Informatics in Medicine Unlocked (Jan 2021)
Designing and usability assessing an electronic personal health record for patients with chronic heart failure in a developing country
Abstract
Background: Chronic heart failure (CHF) is one of the serious chronic progressive conditions with the highest incidence, mortality, and disability so that its complications can be controlled and prevented through self-care behaviors. An electronic personal health record (e-PHR) can increase patients' understanding of their level of health to improve it. Objective: This study aimed to design an e-PHR system and assess its usability for patients with CHF. Methods: This applied developmental research was conducted in 2019. Based on the literature review, a questionnaire was designed to assess and determine the data elements required for the e-PHR system of patients with CHF by 14 cardiologists and 40 nurses employed at Cardiology departments of hospitals in Iran. Then the system was designed and developed using the PHP programing language and MySQL database server and implemented on a web server. The system's usability was assessed by three cardiologists and three patients using the System Usability Scale (SUS) questionnaire and five health information technology experts using Nielsen's usability heuristics. Results: The experts approved the system design elements, including 225 data elements, such as identity information, vital signs, diet and liquids, health records, symptoms, medications, vaccination, tests, social records, physical activities, sexual activities, and travel. The most important elements in this system were social records (98.52%) and physical activities (97.53%), whereas the least important element was vaccination (80%). Patients and cardiologists gave 83.33 and 85 SUS scores to the designed system, respectively. In other words, they evaluated the system usability at a ''good'' level. Based on Nielsen's usability heuristics, the system had 30 unique problems, with overall average severity of 2.39. Conclusion: The designed e-PHR system for CHF patients obtained good and satisfactory results in usability assessment. Therefore, this web-based system can be easily employed for the condition management of patients with CHF.
