AMA, MedStar framework spotlights EHR usability

The American Medical Association (AMA) and MedStar Health’s National Center for Human Factors in Healthcare have developed a comparative EHR User-Centered Design Evaluation Framework to promote transparency around how EHRs are designed and user-tested.

The framework aims to drive improvements in clinician support and patient safety, but shows a lack of focus among regulators and industry on user-centered design and usability testing.

The EHR User-Centered Design Evaluation Framework drills down on the design and testing processes for optimizing usability in 20 common EHR products using information reported by EHR vendors to meet usability certification requirements set by the Office of the National Coordinator for Health IT (ONC). The framework goes beyond the low gauge set by federal usability certification criteria and evaluates the vendor’s compliance with best practices for user-centered design processes according to a 15 point scale developed by MedStar’s Human Factors Center in collaboration with the AMA.

“It is important to recognize that this framework evaluates conformity with best practices identified in human factors and usability literature for user-centered design and testing. We are not evaluating the actual usability of the product as experienced by end users,” said Raj Ratwani, PhD, scientific director of the Human Factors Center and a principle developer of the framework. “Alignment with best practices for user-centered design and testing is a starting point that regulators and industry should meet and exceed. The framework we developed is the first step in bringing greater transparency to the usability processes of EHR vendors.”

The two organizations developed the framework because they feel that "ONC’s requirements do not go far enough to encourage fully functional and usable products. This framework can be used by the ONC to improve their certification program, and as a method to track improvements EHR vendors make as they recertify their products over time,” reads the mission statement.

“Physician experiences documented by the AMA demonstrate that most EHR systems fail to support effective and efficient clinical work, and continued issues with usability are a key factor driving low satisfaction with many EHR products,” said AMA President Steven J. Stack, MD. “Our goal is to shine light on the low-bar of the certification process and how EHRs are designed and user-tested in order to drive improvements that respond to the urgent physician need for better designed EHR systems.”

Ratwani added, “To improve the usability of EHRs we need to promote rigorous usability development processes based on recognized methods and standards.”