JMIR Publications

ABSTRACT

Background:

Intensive care clinicians rely on timely access to large volumes of electronic data to make complex decisions. The Central Adelaide Local Health Network (CALHN) implemented an electronic medical record (EMR) across its hospitals in South Australia, but the generic user interface is not optimised for critical care workflows. The CALHN Critical Care Informatics System (CCCIS) was developed as a prototype user interface (UI) to present ICU-relevant information in a more intuitive, task-focused format.

Objective:

This study aimed to evaluate the usability of CCCIS from the perspective of senior intensivists, and to identify key design principles for effective critical care informatics systems.

Methods:

We undertook a usability study with eight intensivists from CALHN. Participants interacted with a prototype version of CCCIS during a structured video-based session incorporating a Cognitive Walkthrough and Think Aloud approach. Sessions were screen-recorded and transcribed. Qualitative data were coded as positive, negative or neutral feedback and grouped into three domains: content, layout and visibility. Emergent themes were mapped across CCCIS components. Following the usability test, participants completed a System Usability Scale, NASA Task Load Index and a bespoke questionnaire assessing perceived usability, cognitive demand and clinical relevance. Reporting is aligned with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines for interview-based research.

Results:

Participants reported that CCCIS supported rapid comprehension of patient information and facilitated integration between physiological data, interventions and clinical trajectory. The ability to customise views and to navigate between ward-level and bed-level information was highlighted as a strength. Areas for improvement included refinement of the ward board, ribbon and vital signs displays, particularly where duplicated information or visual clutter reduced clarity. Across the content, layout and visibility domains, recurrent themes included the importance of structured tabular displays, consistent visual hierarchies and explicit highlighting of clinically salient values. Survey responses suggested that CCCIS was easy to learn and use, exerted low cognitive demand, and was perceived as clinically relevant to everyday critical care practice.

Conclusions:

In this qualitative usability evaluation, intensivists perceived CCCIS as a usable and clinically meaningful critical care informatics system. The study identified design principles—such as structured presentation of data, alignment with mental models of ICU workflow and support for rapid synthesis of information—that may inform further development of CCCIS and other electronic medical record-integrated ICU interfaces.