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User-Centered Design, Experience, and Usability of an Electronic Consent User Interface to Facilitate Informed Decision-Making in an HIV Clinic

Ramos, S. Raquel PhD, MSN, MBA, FNP-BC

CIN: Computers, Informatics, Nursing: November 2017 - Volume 35 - Issue 11 - p 556–564
doi: 10.1097/CIN.0000000000000356

Health information exchange is the electronic accessibility and transferability of patient medical records across various healthcare settings and providers. In some states, patients have to formally give consent to allow their medical records to be electronically shared. The purpose of this study was to apply a novel user-centered, multistep, multiframework approach to design and test an electronic consent user interface, so patients with HIV can make more informed decisions about electronically sharing their health information. This study consisted of two steps. Step 1 was a cross-sectional, descriptive, qualitative study that used user-centric design interviews to create the user interface. This informed Step 2. Step 2 consisted of a one group posttest to examine perceptions of usefulness, ease of use, preference, and comprehension of a health information exchange electronic consent user interface. More than half of the study population had college experience, but challenges remained with overall comprehension regarding consent. The user interface was not independently successful, suggesting that in addition to an electronic consent user interface, human interaction may also be necessary to address the complexities associated with consenting to electronically share health information. Comprehension is key factor in the ability to make informed decisions.

Author Affiliation: School of Nursing, Yale University, Orange, CT.

S.R.R. is funded by Self and Family Management of Chronic Illness (T32NR008346) (principal investigator: Nancy Reynolds). This work was funded by Reducing Health Disparities Through Informatics (T32NR07969) (principal investigator: Suzanne Bakken).

The author has disclosed that she has no significant relationships with, or financial interest in any commercial companies pertaining to this article.

Corresponding author: S. Raquel Ramos, PhD, MSN, MBA, FNP-BC, School of Nursing, Yale University, 400 West Campus Dr, Orange, CT 06477 (

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