November 5, 2018
Thanks to the HITECH (Health Information Technology for Economic and Clinical Health) Act that was passed nearly a decade ago, EHR adoption has increased significantly in the United States. In fact, according to recent surveys, it is now approaching 100% in hospitals and almost 90% in physician office settings.
With the increase in adoption, comes an increase in scrutiny surrounding the usability of the EHR (Electronic Health Record) systems themselves. Factors such as whether the system is cumbersome, user-friendly, or inhibits the ability of the user to effectively complete their work are all related to the usability of the system. According to a recent Peer60 Report, 50% of EHR users considered the usability of EHR systems to be a major issue. Many believe that in a rush to adopt new technology, decision makers didn’t pay close attention to usability. Additionally, some vendors weren’t completely honest about their EHR’s level of usability (of course vendors say their systems are easy-to-use, but saying it and proving it are two different things).
That is now changing. As Promoting Interoperability replaced Meaningful Use, and ONC 2015 Edition certification came into play, we are seeing the ONC raising the bar for usability and attempting to hold vendors accountable for improving EHR design and usability processes.
In the Infographic below, see a graphic representation of what Usability is, why it’s so important and how it can be measured (or read on below for a more detailed explanation).
According to Healthcare Information Management Systems Society (HIMSS) EHR Usability is defined as:
“The effectiveness, efficiency and satisfaction with which specific users can achieve a specific set of tasks in a particular environment. In essence, a system with good usability is easy to use and effective. It is intuitive, forgiving of mistakes and allows one to perform necessary tasks quickly, efficiently and with a minimum of mental effort.”
Is EHR usability important? You better believe it! Productivity, patient safety, clinician satisfaction, clinician burnout, profitability (time is money!) – all of these things and more are impacted by an EHR’s usability or lack thereof. Some experts even conclude that it’s the single most important thing to look for when choosing a new EHR. Plus, it’s required for patient-safety related 2015 Edition criteria by the ONC.
Usability is traditionally not easy to measure. However, since improving the EHR user experience has become an imperative goal across the industry, the ONC established 2015 Edition Safety-Enhanced Design criterion that requires EHR vendors certifying to patient safety-related criteria to have a user-centered design approach. As part of this, EHR vendors must conduct and submit an industry-standard summative usability evaluation of their system. This usability study measures the effectiveness or ability to complete a task, efficiency or how quickly the user was able to complete the task, as well as the user’s satisfaction with how easy or intuitive the task was.
For the 2015 Edition, ONC now requires a minimum of 10 participants per task and for the raw data obtained during the study to be submitted to the Certified Health IT Product List (CHPL) at https://chpl.healthit.gov/#/collections/sed.
For full Usability Reports by product, go to the Certified Health IT Products list, then type in the product name on the search bar, view the details for the product, then click on the Full Usability report.
One of the most important things to look at in the hyperlinks to the full Usability Reports is the SUS or System Usability Scale. It’s based on a 100-point scale, and provides a global subjective evaluation of the users’ satisfaction with the system based on performance. Broadly interpreted, scores under 60 represent systems with poor usability; scores over 80 would be considered above average.
Other things to pay attention to in the report are the average overall completion rate, number and background of participants, and any participant comments.
Did you know? Not all vendors have been reporting their System Usability Score.
When it comes to EHR usability, not all vendors are created equal. Below is a graph which highlights the EHR Usability score by vendor for the Emergency Department segment.
Bottom line…When choosing an EHR, it’s critical to look for one that is ONC 2015 Edition certified BUT you also need to look at and evaluate the usability report submitted by any vendor you are evaluating. Doing so will not only help improve your bottom line, but your clinicians and patients will thank you.
Have any questions on EHR Usability? Contact us to let us know and we’ll be in touch shortly.