title: Human Factors in the Large: Experiences from Denmark, Finland and Canada in Moving Towards Regional and National Evaluations of Health Information System Usability. Contribution of the IMIA Human Factors Working Group.
abstract: OBJECTIVE
  The objective of this paper is to explore approaches to understanding the usability of health information systems at regional and national levels.
  
  
  METHODS
  Several different methods are discussed in case studies from Denmark, Finland and Canada. They range from small scale qualitative studies involving usability testing of systems to larger scale national level questionnaire studies aimed at assessing the use and usability of health information systems by entire groups of health professionals.
  
  
  RESULTS
  It was found that regional and national usability studies can complement smaller scale usability studies, and that they are needed in order to understand larger trends regarding system usability. Despite adoption of EHRs, many health professionals rate the usability of the systems as low. A range of usability issues have been noted when data is collected on a large scale through use of widely distributed questionnaires and websites designed to monitor user perceptions of usability.
  
  
  CONCLUSIONS
  As health information systems are deployed on a widespread basis, studies that examine systems used regionally or nationally are required. In addition, collection of large scale data on the usability of specific IT products is needed in order to complement smaller scale studies of specific systems.
authors.affiliation: Andre Kushniruk, School of Health Information Science, University of Victoria, Victoria, Canada, E-mail: andrek@uvic.ca.
authors.forename: A
authors.initials: A
authors.lastname: Kushniruk
authors.forename: J
authors.initials: J
authors.lastname: Kaipio
authors.forename: M
authors.initials: M
authors.lastname: Nieminen
authors.forename: H
authors.initials: H
authors.lastname: Hyppönen
authors.forename: T
authors.initials: T
authors.lastname: Lääveri
authors.forename: C
authors.initials: C
authors.lastname: Nohr
authors.forename: A M
authors.initials: AM
authors.lastname: Kanstrup
authors.forename: M
authors.initials: M
authors.lastname: Berg Christiansen
authors.forename: M-H
authors.initials: MH
authors.lastname: Kuo
authors.forename: E
authors.initials: E
authors.lastname: Borycki
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D002170:Canada; D003718:Denmark; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006804:Ergonomics; D005387:Finland; D063005:Health Information Systems / Q000706:statistics & numerical data*; D006801:Humans; D008490:Medical Informatics; D050316:Medical Order Entry Systems
keywords: Health informatics; evaluation; health information systems; human factors; usability