Study finds variation among vendors' EHR usability

A new study found significant variation in EHR vendors' commitment and understanding of the need for usable EHRs.

The study was published in the Journal of the American Medical Informatics Association.

Poor EHR usability increases provider frustration, can hinder adoption of the systems and leads to errors that can jeopardize patient safety, the researchers found. 2014 EHR Certification criteria require vendors to attest that they use user-centered design (USD) processes and report usability testing results.

Since most usability studies focus on providers rather than EHR developers, the researchers visited 11 unidentified EHR vendors to analyze their UCD processes and determine the challenges vendors face in integrating usability with EHR development.

They categorized vendors into three levels: well-developed UCD, basic UCD and "misconceptions of UCD," such as believing that simply having the ability to respond to feature requests and complaints constitutes UCD.

Some vendors, typically the smaller ones, had no staff member experts in EHR usability. Vendors also faced varying challenges in making their EHRs more usable. Vendors in the well-developed UCD category reported an inability to get providers to share design-related adverse events while vendors with basic UCD had knowledge gaps and difficulty recruiting participants to discuss UCD. Vendors with misconceptions didn't understand the business case for UCD and the need to invest in it.

"At the policy level, the variability in UCD practices and the fact that some vendors have a misconception of UCD, yet have certified EHR products in the marketplace, suggest that certification requirements may need to be adjusted." the researchers wrote. They also recommended further study to determine the relationship between usability and the rigor of the process used.

Read the study.