Empowering patients to address diabetes care gaps: formative usability testing of a novel patient portal intervention.

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Clinical Guidelines
Authored By
Nelson LA, Reale C, Anders S, Beebe R, Rosenbloom ST, Hackstadt A, Harper KJ, Mayberry LS, Cobb JG, Peterson N, Elasy T, Yu Z, Martinez W
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Interests
Endocrinology
Internal/Family Medicine
Speciality
Endocrinology
Internal/Family Medicine
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volume
6
ISSN
2574-2531
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ISSN
2574-2531
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Additional Info
["Nelson LA, Reale C, Anders S, Beebe R, Rosenbloom ST, Hackstadt A, Harper KJ, Mayberry LS, Cobb JG, Peterson N, Elasy T, Yu Z, Martinez W","Publisher: Oxford University Press on behalf of the American Medical Informatics Association Country of Publication: United States NLM ID: 101730643 Publication Model: eCollection Cited Medium: Internet ISSN: 2574-2531 (Electronic) Linking ISSN: 25742531 NLM ISO Abbreviation: JAMIA Open Subsets: PubMed not MEDLINE","Journal Article","2023-04-27","JAMIA open [JAMIA Open] 2023 Apr 27; Vol. 6 (2), pp. ooad030. Date of Electronic Publication: 2023 Apr 27 (Print Publication: 2023).","English","2574-2531","JAMIA open","6"]
Description
Objective: The aim of this study was to design and assess the formative usability of a novel patient portal intervention designed to empower patients with diabetes to initiate orders for diabetes-related monitoring and preventive services.<br />Materials and Methods: We used a user-centered Design Sprint methodology to create our intervention prototype and assess its usability with 3 rounds of iterative testing. Participants (5/round) were presented with the prototype and asked to perform common, standardized tasks using think-aloud procedures. A facilitator rated task performance using a scale: (1) completed with ease, (2) completed with difficulty, and (3) failed. Participants completed the System Usability Scale (SUS) scored 0-worst to 100-best. All testing occurred remotely via Zoom.<br />Results: We identified 3 main categories of usability issues: distrust about the automated system, content concerns, and layout difficulties. Changes included improving clarity about the ordering process and simplifying language; however, design constraints inherent to the electronic health record system limited our ability to respond to all usability issues (eg, could not modify fixed elements in layout). Percent of tasks completed with ease across each round were 67%, 60%, and 80%, respectively. Average SUS scores were 87, 74, and 93, respectively. Across rounds, participants found the intervention valuable and appreciated the concept of patient-initiated ordering.<br />Conclusions: Through iterative user-centered design and testing, we improved the usability of the patient portal intervention. A tool that empowers patients to initiate orders for disease-specific services as part of their existing patient portal account has potential to enhance the completion of recommended health services and improve clinical outcomes.<br /> (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Medical Informatics Association.)
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