Continuous improvement of health care is bound to the technological advancements affecting the quality of patient care, especially Health Information Management. The objective of our work was to assess the usability and end-user perception of Health Information Systems (HISs) which is pivotal to improve overall efficiency in medical centers.
Methods:
To understand the intricacies of assessing the usability of such systems at Hospitals, we conducted a rapid review guided by PRISMA, utilizing Medline and CINHAL databases, which resulted in 10,960 articles. Initially, these articles were screened by title and abstract, followed by full text screening with two groups of two reviewers each, which led to the inclusion of 98 articles in the final thematic analysis.
Results:
The rapid review resulted in ten major themes which offered a comprehensive framework for assessing the HIS user experience from the perspective of hospital end-users. These themes include: operational impact & usefulness, usability & interface, reliability & connectivity, impact on patient care, interruptions, hardware, user proficiency & training, service desk & information technology support, collaboration & communication, and security.
Conclusion:
The main findings suggest that the various HIS services are effective tools that enhance clinical workflows and subsequently patient care. However, some usability issues, such as complex system designs, interruptive alerts and system crashes should be addressed to improve health care staff’s health care user experience. Future research should examine customized HIS designs to decrease workflow interruption, minimize workload, and improve staff productivity, which would ultimately optimize the user experience.
Mkalira MsiskaKE, KumitawaA, KumwendaB. Factors affecting the utilisation of electronic medical records system in Malawian central hospitals. Malawi Med J, 2017; 29(3):247–253; doi: 10.4314/mmj.v29i3.4
4.
SalahuddinL, IsmailZ, Abd GhaniMK, et al.Exploring the contributing factors to workarounds to the hospital information system in Malaysian hospitals. J Eval Clin Pract, 2020; 26(5):1416–1424; doi: 10.1111/jep.13326
5.
AlotaibiYK, FedericoF. The impact of health information technology on patient safety. Saudi Med J, 2017; 38(12):1173–1180; doi: 10.15537/smj.2017.12.20631
6.
EpizitoneA, MoyaneSP, AgbehadjiIE. A systematic literature review of health information systems for healthcare. Healthcare (Basel), 2023; 11(7):959; doi: 10.3390/healthcare11070959
7.
ZhangX-Y, ZhangP. Recent perspectives of electronic medical record systems. Exp Ther Med, 2016; 11(6):2083–2085; doi: 10.3892/etm.2016.3233
8.
AlboliteehM. A cross-sectional study of nurses’ perception toward utilization and barriers of electronic health record. Makara J Health Res, 2022; 26(3); doi: 10.7454/msk.v26i3.1369
9.
SafiS, ThiessenT, SchmailzlKJ. Acceptance and resistance of new digital technologies in medicine: Qualitative study. JMIR Res Protoc, 2018; 7(12):e11072; doi: 10.2196/11072
10.
Kutney-LeeA, CarthonJMB, SloaneDM, et al.Electronic health record usability: Associations with nurse and patient outcomes in hospitals. Med Care, 2021; 59(7):625–631; doi: 10.1097/MLR.0000000000001536
11.
KetikidisP, DimitrovskiT, LazurasL, et al.Acceptance of health information technology in health professionals: An application of the revised technology acceptance model. Health Informatics J, 2012; 18(2):124–134; doi: 10.1177/1460458211435425
12.
AljarrahE, ElrehailH, AababnehB. E-voting in Jordan: Assessing readiness and developing a system. Comput Hum Behav, 2016; 63:860–867; doi: 10.1016/j.chb.2016.05.076
13.
AlsohimeF, TemsahM-H, Al-EyadhyA, et al.Satisfaction and perceived usefulness with newly-implemented Electronic Health Records System among pediatricians at a university hospital. Comput Methods Programs Biomed, 2019; 169:51–57; doi: 10.1016/j.cmpb.2018.12.026
14.
BerniA, BorgianniY. From the definition of user experience to a framework to classify its applications in design. Proc Des Soc, 2021; 1:1627–1636; doi: 10.1017/pds.2021.424
15.
GatianAW. Is user satisfaction a valid measure of system effectiveness? Inf Manage, 1994; 26(3):119–131; doi: 10.1016/0378-7206(94)90036-1
16.
HersiM, StevensA, QuachP, et al.Effectiveness of personal protective equipment for healthcare workers caring for patients with filovirus disease: A rapid review. PLoS One, 2015; 10(10):e0140290; doi: 10.1371/journal.pone.0140290
17.
KhairatS, ColemanC, OttmarP, et al.Evaluation of physicians’ electronic health records experience using actual and perceived measures. Perspect Health Inf Manag, 2022; 19(1):1k.
18.
GiraldoL, SchachnerB, LunaD, et al.Electronic whiteboard in the inpatient care management: Nurses’ perceptions about the use. Stud Health Technol Inform, 2020; 270:188–192; doi: 10.3233/SHTI200148
19.
BusseTS, JuxC, LaserJ, et al.Involving health care professionals in the development of electronic health records: Scoping review. JMIR Hum Factors, 2023; 10:e45598; doi: 10.2196/45598
20.
DentonCA, SoniHC, KannampallilTG, et al.Emergency physicians’ perceived influence of EHR use on clinical workflow and performance metrics. Appl Clin Inform, 2018; 9(3):725–733; doi: 10.1055/s-0038-1668553
21.
ThornSA, CarterMA, BaileyJE. Emergency physicians’ perspectives on their use of health information exchange. Ann Emerg Med, 2014; 63(3):329–337; doi: 10.1016/j.annemergmed.2013.09.024
22.
CresswellKM, BatesDW, WilliamsR, et al.Evaluation of medium-term consequences of implementing commercial computerized physician order entry and clinical decision support prescribing systems in two ‘early adopter’ hospitals. J Am Med Inform Assoc, 2014; 21(e2):e194–e202; doi: 10.1136/amiajnl-2013-002252
23.
HadjiB, MartinG, DupuisI, et al.14 Years longitudinal evaluation of clinical information systems acceptance: The HEGP case. Int J Med Inform, 2016; 86:20–29; doi: 10.1016/j.ijmedinf.2015.11.016
24.
HsiehP-J, LaiH-M, MaC-C, et al.An extended expectation-confirmation model for mobile nursing information system continuance. Res Theory Nurs Pract, 2016; 30(4):282–301; doi: 10.1891/1541-6577.30.4.282
25.
Sauers-FordHS, HamlineMY, GosdinMM, et al.Acceptability, usability, and effectiveness: A qualitative study evaluating a pediatric telemedicine program. Acad Emerg Med, 2019; 26(9):1022–1033; doi: 10.1111/acem.13763
26.
StrudwickG, McGillis HallL, NagleL, et al.Acute care nurses’ perceptions of electronic health record use: A mixed method study. Nurs Open, 2018; 5(4):491–500; doi: 10.1002/nop2.157
27.
AElM. Adoption and barriers to adoption of electronic health records by nurses in three governmental hospitals in Eastern Province, Saudi Arabia. Perspect Health Inf Manag, 2015; 12(Fall):1f.
28.
KaritisK, GallosP, TriantafyllouIS, et al.Chios hospital information system assessment. Stud Health Technol Inform, 2021; 287:158–162; doi: 10.3233/SHTI210837
29.
CohenJF, ColemanE, KangetheMJ. An importance-performance analysis of hospital information system attributes: A nurses’ perspective. Int J Med Inform, 2016; 86:82–90; doi: 10.1016/j.ijmedinf.2015.10.010
30.
Al-MujainiA, Al-FarsiY, Al-ManiriA, et al.Satisfaction and perceived quality of an electronic medical record system in a tertiary hospital in Oman. Oman Med J, 2011; 26(5):324–328; doi: 10.5001/omj.2011.81
31.
De LeeuwJA, WoltjerH, KoolRB. Identification of factors influencing the adoption of health information technology by nurses who are digitally lagging: In-depth interview study. J Med Internet Res, 2020; 22(8):e15630; doi: 10.2196/15630
32.
MoghadamMAA, BakhshAF. Hospital information system utilization in Iran: A qualitative study. Acta Med Iran, 2014; 855–859.
33.
SouzaC, MorbeckR, MiltonS, et al.Barriers and benefits in telemedicine arising between a high-technology hospital service provider and remote public healthcare units: A qualitative study in Brazil. Telemed J E Health, 2017; 23(6):527–532; doi: 10.1089/tmj.2016.0158
34.
TolentinoDA, PatmonF, GephartSM. A descriptive study of nurses’ experiences with unintended consequences of the electronic health record in Two Urban Hospitals. J Inform Nurs, 2021; 6(2):6–10.
35.
ChowSK, ChinW-Y, LeeH-Y, et al.Nurses’ perceptions and attitudes towards computerisation in a private hospital. J Clin Nurs, 2012; 21(11–12):1685–1696; doi: 10.1111/j.1365-2702.2011.03905.x
36.
TilahunB, FritzF. Comprehensive evaluation of electronic medical record system use and user satisfaction at five low-resource setting hospitals in Ethiopia. JMIR Med Inform, 2015; 3(2):e22; doi: 10.2196/medinform.4106
37.
KpobiL, SwartzL, Ofori-AttaAL. Challenges in the use of the mental health information system in a resource-limited setting: Lessons from Ghana. BMC Health Serv Res, 2018; 18(1):98; doi: 10.1186/s12913-018-2887-2
38.
D’CostaS, SinhaRK. Usability assessment of hospital information system integrated electronic medical record. Online J Health Allied Sci, 2018; 17.
39.
BoyerL, Baumstarck-BarrauK, BelzeauxR, et al.Validation of a professionals’ satisfaction questionnaire with electronic medical records (PSQ-EMR) in psychiatry. Eur Psychiatry, 2011; 26(2):78–84; doi: 10.1016/j.eurpsy.2009.10.007
40.
HeidarizadehK, RassouliM, ManoochehriH, et al.Nurses’ perception of challenges in the use of an electronic nursing documentation system. Comput Inform Nurs, 2017; 35(11):599–605; doi: 10.1097/CIN.0000000000000358
41.
MurphyP, Carter-TempletonH. Nurses’ ease-of-use ratings of the electronic medical record in the care of persons with heart failure. Comput Inform Nurs, 2023; 41(5):261–265; doi: 10.1097/CIN.0000000000001020
42.
UnniP, StaesC, WeeksH, et al.Why aren’t they happy? An analysis of end-user satisfaction with Electronic health records. AMIA Annu Symp Proc, 2016; 2016:2026–2035.
43.
SidebottomAC, CollinsB, WindenTJ, et al.Reactions of nurses to the use of electronic health record alert features in an inpatient setting. Comput Inform Nurs, 2012; 30(4):218–226; doi: 10.1097/NCN.0b013e3182343e8f
44.
LindrothHL, PinevichY, BarwiseAK, et al.Information and data visualization needs among direct care nurses in the intensive care unit. Appl Clin Inform, 2022; 13(5):1207–1213; doi: 10.1055/s-0042-1758735
45.
LloydS, LongK, ProbstY, et al.Medical and nursing clinician perspectives on the usability of the hospital electronic medical record: A qualitative analysis. Health Inf Manag, 2024; 53(3):189–197; doi: 10.1177/18333583231154624
LemonC, LiuN, LaneS, et al.Changes in user perceptions of a telemedicine system over time: From initial implementation to everyday use. Telemed J E Health, 2018; 24(7):552–559; doi: 10.1089/tmj.2017.0194
48.
TajirianT, StergiopoulosV, StrudwickG, et al.The influence of electronic health record use on physician burnout: Cross-sectional survey. J Med Internet Res, 2020; 22(7):e19274; doi: 10.2196/19274
49.
WindenTJ, BolandLL, FreyNG, et al.Care everywhere, a Point-to-Point HIE tool. Appl Clin Inform, 2014; 5(2):388–401; doi: 10.4338/ACI-2013-12-RA-0100
50.
AlamriY, CrossN, Tan-SmithC, et al.Usability survey of an inpatient electronic clinical communication platform at a large New Zealand tertiary hospital. N Z Med J, 2023; 136(1570):54–60; doi: 10.26635/6965.5989
51.
BloomMV, HuntingtonMK. Faculty, resident, and clinic staff’s evaluation of the effects of EHR implementation. Fam Med, 2010; 42(8):562–566.
JedwabRM, ManiasE, HutchinsonAM, et al.Nurses’ experiences after implementation of an organization-wide electronic medical record: Qualitative descriptive study. JMIR Nurs, 2022; 5(1):e39596; doi: 10.2196/39596
54.
de HoopT, NeumuthT. Evaluating electronic health record limitations and time expenditure in a German Medical Center. Appl Clin Inform, 2021; 12(5):1082–1090; doi: 10.1055/s-0041-1739519
55.
BoonstraA, VersluisA, VosJFJ. Implementing electronic health records in hospitals: A systematic literature review. BMC Health Serv Res, 2014; 14:370; doi: 10.1186/1472-6963-14-370
56.
CillessenFH, de Vries RobbéPF, BiermansMC. A hospital-wide transition from paper to digital problem-oriented clinical notes. Appl Clin Inform, 2017; 8(2):502–514; doi: 10.4338/ACI-2016-08-RA-0137
57.
SallehMIM, AbdullahR, ZakariaN. Evaluating the effects of electronic health records system adoption on the performance of Malaysian health care providers. BMC Med Inform Decis Mak, 2021; 21(1):75; doi: 10.1186/s12911-021-01447-4
58.
LeeS. Effect of electronic medical record quality on nurses’ perceived usefulness and ease of use. Comput Inform Nurs, 2022; 40(8):562–570; doi: 10.1097/CIN.0000000000000845
59.
ChouWJ, TsaiPY, LinSY, et al.Evaluation of clinical nursing information system in Taiwan regional hospital. Stud Health Technol Inform, 2017; 245:1353.
60.
StylianidesA, MantasJ, PouloukasS, et al.Evaluation of the Integrated Health Information System (IHIS) in public hospitals in Cyprus utilizing the DIPSA framework. Acta Inform Med, 2019; 27(4):240–244; doi: 10.5455/aim.2019.27.240-244
61.
SchopfTR, NedrebøB, HufthammerKO, et al.How well is the electronic health record supporting the clinical tasks of hospital physicians? A survey of physicians at three Norwegian hospitals. BMC Health Serv Res, 2019; 19(1):934; doi: 10.1186/s12913-019-4763-0
62.
ShopoKD, KrugerL, BesterP. Nurses’ attitudes towards a computerised health information system in a private South African Hospital. Ajnm, 2020; 22(1):15; doi: 10.25159/2520-5293/4982
63.
MasefieldSC, MsosaA, GrugelJ. Challenges to effective governance in a low income healthcare system: A qualitative study of stakeholder perceptions in Malawi. BMC Health Serv Res, 2020; 20(1):1142; doi: 10.1186/s12913-020-06002-x
64.
KawilaC, WG, OtienoG, et al.The Role leadership style plays in the integration of health management information system. IJCA, 2018; 181(2):1–5; doi: 10.5120/ijca2018917406
65.
Santos Mc dosMH, deF. Analysing the use of a computerized system by hospital managers. Acta Paul Enferm, 2018; 31(1):1–6; doi: 10.1590/1982-0194201800002
RussAL, SaleemJJ, JusticeCF, et al.Electronic health information in use: Characteristics that support employee workflow and patient care. Health Informatics J, 2010; 16(4):287–305; doi: 10.1177/1460458210365981
68.
ChoY, KimM, ChoiM. Factors associated with nurses’ user resistance to change of electronic health record systems. BMC Med Inform Decis Mak, 2021; 21(1):218; doi: 10.1186/s12911-021-01581-z
69.
LeeM, KimK, ShinY, et al.Advancements in Electronic Medical Records for Clinical Trials: Enhancing Data Management and Research Efficiency. Cancers (Basel), 2025; 17(9):1552; doi: 10.3390/cancers17091552
70.
BajwaJ, MunirU, NoriA, et al.Artificial intelligence in healthcare: Transforming the practice of medicine. Future Healthc J, 2021; 8(2):e188–e194; doi: 10.7861/fhj.2021-0095
71.
VentolaCL. Mobile devices and apps for health care professionals: Uses and benefits. Pharm Ther, 2014; 39(5):356–364.
