Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 27, 2018
Open Peer Review Period: Dec 4, 2018 - Jan 29, 2019
Date Accepted: Feb 18, 2019
(closed for review but you can still tweet)
Validating the National Usability-focused HIS Scale (NuHISS) for Physicians
ABSTRACT
Background:
Problems in the usability of health information systems (HIS) are well acknowledged, but research still lacks a validated questionnaire for measuring and monitoring different dimensions of usability of HIS. Such questionnaires are needed not only for research, but also for developing usability of HIS from the viewpoint of end-user experiences.
Objective:
To develop and test the validity of questionnaire measuring National usability-focused HIS-scale (NuHISS) among nationally representative sample of Finnish physicians.
Methods:
We utilized two cross-sectional data collected from a random sample of Finnish physicians in 2014 (N = 3781; 61.9 % women) and 2017 (N= 4018; 64.8 % women). Exploratory factor analyses and structural equation modelling (SEM) were applied to test structural validity of the NuHISS. As the concurrent validity measure we used the self-reported overall quality of the electronic health record system (“school grade”) provided by the participants using marginal structural models.
Results:
The exploratory factor analyses with varimax rotation suggested that the seven-factor solution did offer a good fit to the data in both samples (C2=2136.14 in 2014 and C2=2109.83 in 2017, both p<.001). Moreover, SEM analyses showed that 7 factor solution provided an acceptable fit in both samples (CFI= 0.92/ 0.91, TLI= 0.92/0.91, NFI= 0.92/0.91, RMSEA= 0.048/0.049, SRMR = 0.040/ 0.039). Also concurrent validity of this solution was shown to be acceptable. Especially the ease of use, but also all other dimensions were associated with overall quality reports independently of measured confounders. The 7 factor solution included dimensions Technical quality, Information quality, Feedback, Ease of use, Benefits, Internal collaboration, and Cross-organisational collaboration.
Conclusions:
NuHISS provides a useful tool for measuring usability of HIS among physicians and offers a valid measure for monitoring the long-term development of HIS on large scale. The relative importance of items needs to be assessed against national eHealth policy goals, and complemented with items that remained outside the NuHISS-scale from the questionnaire when appropriate.
Citation
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Copyright
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