title: Usability evaluation of the progress note construction set.
abstract: BACKGROUND
  The Veterans Administration (VA) Computerized Patient Record System (CPRS) is a nationally deployed software product that integrates provider order entry, progress notes, vitals, consults, discharge summaries, problem lists, medications, labs, radiology, transcribed documents, study reports, and clinical reminders. Users rapidly adopted the graphical user interface for data retrieval, but demanded options to typing for data entry. We programmed "point and click" forms that integrate with CPRS individually, but were soon overwhelmed by requests. Subsequently, we developed the Progress Note Construction Set (PNCS); a tool suite that permits subject matter experts without programming skills to create reusable "point and click" forms. In this study, we evaluate the usability of these user-constructed forms.
  
  
  METHODS
  An untrained, non-VA subject matter expert used the PNCS to create a graphical form for "skin tear" documentation. Ten VA nurses used the skin tear form to document findings for 7 standardized clinical scenarios. Following each scenario the subjects answered usability questions about the form.
  
  
  RESULTS
  The subject matter expert created the skin tear form in 78 minutes. Users found the form to facilitate their data entry (p 0.0265), and to be at least as fast (p 0.0029) and as easy to use as expected (p 0.0166). Average note entry time was 3.4 minutes.
  
  
  CONCLUSIONS
  The PNCS allowed a non-programmer to quickly create a usable, CPRS-integrated point and click form. Users found the subject matter expert s form fast and easy to use. The tool suite is a more scaleable form creation method because capacity is no longer limited by programmer availability.
authors.affiliation: VA Tennessee Valley Healthcare System, Vanderbilt University, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Brown
authors.forename: S
authors.initials: S
authors.lastname: Hardenbrook
authors.forename: L
authors.initials: L
authors.lastname: Herrick
authors.forename: J
authors.initials: J
authors.lastname: St  Onge
authors.forename: K
authors.initials: K
authors.lastname: Bailey
authors.forename: P L
authors.initials: PL
authors.lastname: Elkin
mesh_terms: D016347:Medical Records Systems, Computerized; D012985:Software Design; D014584:User-Computer Interface