Electronic Health Record Information Design and Usability Toolkit (Maryland)

Project Final Report (PDF, 1.03 MB)

Project Details - Ended

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Summary:

While health information technology (IT) systems are expected to significantly reduce medication errors, studies have found that issues with usability and information design can actually facilitate errors or decrease the efficiency gains made possible by health IT. While electronic health records (EHRs) might be an improvement over their paper predecessors, studies reveal that many of today’s systems scatter important data that clinicians need for a single patient encounter in many places.

This project set out to design, develop, test, and disseminate a toolkit by which health care organizations – specifically primary care practices – can assess the usability of EHR systems. Important audiences for the toolkit also include health IT vendors, certification organizations, and others. Development of the toolkit will increase attention to the importance of EHR usability and help promote design of systems that better support proper diagnosis, identification of high risk patients, tracking of patient health parameters over time, and population health management.

A background report was developed to identify and assess a range of usability methods, metrics, and instruments, and provide specific recommendations for which of these are most appropriate for inclusion into the toolkit.

The main objectives of this project were to:

  1. Develop and refine a toolkit for primary care clinicians that supports rapid yet meaningful usability evaluations of EHR systems.
  2. Disseminate the toolkit as a means to increase attention to the importance of EHR usability, to promote use evidence-based usability evaluation methods, and to stimulate collaboration among entities developing and implementing EHR systems.
  3. Inform EHR accreditation efforts around usability, including those by the National Institute of Standards and Technology (NIST).

Electronic Health Record Usability Toolkit - 2010

Summary Highlights

  • Principal Investigator: 
  • Organization: 
  • Contract Number: 
    290-09-00023I-7
  • Project Period: 
    August 2010 – February 2012
  • AHRQ Funding Amount: 
    $429,469
  • PDF Version: 
    (PDF, 426.13 KB)


Target Population: General

Summary: While health information technology (IT) systems are expected to significantly reduce medication errors, studies have found that issues with usability can actually facilitate errors or decrease the efficiency gains made possible by health IT. While electronic health records (EHRs) might be an improvement over their paper predecessors, studies reveal that many of today's systems scatter important data that clinicians need for a single-patient encounter.

A project team comprised of staff from Westat's Center for Health IT, the School of Nursing at Duke University, the Center for Health Information and Decision Systems at the University of Maryland at College Park, and the American Academy of Family Physicians will design, develop, test, and disseminate a toolkit with which health care organizations—specifically primary care practices—can assess the usability of their EHR system. Audiences for the toolkit also include health IT vendors and certification organizations. Development of the toolkit will increase attention to the importance of EHR usability and help promote design of systems that better support proper diagnosis, identification of high-risk patients, tracking of patient health parameters over time, and population health management.

A background report will identify and assess a range of usability methods, metrics, and instruments, and will provide specific recommendations to include in the toolkit. A preliminary EHR usability toolkit will then be developed based upon these recommendations and subsequently tested in nine primary care practices with nine EHR systems developers, and in one EHR certification organization. The findings from these pilot tests will inform a final version of the toolkit before it is disseminated.

Project Objectives:
  • Develop background report. (Ongoing)
  • Develop and refine a toolkit for primary care clinicians that supports rapid yet meaningful usability evaluations of their currently-implemented EHRs. (Upcoming)
  • Disseminate the toolkit to increase awareness about the importance of EHR usability, to promote use of evidence-based usability evaluation methods, and to stimulate collaboration among entities developing and implementing EHR systems. (Upcoming)
  • Inform EHR accreditation efforts on usability, including those by the National Institute of Standards and Technology. (Upcoming)

2010 Activities: Activities focused on conducting the initial kickoff call between the Agency for Healthcare Research and Quality and the project team; as well as developing the work, project, and compliance plans. In addition, the expert panel and workgroups were established and have begun convening meetings via Web-enabled teleconferences. The five topic areas on which workgroups have been established are: 1) approaches to assessing usability; 2) toolkit development approaches; 3) evaluation of the proposed toolkit throughout its development cycle; 4) assessment of the testing plan and results; and 5) dissemination plans. Lastly, the project team began developing the background report.

Preliminary Impact and Findings: This project has no findings to date.

Strategic Goal: Develop and disseminate health IT evidence and evidence-based tools to improve health care decisionmaking through the use of integrated data and knowledge management

Business Goal: Knowledge Creation

EHR toolkit: a background report on usability and electronic health records

Citation:
Johnson CM, Johnston D, Crowley PK, et al. EHR usability toolkit: a background report on usability and electronic health records (Prepared by Westat under Contract No. 290-09-00023I-7). AHRQ Publication No. 11-0084-EF. Rockville, MD: Agency for Healthcare Research and Quality. August 2011. (PDF, 1.03 MB)
Principal Investigator: 
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Research Method: 
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