During December 2008 and January 2009, the user experience research firm User Centric conducted an independent comparative usability study of two existing online personal health record applications, Google Health and Microsoft HealthVault. (Neither Google nor Microsoft commissioned or participated in this study in any manner.) During this study, 30 participants completed key tasks using each PHR application and provided qualitative feedback, ratings and preference data on five specific dimensions: Overall usability, utility (usefulness of features), security, privacy and trust. Participants performed up to seven tasks on both Google Health and Microsoft HealthVault, which included three tasks that explored each application's unique features. Midway through the study, a third PHR application, MyMedicalRecords.com, was added to gather additional qualitative data.
Figure 1: Homepages of Google Health (top) and Microsoft HealthVault (bottom) as they initially appear to users.
The majority of study participants found PHRs to be useful and stated that they had an interest in building their own PHRs after the study. Overall, participants indicated that they found Google Health more usable because navigation and data entry of health information was easier than on the other applications. Participants said that the Google Health application utilized more familiar medical terminology and provided a persistent health information profile summary.
Overall, participants liked how the Google Health interface allowed them to quickly enter medical information. The left hand navigation, tabs, and profile summary all contributed to a fairly smooth user experience for data entry, which is a critical PHR task. However, there was still room for improvement. Participants had trouble attaching dates to health information, figuring out where to start, and finding where they could add another family member.
In general, participants had more trouble with the Microsoft HealthVault interface. The most troublesome elements were the confusing navigation, the presentation of all terms in medical jargon, and the inconsistency between different data entry elements. However, reaction to Microsoft HealthVault was not completely negative -- even though they struggled to enter their health information, several participants still reacted favorably to the very high level of detail the system allowed them to enter. In addition, participants liked the ability to add details to an item immediately after adding the item itself. This represented an efficient flow that Google Health did not provide.
Participants found PHRs to be fairly desirable by the end of the study. The PHRs' baseline functionality was appealing, and both Google Health and Microsoft HealthVault each had a few well-received exclusive features
Google Health's preference on this dimension is likely due to two factors. First, participants sometimes seemed to confuse utility with usability, even though researchers specifically asked about "usefulness of features." This, along with Google Health's better ease of use, would explain a shift in participants' utility preference. Second, Google Health included the highly desirable drug interaction feature, which was ranked most appealing out of all the features in the post-test questionnaire. This was the only outstanding feature among the six PHR-exclusive features, so it may also have boosted the perception of Google Health's utility.
The key contributors to Microsoft HealthVault's more frequent preference on security, privacy and trust were a strong brand image, professional-looking visual design and a higher perceived information content.
User Centric's comparative study found that neither Google Health nor Microsoft HealthVault were perfect applications; each had flaws in the user experience which were seen to reduce participants' willingness to adopt PHR technology. However, participants preferred Google Health over Microsoft HealthVault on the whole, mainly due to Google Health's greater ease of use. Although features, security, privacy and trust certainly did influence participants' overall evaluations, it is critical to note that their major difficulties with both applications - and their strongest criticisms - were related to the user experience. Improvements to the user experience therefore represent the largest opportunity for improving the patient's experience with a PHR.
Based on this usability study, User Centric has identified several best practices to be included in a working model for PHR interfaces that facilitates user adoption.
Visit our EHR User Experience Consulting section to learn how User Centric can help make your EHR application and its user interface more effective, efficient, intuitive, and satisfying to use.