Comprehensive user-centered design and testing for EHR products is critical to ensure the tools are helping improve patient safety and outcomes, as well as meeting the workflow and information needs of providers. A new tool, the EHR User-Centered Design Evaluation Framework, covers testing processes for optimizing usability in 20 common EHRs.
Built via a collaboration between the AMA and MedStar Health's National Center for Human Factors in Healthcare, the framework measures vendor compliance with best practices for user-centered design according to a 15-point scale. The tool goes beyond the "low gauge" criteria for usability evaluation and certification set forth by the federal government, according to an AMA statement.
"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," Raj Ratwani, PhD, scientific director of the Human Factors Center and a principle developer of the framework, said in a statement. "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 framework is built on a 2015 study authored by Dr. Ratwani from the September edition of the Journal of the American Medical Association. In the paper, researchers performed an analysis of the number of meaningful use attestations between April 1, 2013 and Nov. 30, 2014. They found a significant percentage of vendors were not following basic federal requirements for certifying the usability of their EHR products.
"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," Steven Stack, MD, president of the AMA, said in a statement. "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."