results Ability to complete health information management tasks, perceived usability, and
positive comments from users improved over the course of the iterative development.
However, patients still encountered significant difficulties accomplishing certain
tasks such as setting up proxy accounts. The problems were most severe when patients
did not start with a clear understanding of tasks that they could accomplish. In exploring
the portal, novice users frequently described anecdotes from their own medical history
or constructed fictional narratives about a hypothetical patient.
Conclusion Chronic illness imposes a significant workload on patients, and applying a task-technology
framework for evaluation of a patient portal helped improve the portal's fit to patient
needs. However, it also revealed that patients often lack a clear understanding of
tasks that would help them accomplish personal health information management. Portal
developers may need to educate patients about types of patient work involving medical
centers, in a way that developers of clinical information systems do not need to do.
An approach to doing this might be to provide narratives about hypothetical patients.
Keywords
electronic patient portal - health information management - chronic disease - workload
- usability - task-technology fit
