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Usability Evaluation of Electronic Health Record System around Clinical Notes Usage-An Ethnographic Study
Rubina F Rizvi1, Jenna L Marquard2, Gretchen M Hultman1
1Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, United States.
Applied Clinical Informatics
|December 15, 2017
Summary
Electronic Health Record (EHR) usability is hindered by poor User-Centered Design (UCD). System-1 showed better usability for clinical notes entry than System-2, highlighting key features for future EHR interface improvements.
Area of Science:
- Health Informatics
- Human-Computer Interaction
- Medical Usability
Background:
- A significant usability gap exists in current Electronic Health Records (EHRs).
- Poor integration of User-Centered Design (UCD) in Graphical User Interface (GUI) development is a primary cause.
- This study addresses the need for improved EHR usability in clinical practice.
Purpose of the Study:
- To assess the usability strengths and weaknesses of two prevalent EHR GUIs.
- Focus on critical clinical notes entry and information-seeking tasks.
- Identify specific features impacting EHR usability.
Main Methods:
- Ethnographic observation of 12 Internal Medicine resident physicians using two EHR systems.
- Analysis of user comments and observer findings for notes entry and information seeking.
- Usability references categorized, feature impact assessed via severity ratings, and findings validated by questionnaires.
Main Results:
- System-1 demonstrated superior usability for clinical notes entry compared to System-2 (26% positive vs. 12% positive references).
- Key features impacting notes entry usability include autopopulation, screen options, and communication.
- Both systems performed comparably in information-seeking tasks, with navigation being a critical feature.
Conclusions:
- This research offers specific usability insights for enhancing future EHR interfaces.
- Findings support aligning EHR development with UCD principles.
- Improved EHR usability can optimize clinical workflows and reduce physician burden.
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