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A structured framework to improve usability in EHR implementation: a user-centered case study in Brazilian mental
Fernanda Peron Gaspary1, Daniel Baia Amaral2, Cristian Vinicius Fagundes1
1Franciscan University, Santa Maria, Brazil.
Frontiers in Digital Health
|January 21, 2026
Summary
Improving electronic health record (EHR) usability in mental healthcare requires a user-centered framework. This study developed and tested such a framework, addressing navigation, integration, and documentation barriers for better digital health transformation.
Area of Science:
- Digital Health
- Human-Computer Interaction
- Healthcare Informatics
Background:
- Electronic Health Record (EHR) systems are crucial for digital health.
- Usability challenges in EHRs hinder effectiveness, especially in mental healthcare.
- Current EHR systems present significant barriers to efficient clinical workflows.
Purpose of the Study:
- To develop and describe a structured, user-centered framework for enhancing EHR usability.
- To address specific usability issues identified in a Brazilian outpatient mental health setting.
- To provide actionable insights for human-centered EHR innovation.
Main Methods:
- Qualitative design research study using the Double Diamond methodology.
- Conducted interviews with 21 healthcare professionals.
- Utilized the Certainties, Suppositions, and Doubts (CSD) matrix, heuristic evaluation, and prototype testing.
Main Results:
- Identified key barriers: non-standardized navigation, limited system integration, inflexible documentation.
- Proposed design-driven improvements: customizable templates, real-time validation, workflow-specific adjustments.
- Demonstrated the effectiveness of a user-centered framework in addressing EHR usability gaps.
Conclusions:
- Integrating service design with usability principles offers a path to human-centered EHRs.
- Addressing systemic usability gaps and contextual demands is vital for EHR innovation.
- The proposed framework provides actionable insights for improving EHRs in complex mental healthcare settings.
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