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Study: Large Number of EHRs Do Not Meet Usability Standards

September 9, 2015
by Heather Landi
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A significant percentage of electronic health record (EHR) vendors failed to meet federally mandated user-centered design requirements and did not conform to usability testing standards for their EHRs, according to a new report.

The report, from the National Center for Human Factors in Healthcare at the Washington, D.C.-based MedStar Health, found that this lack of adherence to usability testing standards by EHR vendors could result in poor usability of EHRs.

Researchers at MedStar Health analyzed data from 50 EHR vendors serving the highest number of providers, specifically hospitals and small private practices. The study used data reported by EHR vendors to the U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology (ONC) to determine whether usability certification requirements and testing standards were met.

ONC has established certification requirements to promote usability practices by EHR vendors as part of a meaningful use program. To develop a certified EHR, vendors are required to attest to using user-centered design and conduct formal usability testing.

The lack of adherence to testing standards could result in EHR products with poor usability, which leads to user frustration and safety risks, according to the study.

Results of the study indicated that out of the 50 EHR vendors, 34 percent had not met the ONC certification requirement of stating their user-centered design process. In addition, 63 percent of vendors used less than the standard of 15 participants during the usability tests of their EHRs and only 22 percent used at least 15 participants with clinical backgrounds. Further, 17 percent of vendors used no physician participants and 5 percent used their own employees when conducting usability tests.

“Enforcement of existing standards, specific usability guidelines, and greater scrutiny of vendor UCD (user-centered design) processes may be necessary to achieve the functional and safety goals for the next generation of EHRs,” the study authors concluded.

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