title: Determining differences in user performance between expert and novice primary care doctors when using an electronic health record (EHR).
abstract: OBJECTIVE
  The goal of this study is to determine usability gaps between expert and novice primary care doctors when using an electronic health record (EHR).
  
  
  METHODS
  Usability tests using video analyses with triangular method approach were conducted to analyse usability gaps between 10 novice and seven expert doctors. Doctors completed 19 tasks, using think-aloud strategy, based on an artificial but typical patient visit note. The usability session lasted approximately 20 minutes. The testing room consisted of the participant and the facilitator. Mixed methods approach including four sets of performance measures, system usability scale (SUS), and debriefing session with participants was used.
  
  
  RESULTS
  While most expert doctors completed tasks more efficiently, and provided a higher SUS score than novice doctors (novice 68, expert 70 out of 100 being perfect score), the result of 'percent task success rate' were comparable (74% for expert group, 78% for novice group, P = 0.98) on all 19 tasks.
  
  
  CONCLUSIONS
  This study found a lack of expertise among doctors with more experience using the system demonstrating that although expert doctors have been using the system longer, their proficiency did not increase with EHR experience. These results may potentially improve the EHR training programme, which may increase doctors' performance when using an EHR. These results may also assist EHR vendors in improving the user interface, which may aid in reducing errors caused from poor usability of the system.
authors.affiliation: Informatics Institute, University of Missouri, Columbia, MO, USA.
authors.forename: Martina A
authors.initials: MA
authors.lastname: Clarke
authors.forename: Jeffery L
authors.initials: JL
authors.lastname: Belden
authors.forename: Min Soon
authors.initials: MS
authors.lastname: Kim
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D058007:Physicians, Primary Care / Q000193:education / Q000706:statistics & numerical data*; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000458:organization & administration*; D013647:Task Performance and Analysis; D014481:United States; D014584:User-Computer Interface
keywords: evaluation; medical informatics