Validation of the usability metrics for evaluating eHealth systems in Tanzania
The prevalence of eHealth systems in healthcare facilities has experienced significant growth in many countries. Nevertheless, a significant obstacle that has arisen pertains to the usability of the implemented systems. This paper focuses on assessing the usability metrics that are applicable in evaluating eHealth systems in Tanzania’s contexts. Data were collected through questionnaires and interviews at six health facilities in Tanzania. The main participants were the health workers who were using the eHealth system in their routine healthcare delivery, including pharmacists, laboratory technicians, doctors, and nurses in their different cadres. The analysis of the findings was performed to obtain usability metrics and contextual issues by computing confirmatory factor analysis (CFA) using structural equation modelling (SEM) for quantitative data and thematic analysis for qualitative data. The results revealed that 11 usability metrics constructs with 54 items and 5 contextual issues constructs with 18 items were applicable in evaluating the usability of eHealth systems in Tanzania
Aljaber, T., Gordon, N., Kambhampati, C., & Brayshaw, M. (2015). An Evaluation Framework for Mobile Health Education Software. 2015 Science and Information Conference (SAI) (pp. 786-790). London, UK: IEEE. doi:10.1109/SAI.2015.7237233
Awang, Z. (2012). Validating the measurement model: CFA. In Zainudin Awang, A handbook on SEM (4th ed., pp. 53-74). Terengganu, Malaysia: Universiti Sultan Zainal Abidin.
Awang, Z., Afthanorhan, A., Mohamad, M., & Asri, M. (2015). An evaluation of measurement model for medical tourism research: The confirmatory factor analysis approach. International Journal of Tourism Policy, 6(1), 29-45.
Bate, P., Robert, G., Fulop, N., Ovretveit, J., & Dixon-Woods, M. (2014, March 27). What is context and why does it matter? The Health Foundation. Retrieved from The Health Foundation: https://www.health.org.uk/newsletter/what-context-and-why-does-it-matter
Broekhuis, M., Velsen, L. v., Peute, L., Halim, M., & Hermens, H. (2020). Conceptualizing usability for the eHealth context: A content analysis of usability problems of eHealth applications. Journal of Medical Internet Research - Preprints. Retrieved from https://preprints.jmir.org/preprint/18198
Broekhuis, M., Velsen, L., & Hermens, H. (2019). Assessing usability of eHealth technology: A comparison of usability benchmarking instruments. International Journal of Medical Informatics, 128, 24-32.
Cangur, S., & Ercan, I. (2015). Comparison of Model Fit Indices Used in Structural Equation Modeling Under Multivariate Normality. Journal of Modern Applied Statistical Methods, 14(1), 152-167. doi:10.22237/jmasm/1430453580
Gu, D., Guo, J., Liang, C., Lu, W., Zhao, S., Liu, B., & Long, T. (2019). Social Media-Based Health Management Systems and Sustained Health Engagement: TPB Perspective. International Journal of Environmental Research and Public Health, 16(9), 1-15. doi:https://doi.org/10.3390/ijerph16091495
Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2014). Multivariate data analysis (7th ed.). UK: Pearson Education Limited.
Halim, M. (2019). The eHealth Usability Matrix: Developing a usability evaluation framework for patient-facing eHealth technologies (Bachelor Thesis). Enschede, Netherland: University of Tewente. Retrieved from http://essay.utwente.nl/78323/1/Halim_BA_BMS.pdf
Hyppönen, H., Kaipio, J., Heponiemi, T., Lääveri, T., Aalto, A.-M., Vänskäi, J., & Elovainio, M. (2019). Developing the National Usability-Focused Health Information System Scale for Physicians: Validation Study. Journal of Internet Medical Research (JIMR), 21(5), e12875.
Islam, M. N., Karim, M. M., Inan, T. T., & Islam, A. K. (2020). Investigating usability of mobile health applications in Bangladesh. BMC Medical Informatics and Decision Making, 20(19), 1-13. doi:https://doi.org/10.1186/s12911-020-1033-3
ISO. (2001). ISO/IEC 9126-1: Software Engineering – Product Quality – Part 1: Quality Model,. ISO.
ISO. (2018). Usability: Definitions and concepts (ISO 9241-11:2018). Retrieved January 13, 2020, from International Standards Organization: https://www.iso.org/obp/ui/#iso:std:iso:9241:-11:ed-2:v1:en
Kavuta, K., Msanjila, S., & Shidende, N. (2023). Assessment of the Influence of Contextual Issues in Evaluating eHealth Systems Usability in Tanzania. East African Journal of Information Technology, 6(1), 155-170. doi:https://doi.org/10.37284/eajit.6.1.1442
Lubua, E. W., & Pretorius, P. D. (2018). The role of Health Information Systems in supporting corporate objectives in Hospital Management. African Conference on Information Systems & Technology, (pp. 1-12). Cape Town, South Africa.
Maguire, M. (2001). Context of Use within usability activities. International Journal of Human-Computer Studies, 55, 453-483.
Mathews, A., & Marc, D. (2017). Usability Evaluation of Laboratory Information Systems. Journal of Pathol Inform, 8(40), 1-8. doi:10.4103/jpi.jpi_24_17
Mohammadi, F., & Mahmoodi, F. (2019). Factors Affecting Acceptance and Use of Educational Wikis: Using Technology Acceptance Model (3). Interdisciplinary Journal of Virtual Learning in Medical Sciences, 1-9. doi:http://dx.doi.org/10.5812/ijvlms.87484
Nabovati, E., Vakili-Arki, H., Eslami, S., & Khajouei, R. (2014). Usability Evaluation of Laboratory and Radiology Information Systems Integrated into a Hospital Information System. Journal of Medical Systems, 38(35), 1-7. doi:https://doi.org/10.1007/s10916-014-0035-z
Netemeyer, R. G., Bearden, W. O., & Sharma, S. (2003). Scaling Procedures: Issues and Applications. SAGE Publications, Inc .
Niranjanamurthy, M., Archikam, N., Himaja, G., & Shetty, P. K. (2014). Research Study on Importance of Usability Testing/ User Experience (UX) Testing. International Journal of Computer Science, 3(10), 78 - 85.
PEW Charitable Trusts. (2019, April 24). Poor Usability of Electronic Health Records Can Lead to Drug Errors, Jeopardizing Pediatric Patients. Retrieved February 21, 2020, from PEW Charitable Trusts: https://www.pewtrusts.org/-/media/assets/2019/04/realworldexamplesofhealthitrisks.pdf
Prgomet, M., Georgiou, A., Callen, J., & Westbrook, J. (2019). Fit Between Individuals, Tasks, Technology, and Environment (FITTE) Framework: A Proposed Extension of FITT to Evaluate and Optimise Health Information Technology Use. International Medical Informatics Association (IMIA), 744-748. doi:10.3233/SHTI190322
Schumacker, R. E., & Lomax, R. G. (2016). A Beginner’s Guide to Structural Equation Modeling (4th ed.). Routledge: Taylor & Francis Group.
Shrestha, N. (2021). Factor analysisas a tool forsurvey analysis. American Journal of Applied Mathematicsand Statistics, 4-11.
Sousa, V. E., & Lopez, K. D. (2017). Towards Usable e-Health: A Systematic Review of Usability Questionnaires. Applied Clinical Informatics, 8, 470-489.
Srinivasan, R., Lilien, G. L., & Rangaswamy, A. (2002). Technological Opportunism and Radical Technology Adoption: An Application to E-Business. Journal of Marketing, 66, 47-60. doi:10.1509/jmkg.220.127.116.1108
Tiihonen, T., Vesisenaho, M., & Sutinen, E. (2008). Concept on Context: IS Meeting Context in Developing Countries. Technology for Innovation and Education in Developing Countries.
Tyllinen, M., Kaipio, J., & Laaveri, T. (2018). A framework for usability evaluation in EHR procurement. Studies in Health Technology and Informatics, 247(1), 446-450. doi:10.3233/978-1-61499-852-5-446
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