While the majority of dissatisfaction with EHRs centers on providers, a recent study sought to understand factors related to poor usability from the vendor perspective.
In a study published in the Journal of the American Medical Informatics Association, researchers visited 11 EHR vendors to analyze their user-centered design process when developing EHRs.
In 2014, the ONC required EHR vendors to earn "Safety Enhanced Design" certification, the process of which entails employing a user-centered design process and conducting and reporting results of usability testing on eight EHR functions. The quality of the user-centered design process could be a key factor in the final usability of EHRs, the researchers hypothesized.
Researchers defined user-centered design as any approach to the design that integrates information about the end users of the product into each stage of the design process, factoring in information such as cognitive needs, abilities and limitations of the users as well as constraints caused by the work environment.
Researchers then interviewed vendor staff members most familiar with software development and user-centered design activity. Vendors were assured anonymity in this study.
Here are seven key findings from the study.
1. After the interviews, researchers were able to group vendors into three distinct groups based on their user-centered design process: well-developed, basic and misconceptions of user-centered design.
2. Well-developed user-centered design vendors have a strong process in place to understand end user requirements, conduct testing on their product and recruit study participants. Additionally, these vendors have a large usability staff.
3. Those in the basic user-centered design category understand the importance of user-centered design, but lack a complete process that fully integrates with their product design and development.
4. Vendors identified as having misconceptions of user-centered design do not have any such process in place and don't fully understand what contributes to a user-centered design process.
5. Each category also faces its own unique challenges. The well-developed user-centered design group largely faces issues relating to detailed, contextually rich studies in certain specialty clinical disciplines, as well as resources needed to conduct studies.
6. Basic user-centered design vendors tend to need assistance to effectively employ user-centered design processes and recruit participants for studies.
7. Those in the misconceptions of user-centered design group lack the education surrounding the importance of user-centered design, as well as senior leadership to foster and support user-centered design initiatives.
"Our results reveal variability in the user-centered design practices of EHR vendors, despite the ONC's certification requirements that all EHR vendors attest to employing a user-centered design process in order to certify their EHR product," researchers concluded.
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