Table 1.

Key study characteristics and major findings.

Study	Country	Study design	Participants	Primary aim	Target of the usability evaluation	Major findings
Barton et al [32]	United States	Qualitative evaluation	Emergency medicine physicians, nurses, geriatrician	To assess a method for integrating diverse expertise such as clinical, patient, care partner, and IT, in the evaluation of patient-facing emergency department after visit summary.	eDSa	Identified usability issues related to readability, comprehensibility, and content organization, highlighting the need to integrate experts’ perspectives during design.
Busse et al [33]	Germany	Mixed methods (Qualitative evaluation and observational)	Pediatric palliative care health care professionals	To evaluate how potential users from the pediatric palliative care setting perceived an electronic cross-facility system.	Both contents of cross-facility medical records and the system used for presentation	Identified critical need for data transfer automation and suggested improvements in search functions and visualizations.
Doyle et al [34]	Australia	Exploratory mixed methods	Parents of children and physicians	To understand parent and clinician experience of discharge communication and engagement in clinical research.	System used for presenting electronic discharge instructions	High success rates and satisfaction scores were observed for both mobile and desktop interfaces, with most tasks completed successfully.
Kernbeck et al [35]	Germany	Qualitative observational	Pediatric palliative care professionals	To evaluate the acceptance of the medication module from potential users’ perspective and to involve them in the development process.	Both contents of cross-facility medical records and the system used for presentation	Identified usability issues related to performance expectancy and learnability, emphasized clarity, and reduced cognitive load.
Naik et al [36]	United States	Observational (user-centered)	People with colorectal cancer	To transform physician-centered discharge warnings into patient-friendly format using health literacy and usability heuristics standards and cognitive interviews.	Both eDS contents and the system used for presentation	Identified inconsistencies in content presentation and readability, highlighted importance of a patient-centered design.
Soto et al [37]	Canada	Mixed methods study	General practitioners, family medicine residents	To improve health information exchange and use of clinical information for decision making.	System used for eDS presentation	Identified usability issues related to drug prescription and medication list visualization.
Tremoulet et al [38]	United States	Qualitative evaluation	Human factors experts, medical professionals	To conduct heuristic evaluation to identify potential usability problems and their level of severity.	Both eDS contents and the system used for presentation	Identified usability issues related to content, comprehensibility, readability, presentation, and organizational aspects of medical documents.
Tremoulet et al [39]	United States	Literature review with mixed methods study	Primary care physicians, nurses, nursing and medical directors, social workers, transition-of-care nurses	To provide insight into how existing acute care eDS support outpatient providers in the coordination of care of older adults.	eDS	Identified usability issues affecting care coordination, emphasized need for standardization of discharge summaries.
Vaigneur [40]	United States	Experimental and survey	Novice readers (caregivers) of discharge instructions	To examine the impact of adjusting readability level of discharge instructions on user comprehension and recall.	eDS	High readability discharge instructions received more attention, better comprehension, and reduced mental demand compared to low readability instructions.
Walsh et al [41]	Australia	Qualitative evaluation	My Health Record users	To identify potential usability issues within My Health Record focusing on eHealth literacy.	Both contents of health information summary and the system used for presentation	Identified usability violations and problems related to language use, website navigation, design elements, and registration processes.
Walsh et al [42]	Australia	Qualitative evaluation	My Health Record users	To identify usability issues with My Health Record through an updated heuristic evaluation.	Both contents of health information summary and the system used for presentation	Identified violations of usability heuristics and highlighted unmet needs for individuals with low eHealth literacy.
Watbled et al [43]	France	Mixed methods	Human factors experts, medical professionals	To apply a combination of methods for longitudinal usability evaluation throughout the system development lifecycle and to identify causes of usability flaws.	System used for presentation of eDS	Identified multiple usability flaws in voice recording systems and emphasized thorough analysis and context-specific evaluations.

^aeDS: electronic discharge summaries.