Today I submitted our team’s paper on ‘Expansion of the Task Complexity Dimension Theoretical Framework for equitable design and evaluation of patient-facing technologies.’ was submitted to JAMIA today. This paper offers another application of the framework that was initially published in JAMIA Open early this year. Below is the abstract for this most recent paper.
Objective: To expand generalizability of the Task Complexity Dimensions Framework (TCDF) and related methods, this study investigated how socioeconomically-marginalized patients perform with, perceive and experience the complexity of technology-mediated tasks when completing five tasks required for a telehealth visit.
Materials and Methods: A user testing study was conducted with adult Medicaid patients at an academic healthcare system in the midwestern United States. Participants (n=19) were asked to think aloud as they completed telehealth tasks that had been integrated into a patient portal, while researchers recorded structured observations of task performance success. Participants then answered follow-up interview questions concerning workload (NASA-TLX), task complexity dimensions using the TCDF, and perceived difficulty. User tests were recorded and transcribed. Mixed analyses involved creating joint displays of the coded qualitative data and descriptively-analyzed quantitative data.
Results and Discussion: The application of the TCDF confirmed that complexity dimensions may make tasks more difficult for socioeconomically-marginalized patients. Three new complexity sub-dimensions provide an expansion to the TCDF: conflicting actions, redundant actions and visual clutter. Overall, input/process clarity and unstructured guidance and conflicting actions were the complexity sub-dimensions perceived to contribute most to task difficulty. When patients encounter complexity dimensions that contribute to task difficulty, they may create workarounds or abandon tasks.
Conclusion: The study further validates the TCDF framework that promotes equitable design and evaluation of patient-facing technologies. Future research should expand the frameworkâs applications to enhance generalizability and to ensure that patient-facing technologies do not encourage socioeconomically-marginalized patients to develop workarounds or abandon tasks.
Antonio, M.G., Stone, A.K., Valdez, R., Buis, L., Dillahunt, T., Veinot, T.C. (2026). Expansion of the Task Complexity Dimension Theoretical Framework for equitable design and evaluation of patient-facing technologies. Journal of the American Medical Informatics Association. [Submitted September 21, 2026].