Usability and cognitive load in the design of a personal health record

While personal health records (PHRs) carry an array of potential benefits such as increased patient engagement, poor usability remains a significant barrier to patients' adoption of PHRs. In this mixed-methods study, we evaluate the usability of an important PHR feature, a patient intake form called the pre-visit summary, from the perspective of cognitive load using real cardiovascular patients in vivo. A validated measure for cognitive load, the NASA Task Load Index, was used along with retrospective interviews to identify tasks within the pre-visit summary that were more mentally challenging for patients. Participants experienced higher cognitive load on the Medications, Immunizations, Active Health Concerns, and Family History pages because these pages required a higher recall of personal health information and due to some user interface design issues. This research is significant because it uses validated measures of cognitive load to study real patients interacting with a PHR in vivo. (C) 2019 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved.