Assessing the information quality and usability of My Health Record within a health literacy framework: What’s changed since 2016?

Abstract

Background: This study examined the health literacy demands of My Health Record (MyHR) in the context of preparing for a government-announced opt-out system by repeating two studies of health information and usability conducted in 2016. Objective: To examine whether Australia’s MyHR meets the information and usability needs of people at risk of low health literacy and changes since 2016. Method: Content analysis: Informed by the 2016 methods and findings, measures of information quality, themes and target audiences were recorded and reported for each online consumer-facing health information resource. Heuristic evaluation: An evaluation of the MyHR and supporting information website was conducted using a predetermined checklist of usability criteria. A list of usability violations for both websites was identified. Results: Total number of resources grew from 80 in 2016 to 233 in 2018. There was little change since 2016 to average readability levels, target audiences, presentation style, links between resources and usability of MyHR. Compared to 2016, this study demonstrated increases in resources from non-government organisations; video resources; translated resources; and resources with themes of privacy, security and post-registration use. Conclusion: This study identified some improvements in information quality since 2016, but gaps remain in information quality and usability which may negatively impact the ability for people with low health literacy to access and use MyHR. Implications: This study provides a framework for ongoing monitoring and evaluation of the suitability of MyHR for people at risk of low health literacy.

Systematic Literature Review of My Health Record System

“…However, Walsh et al [19] analysed the content of the MyHR system and contradicted that finding. The authors hold the view that relevant information about how patients can engage with healthcare professionals was not provided.…”

“…Several authors [8,10,[15][16][17][18][19] in this area discussed both positive and negative issues of the system and information quality and access. The positive outcomes are that the health information stored in several repositories can be accessed by one system through an interface that shows relevant information on the first website page, which eliminates the reliance on patients remembering facts about their health during medical appointments.…”

“…[10] Additionally, some segments of the Australian community are unable to access and navigate the MyHR system (e.g., elderly citizens). [19] This inability could result in erroneous data that increases the likelihood of risk and harm.…”

“…Health literacy was also found to be a concern, with varying levels of knowledge related to the regions in Australia. [8,18,19] In addition to this, while the public might understand the system's language, minority groups might not. It was also identified that medical jargon could lead to misinterpretation of information, and not all data is fit for sharing, for example, laboratory results.…”

A Tale of Two Inspection Methods: Comparing an eHealth Literacy and User Experience Checklist with Heuristic Evaluation

“…Additionally, another group of researchers used both methods [14]. In their subsequent study, the researchers [18] reported that the HLO checklist "was easier to use and returned more specific results than the second heuristic set" (i.e., Evidence-Based Heuristics), with two exceptions which they integrated into their inspection checklist. We categorized these findings into strengths and weaknesses for each tool and examined them for commonalities.…”