Usability of a mobile electronic medical record prototype: a verbal protocol analysis

Background. Point of care access to electronic medical records may provide clinicians with the information they want when they need it and may in turn improve patient safety. Yet providing an electronic medical record on handheld devices presents many usability challenges, and it is unclear whether clinicians will use them. Methods. An iterative design process for the development and evaluation of a prototype of a mobile electronic medical record was performed. Usability sessions were conducted in which physicians were asked to 'think aloud' while working through clinical scenarios using the prototype. Verbal protocol analysis, which consists of coding utterances, was conducted on the transcripts from the sessions and common themes were extracted. Results. Usability sessions were held with five family physicians and four internists with varying levels of computer expertise. Physicians were able to use the device to complete 52 of 54 required tasks. Users commented that it was intuitive (9/9), would increase accessibility (5/9) but for them to use it, it would need the system to be fast and time-saving (5/9). Users had difficulty entering information (5/9) and reading the screen (4/9). In terms of functionality, users had concerns about completeness of information (6/9), details of ordering (5/9) and desired billing functionality (5/9) and integration with other systems (4/9). Conclusions. While physicians can use mobile electronic medical records in realistic scenarios, certain requirements likely need to be met including a fast system with easy data selection, easy data entry and improved display before widespread adoption occurs.