6.18 Barlach, A., M.Hertzum, and J. Simonsen (2013): “Pilot implementation Driven by Effects Specifications and Formative Usability Evaluation”, in M.A. Garcia-Ruiz (Ed.): Cases on Usability Engineering: Design and Development of Digital Products, IGI global, Hershey, PA, pp. 221-254.


This chapter reports on the usability-engineering work performed throughout the pilot implementation of an Electronic Healthcare Record (EHR). The case describes and analyzes the use of pilot implementations to formatively evaluate whether the usability of the EHR meets the effects specified for its use.

The project was initiated during the autumn of 2010 and concluded in the spring of 2012. The project configured and implemented an EHR at a Maternity ward at one hospital located in a European region and then transferred this system to another ward at another hospital in the same region.

The project was conducted using effects-driven IT development: a process comprised of workshops with specification of the usage effects by management and end-users followed by an agile development process progressing through mock-ups, prototypes and finally the pilot system. Effects were iteratively refined and evaluated to achieve alignment with the intended design, and quantitatively measured to document the desired effects.

The pilot implementation is analyzed, and the lessons learned are discussed in relation to usability engineering in general.