Identifying Audit Trail Viewer Requirements for User-Focused Design: A Qualitative Focus Group Study

Audit Trail Viewer (ATV) is a tool to extract information from an audit database which is medico-legally binding and valid for a legal challenge. Availability of ATV should help promote transparency for patients. Care providers could be more careful on what to be recorded in a patient Electronic Health Record (EHR). This pilot study aims to identify basic requirements for ATV from patients' perspectives. Two focus group and two face-to-face interviews were conducted with 14 participants. Of these, 12 participants were spilt into two groups while two appointments were set up for face-to-face interviews. Focus group participants were employees of a company while two interviewees were research staff of a research institute. Five questions covered 5 topics, e.g. fit for purpose, functionality, user interface, usability, and potential barriers, were asked. Audio-recording of all sessions was transcribed verbatim. The transcripts were analyzed by three researchers. Participants felt that they should have access to their ATV to monitor, identify, and validate their EHR. ATV should be an intuitive secured web-based application with password protected and should be listed in chronological order with save, and print options. Language used should be simple and self-explanatory. There should also be links to their full EHR and some health-related websites. The ATV should be highly responsive, stable, and reliable. Computer literacy, language, availability, and lack of incentives could be major barriers for ATV. These findings can help develop a web-based, user-focused design ATV. Unlike web-design, some findings such as printing out and downloading options are not feasible due to some constraints such as regulatory requirements and technology limitations. Language, security, and computer literacy would be among big challenges. If patients could access their EHR and other health-related websites via ATV, this should empower them to take control over their healthcare.