Clinician feedback: qualitative
Clinicians express frustrations—and suggestions for improvement—concerning their EHR interfaces
Dave Pao
1 min read
'Put it this way: If online shopping sites relied on this many clicks and windows opening from scratch, they would not have a business!'
- Anonymous clinician
Qualitative responses were analysed from a pilot and national mixed methods clinical usability (CU) survey of Integrated Sexual Health (ISH) clinicians. Free text responses were coded by Thematic Analysis (Braun & Clarke 2006) into themes and nested sub-themes, where relevant to clinical usability (using MaxQDA2022™). Illustrative quotes are shown in cyan in the image below.
From 174 completed surveys, 6912 words were coded into 494 segments relevant to clinical usability.
‘Likes’ were expressed in 97 (20%) segments, with half describing benefits inherent to the digital medium: legibility, no lost records, remote access and searchability. Other ‘Likes’ included non-complex patients and procedure documentation. 'Likes' are are not shown in the image below.
‘Frustrations + Suggestions for improvement’ are shown in the image below. These were expressed in 397 (80%) segments, coded into five main themes (with nested sub-themes):
1. Review of data (overview and navigating data silos)
2. Reasoning with data (clinical relevance and salience)
3. Input of data (simultaneous data input and review, and more intuitive templates)
4. Digital affordances (generic and clinical, including augmented intelligence)
5. Specific clinical scenarios (contraception, MDT collaboration, Partner Notification, prescribing, results review, safeguarding, STIs (e.g., PrEP) and vaccinations)
Findings reveal that clinicians face serious difficulties, beyond generic digital usability and interoperability, from EHR interfaces that do not cognitively support their clinical practice. These five key themes offer structured, granular objectives for improving clinical usability. This collective expression of the ISH clinician community voice is a valuable contribution to building a collaborative relationship with EHR vendors.
A final iteration of this clinical usability survey is discussed (and downloadable) in another post.
Braun, V. and Clarke, V. (2006). Using thematic analysis in psychology. Qualitative research in psychology, 3 (2), pp.77–101.
November 2023
