Evaluating Usability of Security Mechanisms of E-Health Applications: Cases from Ethiopia
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Date
2020-06-06
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Addis Ababa University
Abstract
E-Health systems play an important role in information processing in healthcare for the benefit of
the patient as well as health professionals in hospital. Various pieces of literature support that many
of e-health applications were developed by using one or more standards in SDLC from start to
finish to fulfill the functional requirement and more with a proper set of security mechanisms in
place, from the development point of view. However, majority of these security mechanisms were
not considered from the users’ point of view. As a result, security of health information is
becoming an important and growing concern for all those delivering healthcare by protecting
sensitive patient records from unauthorized people using security mechanisms.
This research is aimed at answering the following two research questions: How usable are the
security mechanisms of e-Health applications in Ethiopia? And how do we improve the usability
aspect of the security mechanisms of e-Health applications? The objective is to evaluate usability
of security mechanisms of e-Health applications functional at health facilities operational under
Addis Ababa Health Bureau and identify strengths and weaknesses of the usability of the security
features of the e-Health applications.
This study uses a qualitative research methodology that uses heuristic evaluation of using three e-
Health applications by three experts with thematic analysis to identify their focus idea from the
collected data. Three e-health systems are widely used by health care facilities in Ethiopia (DHIS2,
SmartCare, and OpenEMR). Data collection instrument having thirteen criteria (Visibility,
revocability, clarity, convey features/expressiveness, learnability, aesthetics and minimalist
design, errors, satisfaction, user suitability, user language, user assistance, security and privacy)
was adopted from a framework developed by Yeratziotis (2011) dissertation and updated in 2012.
The finding reviled that out of the thirteen criteria, learnability, aesthetics and minimalist design,
and user language were in compliance, in contrary revocability and user suitability were not in
compliance with security features according to all the experts review of all e-Health applications.
Finally, recommendations were given for practice and suggestions forwarded for future research.
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Keywords
Application Security, Usability, Usable Security, Human-Computer Interaction