EHR User-Centered Design Evaluation Framework

Understanding the Usability Processes of EHR Vendors

The American Medical Association and MedStar Health’s National Center for Human Factors in Healthcare developed a framework, based on the science of user-centered design (UCD), to increase transparency of electronic health record (EHR) vendor usability processes. Our framework uses a 15 point scale to examine EHR vendor use of UCD best practices—not the actual usability of the EHR as experienced by end users. We used this framework to analyze EHR vendor testing reports available from the Office of the National Coordinator’s (ONC) Certified Health Product List (CHPL) for 20 common EHRs (15 ambulatory and 5 inpatient products). EHR vendors are only required to report on the UCD process they followed for eight capabilities that the ONC considers important for patient safety and the ONC does not use UCD best practices as a basis for certification.

Our Goal

Our goal is to draw attention to the narrow focus on only eight capabilities among the dozens required by the ONC for the Meaningful Use (MU) program and to the absence of best practices in the certification process. UCD is an essential component in improving patient safety and the satisfaction of physicians, patients, and medical professionals who use EHRs. Many of the EHR vendors do not meet best practices for UCD but are still certified by the ONC. We believe that EHRs should be designed with the end user in mind and that the 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.

Non-Endorsement Disclaimer:  In publishing this report, neither MedStar Health nor the American Medical Association is endorsing any EHRs or other technology.  This report was not sponsored, funded or in any way facilitated by any EHR or similar technology vendor.  User decisions regarding the selection of EHR technologies, products and services must take into account many varied characteristics, which are beyond the scope of this report.

How to Read This Chart:

medstar-fails Meets UCD best practices for process

medstar-partial Partially meets UCD best practices for process

medstar-meets Does not meet UCD best practices for process

What a Perfect Score Means:

A perfect score means that the EHR vendor meets user-centered design and testing best practices. A perfect score does not imply the EHR vendor product has perfect usability.

EHR VendorUCD ProcessTesting MethodologyTesting ResultsTotal Score
Reported ProcessParticipantsClinical ExpertiseUse CasesMetricsEffectivenessImprovements

Allscripts Enterprise EHR

v11.4.1

1medstar-fails1medstar-fails1medstar-fails1medstar-fails1medstar-fails1medstar-fails1medstar-fails1515

Allscripts Sunrise Acute

v15.1-c INPATIENT

1medstar-fails1medstar-fails1medstar-fails1medstar-fails1medstar-fails1medstar-fails1medstar-fails1515

Amazing Chart

v7.0

1medstar-fails3medstar-meets1medstar-fails2medstar-partial1medstar-fails1medstar-fails2medstar-partial1212

Athena Clinicals

v14.9

1medstar-fails1medstar-fails1medstar-fails1medstar-fails1medstar-fails1medstar-fails2medstar-partial13.513.5

Cerner

Powerchart INPATIENT 2012.01.34

1medstar-fails2medstar-partial1medstar-fails1medstar-fails1medstar-fails1medstar-fails2medstar-partial1313

Dr Systems

eHR MU v2.0

3medstar-meets3medstar-meets2medstar-partial2medstar-partial1medstar-fails1medstar-fails1medstar-fails77

E-MD

Solution Series v8

1medstar-fails1medstar-fails1medstar-fails1medstar-fails3medstar-meets3medstar-meets1medstar-fails1111

eClinical Works

Version 10

3medstar-meets3medstar-meets2medstar-partial3medstar-meets1medstar-fails1medstar-fails2medstar-partial55

Epic Systems

EpiCare Ambulatory 2014 (Epic2012)

1medstar-fails1medstar-fails1medstar-fails2medstar-partial3medstar-meets3medstar-meets2medstar-partial99

GE Healthcare1

Centricity Enterprise v6.11

1medstar-fails2medstar-partial1medstar-fails1medstar-fails1medstar-fails3medstar-meets1medstar-fails11.511.5

Greenway

PrimeSUITE 2014(17.0)

3medstar-meets3medstar-meets2medstar-partial2medstar-partial1medstar-fails1medstar-fails1medstar-fails77

McKesson

Paragon 12&2.0 INPATIENT

1medstar-fails1medstar-fails1medstar-fails2medstar-partial1medstar-fails1medstar-fails1medstar-fails14.514.5

McKesson Specialty Health

iKnowMedEHR v6.7

1medstar-fails1medstar-fails1medstar-fails1medstar-fails1medstar-fails1medstar-fails1medstar-fails1515

Medhost

EDIS v4.4 INPATIENT

1medstar-fails3medstar-meets1medstar-fails3medstar-meets1medstar-fails1medstar-fails2medstar-partial11.511.5

Medical Information Technology

MPM 5.6.6

1medstar-fails2medstar-partial1medstar-fails3medstar-meets1medstar-fails1medstar-fails1medstar-fails13.513.5

Meditech Magic

Core HCIS 5.66 INPATIENT

1medstar-fails3medstar-meets1medstar-fails3medstar-meets1medstar-fails1medstar-fails1medstar-fails1313

Modernizing Medicine

EMA 4.0.0.2

1medstar-fails1medstar-fails2medstar-partial2medstar-partial1medstar-fails3medstar-meets2medstar-partial1313

Nextgen Healthcare

Ambulatory 5.8.2

3medstar-meets2medstar-partial1medstar-fails1medstar-fails1medstar-fails1medstar-fails1medstar-fails9.59.5

Practice Fusion

v3.1

1medstar-fails3medstar-meets1medstar-fails2medstar-partial1medstar-fails1medstar-fails1medstar-fails13.513.5

SRSsoft

v9

1medstar-fails3medstar-meets2medstar-partial2medstar-partial1medstar-fails1medstar-fails1medstar-fails1212

Footnotes

1. The UCD process for the GE Centricity ambulatory product was stated in the CHPL report for the inpatient GE Centricity product.