title: User perspectives on the usability of a regional health information exchange.
abstract: OBJECTIVE
  We assessed the usability of a health information exchange (HIE) in a densely populated metropolitan region. This grant-funded HIE had been deployed rapidly to address the imminent needs of the patient population and the need to draw wider participation from regional entities.
  
  
  METHODS
  We conducted a cross-sectional survey of individuals given access to the HIE at participating organizations and examined some of the usability and usage factors related to the technology acceptance model.
  
  
  METHODS
  We probed user perceptions using the Questionnaire for User Interaction Satisfaction, an author-generated Trust scale, and user characteristic questions (eg, age, weekly system usage time).
  
  
  RESULTS
  Overall, users viewed the system favorably (ratings for all usability items were greater than neutral (one-sample Wilcoxon test, p<0.0014, Bonferroni-corrected for 35 tests). System usage was regressed on usability, trust, and demographic and user characteristic factors. Three usability factors were positively predictive of system usage: overall reactions (p<0 0.01), learning (p<0.05), and system functionality (p<0.01). Although trust is an important component in collaborative relationships, we did not find that user trust of other participating healthcare entities was significantly predictive of usage. An analysis of respondents' comments revealed ways to improve the HIE.
  
  
  CONCLUSIONS
  We used a rapid deployment model to develop an HIE and found that perceptions of system usability were positive. We also found that system usage was predicted well by some aspects of usability. Results from this study suggest that a rapid development approach may serve as a viable model for developing usable HIEs serving communities with limited resources.
authors.affiliation: Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee 37203, USA. cindy.gadd@vanderbilt.edu
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Gadd
authors.forename: Yun-Xian
authors.initials: YX
authors.lastname: Ho
authors.forename: Cather Marie
authors.initials: CM
authors.lastname: Cala
authors.forename: Dana
authors.initials: D
authors.lastname: Blakemore
authors.forename: Qingxia
authors.initials: Q
authors.lastname: Chen
authors.forename: Mark E
authors.initials: ME
authors.lastname: Frisse
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003258:Consumer Behavior; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D033181:Information Dissemination; D016015:Logistic Models; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D013714:Tennessee; D035502:Trust; D014584:User-Computer Interface