Applying Persuasive Design Techniques to Influence Data-Entry Behaviors in Primary Care: Repeated Measures Evaluation Using Statistical Process Control
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Date
2018-10-11
Authors
St-Maurice, Justin
Burns, Catherine
Wolting, Justin
Journal Title
Journal ISSN
Volume Title
Publisher
JMIR
Abstract
Background: Persuasive design is an approach that seeks to change the behaviors of users. In primary care, clinician behaviors
and attitudes are important precursors to structured data entry, and there is an impact on overall data quality. We hypothesized
that persuasive design changes data-entry behaviors in clinicians and thus improves data quality.
Objective: The objective of this study was to use persuasive design principles to change clinician data-entry behaviors in a
primary care environment and to increase data quality of data held in a family health team’s reporting system.
Methods: We used the persuasive systems design framework to describe the persuasion context. Afterward, we designed and
implemented new features into a summary screen that leveraged several persuasive design principles. We tested the influence of
the new features by measuring its impact on 3 data quality measures (same-day entry, record completeness, and data validity).
We also measured the impacts of the new features with a paired pre-post t test and generated XmR charts to contextualize the
results. Survey responses were also collected from users.
Results: A total of 53 users used the updated system that incorporated the new features over the course of 8 weeks. Based on
a pre-post analysis, the new summary screen successfully encouraged users to enter more of their data on the same day as their
encounter. On average, the percentage of same-day entries rose by 10.3% for each user (P<.001). During the first month of the
postimplementation period, users compensated by sacrificing aspects of data completeness before returning to normal in the
second month. Improvements to record validity were marginal over the study period (P=.05). Statistical process control techniques
allowed us to study the XmR charts to contextualize our results and understand trends throughout the study period.
Conclusions: By conducting a detailed systems analysis and introducing new persuasive design elements into a data-entry
system, we demonstrated that it was possible to change data-entry behavior and influence data quality in a reporting system. The
results show that using persuasive design concepts may be effective in influencing data-entry behaviors in clinicians. There may
be opportunities to continue improving this approach, and further work is required to perfect and test additional designs. Persuasive
design is a viable approach to encourage clinician user change and could support better data capture in the field of medical
informatics.
Description
https://doi.org/10.2196/humanfactors.9029
Keywords
data collection, data entry, data accuracy, health care, persuasive design, persuasive systems design framework, user interface