1142 — Evaluation of a Health Care Icon Set

Drews FA, VA Salt Lake City; Wilck N, Human Factors Engineering Office; Plew W, Human Factors Engineering Office; Herout J, Human Factors Engineering Office; Gleed J, VA Salt Lake City; Zadra J, VA Salt Lake City;

Objectives:
Graphical user interfaces use icons to increase the usability of the interface. In Health Care, Electronic Health Record (EHR) software often uses icons in the graphical user interface that are not standardized, resulting in reduced usability of the software.

Methods:
Thirty-two health care providers (physicians and nurses) participated in this study. Participants saw a series of 31 icons of which they had to select the most likely function the icon represented. For each icon, participants saw a list of possible function the icon could represent

Results:
Three groups of icons were identified in terms of icon-function agreement. The first group involved icons with agreement in excess of 90%. A second group of icons fell into the category of medium agreement of 50% to 89%. The third group of icons fell into the category of icons with little agreement < 50%. Overall the majority of icons fell into the last group. In addition, agreement between physicians and nurses concerning icon-function selection varied between groups significantly. Finally, two icons that are currently used in CPRS were included and agreement for these was medium to extremely low.

Implications:
The current study explored the usability of health care icons and identified a number of problems with the icons that are currently being used in Electronic Health Record systems. Among these issues are that while for some icons there is a strong association between an icon and its represented function, in many cases this association is weak at best. Also, in terms of the icon-function relationship there are differences between health care providers, which is an issue since these provider groups use the same EHR. Third, this study identifies significant problems related to icons that are currently in use in the VA Electronic Health Record system. The high degree of ambiguity associated with these icons indicates potential usability issue.

Impacts:
The results of this study indicate that there is a significant need for a usability-driven icon design process for health care icons. This is especially the case for the next version of the VA EHR.