Optimization of an EHR mobile application using the UFuRT conceptual framework

Drchrono is an Electronic Healthcare Record (EHR) application designed specifically for the iPad. Described as portable, efficient and accessible anywhere, drchrono has several features that might be attractive to health care providers. However, EHRs have to conform to certain Federal Healthcare Information Technology Guidelines, which are evaluated in a series of 12 test procedures, defined by the Office of the National Coordinator for Health Information Technology (ONC). In this study, we evaluated Test Procedure for §170.302 (c) Maintain up-to-date problem list, in drchrono. The methodology for our evaluation was contained within Zhang's unified framework for usability, using UFuRT, i.e. user, functional, representation and task analyses. Based upon the analysis, using Adobe Flex, we then designed a prototype that corrected or improved on perceived weaknesses in the functionality served by the test procedure. We applied the test procedure taxonomy to a prototypic modification of drchrono, and then repeated the UFuRT usability analysis. We also used a 14-item heuristic evaluation by each member of our informatics team. Our findings support a conclusion that UFuRT is a valuable tool to evaluate EHR usability and that an "up-to-date problem" list may be customized, according to healthcare provider preference.