Transitioning from Paper to Electronic Medical Records in Austrian Helicopter Emergency Medical Services: A Usability Evaluation

Introduction: This study examines the development and usability evaluation of an electronic documentation application specifically designed for the Austrian Helicopter Emergency Medical Service (HEMS). The primary objective is to assess how HEMS crew members, accustomed to paper-based documentation, perceive the usability of the electronic system. Method: The application was developed using React Native and tailored to the unique demands of the high-stress environment characteristic of HEMS. No existing digital documentation solutions were analyzed or incorporated; instead, the design was grounded entirely in evidence-based practices. The development process underwent iterative refinement based on user feedback in collaboration with a HEMS crew member. A total of thirty healthcare professionals were recruited through convenience and purposive sampling methods. Usability was evaluated using the System Usability Scale (SUS), complemented by qualitative insights obtained from open-ended questions. Results: The findings indicate an average System Usability Scale (SUS) score of 79.92. Notably, older and more experienced users, as well as those possessing advanced digital skills, provided favorable ratings for the application. Conversely, younger and less experienced users exhibited lower levels of satisfaction. The qualitative analysis revealed four primary themes: automation and integration, the need for improvement and adaptation, a positive disposition towards the application, and prioritization of simplification and efficiency despite existing concerns. Conclusion: This study underscores the necessity for ongoing optimization within digital healthcare applications, highlighting the critical alignment with user needs. Future developments should prioritize not only technical enhancements but also the optimization of the overall user experience.