title: Electronic health record usability: analysis of the user-centered design processes of eleven electronic health record vendors.
abstract: The usability of electronic health records (EHRs) continues to be a point of dissatisfaction for providers, despite certification requirements from the Office of the National Coordinator that require EHR vendors to employ a user-centered design (UCD) process. To better understand factors that contribute to poor usability, a research team visited 11 different EHR vendors in order to analyze their UCD processes and discover the specific challenges that vendors faced as they sought to integrate UCD with their EHR development. Our analysis demonstrates a diverse range of vendors' UCD practices that fall into 3 categories: well-developed UCD, basic UCD, and misconceptions of UCD. Specific challenges to practicing UCD include conducting contextually rich studies of clinical workflow, recruiting participants for usability studies, and having support from leadership within the vendor organization. The results of the study provide novel insights for how to improve usability practices of EHR vendors.
authors.affiliation: National Center for Human Factors in Healthcare, MedStar Health, Washington, DC, USA Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC, USA raj.ratwani@medicalhfe.org.
authors.forename: Raj M
authors.initials: RM
authors.lastname: Ratwani
authors.affiliation: National Center for Human Factors in Healthcare, MedStar Health, Washington, DC, USA Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC, USA Department of Industrial and Systems Engineering, State University of New York at Buffalo, Buffalo, New York, USA.
authors.forename: Rollin J
authors.initials: RJ
authors.lastname: Fairbanks
authors.affiliation: National Center for Human Factors in Healthcare, MedStar Health, Washington, DC, USA Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC, USA.
authors.forename: A Zachary
authors.initials: AZ
authors.lastname: Hettinger
authors.affiliation: National Center for Human Factors in Healthcare, MedStar Health, Washington, DC, USA Department of Industrial and Systems Engineering, State University of New York at Buffalo, Buffalo, New York, USA.
authors.forename: Natalie C
authors.initials: NC
authors.lastname: Benda
mesh_terms: D001292:Attitude to Computers; D003132:Commerce; D057286:Electronic Health Records / Q000592:standards; D006804:Ergonomics; D006801:Humans; D007407:Interviews as Topic; D014584:User-Computer Interface
keywords: electronic health records; health information technology; human factors; usability