title: Importance of testing for usability when selecting and implementing an electronic health or medical record system.
abstract: OBJECTIVE
  An oncology electronic health record (EHR) was implemented without prior usability testing. Before expanding the system to new clinics, this study was initiated to examine the role of usability testing in the evaluation of an EHR product and whether novice users could identify issues with usability that resonated with more experienced users of the system. In addition, our study evaluated whether usability issues with an already implemented system affect efficiency and satisfaction of users.
  
  
  METHODS
  A general usability guide was developed by a group of five informaticists. Using this guide, four novice users evaluated an EHR product and identified issues. A panel of five experts reviewed the identified issues to determine agreement with and applicability to the already implemented system. A survey of 42 experienced users of the previously implemented EHR was also performed to assess efficiency and general satisfaction.
  
  
  RESULTS
  The novice users identified 110 usability issues. Our expert panel agreed with 90% of the issues and recommendations for correction identified by the novice users. Our survey had a 54% response rate. The majority of the experienced users of the previously implemented system, which did not benefit from upfront usability testing, had a high degree of dissatisfaction with efficiency and general functionality but higher overall satisfaction than expected.
  
  
  CONCLUSIONS
  In addition to reviewing features and content of an EHR system, usability testing could improve the chances that the EHR design is integrated with existing workflow and business processes in a clear and efficient way.
authors.affiliation: Office of the Dean; Department of Medicine; and Division of Hematology-Oncology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA.
authors.forename: Natalie J
authors.initials: NJ
authors.lastname: Corrao
authors.forename: Alan G
authors.initials: AG
authors.lastname: Robinson
authors.forename: Michael A
authors.initials: MA
authors.lastname: Swiernik
authors.forename: Arash
authors.initials: A
authors.lastname: Naeim
references.citation: J Oncol Pract. 2007 May;3(3):172-173
references.pmid: 29455609
references.citation: J Oncol Pract. 2007 Nov;3(6):340
references.pmid: 20859391
references.citation: Telemed J E Health. 2006 Feb;12(1):24-34
references.pmid: 16478410
references.citation: J Oncol Pract. 2005 Jul;1(2):64-5
references.pmid: 20871682
references.citation: J Oncol Pract. 2007 Mar;3(2):106-107
references.pmid: 29447535
references.citation: J Oncol Pract. 2007 Nov;3(6):321-322
references.pmid: 29436961
references.citation: J Oncol Pract. 2007 Sep;3(5):278-279
references.pmid: 29442600
references.citation: J Oncol Pract. 2006 Sep;2(5):262
references.pmid: 20859348
references.citation: Int J Med Inform. 2003 Aug;71(1):43-50
references.pmid: 12909157
references.citation: J Biomed Inform. 2004 Feb;37(1):56-76
references.pmid: 15016386
references.citation: J Oncol Pract. 2008 Jan;4(1):43-44
references.pmid: 29443605
references.citation: J Oncol Pract. 2008 Jul;4(4):203-206
references.pmid: 29447501
references.citation: J Oncol Pract. 2007 Mar;3(2):76-77
references.pmid: 29447536
references.citation: J Oncol Pract. 2006 Mar;2(2):75-6
references.pmid: 20871720
references.citation: J Oncol Pract. 2006 Mar;2(2):67-9
references.pmid: 20871719
references.citation: J Oncol Pract. 2008 Jan;4(1):41-2
references.pmid: 20859442
references.citation: J Biomed Inform. 2003 Feb-Apr;36(1-2):23-30
references.pmid: 14552844
references.citation: J Oncol Pract. 2007 Jul;3(4):231-232
references.pmid: 29452502
references.citation: J Oncol Pract. 2008 Sep;4(5):254-257
references.pmid: 29452528