Q.U.i.P.S. Navigator

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usability, safety and privacy

The Q.U.i.P.S. model

To assist managers and systems developers in determining these factors a risk-based quality model known as Q.U.i.P.S. was developed. Q.U.i.P.S. takes a systematic approach to evaluating critical aspects in health care applications that lead to the development and deployment of a quality IT products (Note Q.U.i.P.S. stands for Quality, Usability, investigation, Privacy and Safety - derived from the Latin quippe, “to be sure”). Quality is multi-faceted concept which is difficult to define and should be treated as a system wide attribute affecting all aspects of a system. Some of these are objective measures, e.g., usage, productivity, and robustness, while others are more subjective such as the general perception and appreciation of a given system.

Figure 1: The QUiPS model

The key attributes for Q.U.i.P.S.

The three attributes of Usability, Privacy and Safety are investigated to provide feedback into the requirements for determining a Quality electronic health information system product. The following provides basic definitions of each of these attributes and outlines their importance to electronic HIS.

Usability is defined as “The extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context of use”. An electronic health information system exhibiting poor usability could suffer from low acceptance or partial usage by the clinicians. Clinicians are not using health information systems to their full functionality, hence evidence is mounting that issues of usability have come to the fore as the ultimate acceptance or rejection of HIS.

Privacy is “the right of individuals to be left alone and to be protected against physical or psychological invasion or the misuse of their property”. As in other sectors of the economy, health records are being migrated from their traditional paper based form to electronic records. Ipso facto, legislators are beginning to take action in order to ensure the security of these national assets. A prime example of such a legal approach is the HIPAA legislation introduced in the United States. The Health Insurance Portability and Accountability Act (HIPAA 1996) introduced regulations relating to data security and privacy within the health care sector. The need for securing health records has attained paramount importance since the legislation came into effect in April 2005. Specifically, HIPAA maintains the protection of the confidentiality, integrity and availability of ‘protected health information’ (PHI) from all foreseeable external and internal security threats and vulnerabilities. The introduction of such landmark legislation in the United States has had a profound effect on the way in which the health care sector and legislators will view security throughout the world, including Australia. This is an area of high sensitivity and can present one of the major obstacles preventing electronic health information systems from being trusted and hence adopted.

Safety refers to the freedom from unacceptable risk of physical injury or damage to the health of people. Safety-related computer systems use a broader definition to include risks other than human such as large economic loss and environmental damage. For an electronic health information system, it would include harm to the system itself. This in turn might put patients’ lives at risk depending on the application in hand and the circumstances surrounding its usage.

Related Publications:

Croll, PR and Croll, J (2004a) Q.U.i.P.S. a Quality Model for Investigating Risk Exposure in e-Health Systems, Medinfo Journal 2004; Vol. 2004, pp. 1023-7. ISSN: 1569-6332.

ACSQHC (2004) Charting the Safety and Quality of Health Care in Australia, Australian Council for Safety and Quality in Health Care and the National Institute of Clinical Studies, ISBN: 0 642 82517 3, July 2004.

Croll, PR and Croll, J (2004b) Usability Evaluations in Community Health Systems, the International Conference on qualitative research, QualIT 2004, Nov 2004, Brisbane, Australia.

Croll, J and Croll, PR (2004c) The System versus The User: An Evaluation of CHIME from Two Different Perspectives, Health Informatics Conference (HIC2004), 26/27 July, Brisbane, Australia.