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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 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.
How to Read This Chart:
Meets UCD best practices for process
Partially meets UCD best practices for process
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.
1. The UCD process for the GE Centricity ambulatory product was stated in the CHPL report for the inpatient GE Centricity product.