A usability and safety analysis of electronic health records: a multi-center study

Author:

Ratwani Raj M12,Savage Erica1,Will Amy1,Arnold Ryan3,Khairat Saif4,Miller Kristen1,Fairbanks Rollin J12,Hodgkins Michael5,Hettinger A Zachary12

Affiliation:

1. National Center for Human Factors in Healthcare, MedStar Health, Washington, District of Columbia, USA

2. Department of Emergency Medicine, Georgetown University School of Medicine, Washington, District of Columbia, USA

3. Department of Emergency Medicine, Drexel University School of Medicine, Philadelphia, Pennsylvania, USA

4. Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

5. American Medical Association, Chicago, Illinois, USA

Abstract

Abstract To characterize the variability in usability and safety of EHRs from two vendors across four healthcare systems (2 Epic and 2 Cerner). Twelve to 15 emergency medicine physicians participated from each site and completed six clinical scenarios. Keystroke, mouse click, and video data were collected. From the six scenarios, two diagnostic imaging, laboratory, and medication tasks were analyzed. There was wide variability in task completion time, clicks, and error rates. For certain tasks, there were an average of a nine-fold difference in time and eight-fold difference in clicks. Error rates varied by task (X-ray 16.7% to 25%, MRI: 0 to 10%, Lactate: 0% to 14.3%, Tylenol: 0 to 30%; Taper: 16.7% to 50%). The variability in time, clicks, and error rates highlights the need for improved implementation optimization. EHR implementation, in addition to vendor design and development, is critical to usable and safe products.

Funder

American Medical Association

MedStar Health

Publisher

Oxford University Press (OUP)

Subject

Health Informatics

Reference12 articles.

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2. Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA;Middleton;J Am Med Inform Assoc,2013

3. Healthcare IT usability and suitability for clinical needs: challenges of design, workflow, and contractual relations;Koppel;Stud Health Technol Inform,2010

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