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Problem:While there seems to be an increase over the last decade in patient activation of individual portal accounts, less than half of patients repeatedly utilize its functions. It is not clear if a user-centered design was utilized to design the current patient portals (Alpert, Krist, Aycock & Kreps, 2016).

v Texting patients can increase medicationadherence for chronic disease patients from50% to 67.8%, or a 17.8% overall increase.

v Patients in their 60s show no difference in theiradoption rate for portal accounts whencompared to patients in their 30s through 50s,and patients in their 20% and 70s have a similarportal registration rate.

v Patient diagnosis and medications inherentlyuse medical terminology which is unfamiliar tothe average user creating a barrier to fullyutilizing this system function.

v One reason may be a lack in functionality thatusers expect from such a system.

Problem: While there seems to be an increase over the last decade in patient activation of individual portal accounts, less than half of patients repeatedly utilize its functions. It is not clear if a user-centered design was utilized to design the current patient portals (Alpert, Krist, Aycock & Kreps, 2016)

Objective Assessment of Patient Portal Requirements

1 Department of Industrial and Systems Engineering, Texas A&M University 3 Department of Environmental and Occupational Health, Texas A&M University 2 Center for Remote Health Technologies and Systems, Texas A&M University 4 NSF Center for Health Organization Transformation, Texas A&M University

1. Background

Sadeghi, M.1 ,Sasangohar, F.1,2,3,4

mahnoosh@tamu.edu ; sasangohar@tamu.edu

2. Research Aims 4. Future WorkA patient portal is a secure online interface thatprovides patients with convenient access topersonal health information at any time. Thesystem may incorporate lab results,prescriptions, medications and so forth.Additionally, this interface can be utilized as away to communicate with the health careprovider, schedule appointments and recordhealth documents.

Top three vendors used by hospitals are:1.Cerner Corp.- Cerner Patient Portal2.MEDITECH- Patient Portal3.Epic Systems Corp.- MyChart (Fig. below)

Derive functional and information requirements to inform the design of a usable, efficient, and interactive Patient Portal

3. Methods & Results- The information functional requirements derivedfrom user input are user-centered and designindependent. This systematically-derived set ofrequirements can inform future design andimprovements to existing patient portal systems.Another benefit of the FIR method is identificationof information required as an input to the systemand an output to the user. Each piece of informationrelates to a function that the system must provide.

Limitations:The major limitation of this study was the smallsample size. 10 participants were recruited forinterviews. While larger sample can provide a widerrange of responses and repeatable results, the resultswere saturated after the sixth interview and similaranswers were given.

What is the next step?- The work is in progress to compare several patientportals for large hospitals in Texas with the derivedinformation requirements to identify opportunitiesfor improving user interaction. Information in anactual patient portal should be compatible withthese derived requirements to meet userexpectations. Future studies include heuristicsanalysis and usability testing of existing patientportal systems to ensure user expectations are met.Heuristics analysis will evaluate features of existingsystems against established principles. Thisevaluation can also include comparison of existingfunctions to those derived in this study. Theseresults could inform design changes, which can thenbe evaluated by usability testing. The goal is toestablish requirements of a patient portal system tomeet user needs.

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Driving Functional Information Requirements based on Literature Reviews and Patient Interviews

For more information about this work, contact Dr. Farzan Sasangohar: sasangohar@tamu.edu ; (979) 458-2337

Evaluate

Redesign

Usability Testing

Compare

Systematic Review of Literature

• A systematic literature review was conducted toinvestigate the factors that need to be considered in thedesign of a patient portal system to improve usability.OvidMedline, PubMed, Cochrane and Google Scholarwere used and returned 2043 articles. After filtering, 27articles remained related to patient’s use of tetheredpersonal electronic medical record systems. Only paperwritten in English were included.

• Findings: Three themes in literature were found:software user interface (usability), comprehension ofinformation delivered, and thirdly, studies on the patientparticipation.

Patient Interviews

• User-centered, semi-structured and prospective interviews were conducted.

• 10 participants from Texas A&M community were askedquestions about the prevalence of the usage, context ofthe usage and users’ expectations in terms offunctionality of patient portals. The participants meanage was 34 and the standard deviation was 14.

• Findings: 70% of participants did not know whatpatient portal is. 80% of participants wanted to be ableto make appointments and see their future appointments.70% of participants wanted to be able to see their labresults and prescriptions.

Functional Information

Requirement

• FIR is a method to derive an objective set ofinformation requirements for an interface in terms offeedback from the system and input from the user.

• High-Level functions are decomposed into lower-levelfunctions which encompass more specific tasks.Information requirements are then derived from low-level functions and represent information as expectedby users. N

• Findings: Nine high level functions were found, 4 ofthem are included in the table. The remaining 5functions are: Accessing information, uploadingdocuments, making payments, get notifications andproviding help.

Functional Information Requirements Analysis