Optimizing the Electronic Health Record for Cardiac Care (Nebraska)

The use of electronic health records (EHRs) promises to substantially alter the practice of medicine. Advocates tout its ability to reduce costs and improve health; however, physician adoption has been slow. Adoption may be hindered by the negative impact of current EHRs on workflow, information flow, and patient safety. This project will study the usability of EHRs use by cardiac care physicians and nurses to develop a set of best practices in EHR design to inform vendors of the wants and needs of clinical providers.

The specific aims of the study are to:

• Determine the usability of the EHR as measured by provider-defined usability (efficiency, effectiveness, and satisfaction). 
• Use value-based software engineering principles and agile development methods to link providers with clinical content and human-computer interface expertise to build and test wireframe models of desired EHR functionality. 
• Use information obtained through the first two aims to synthesize the characteristics of users’ preferences (clinical setting, clinical expertise and learning style, etc.) and demographics (age, gender, race/ethnicity, and comfort with technology) and propose a set of best practice designs to guide EHR developers. 

For the first aim, the investigators will use cardiovascular clinical scenarios and trained simulated patients (actors) to test existing installed EHRs. They will define the tasks to be measured and collect data using parallel mixed methods that include task-driven usability studies, quantitative data, and qualitative interviews. For the second aim, they will use the information gathered in the first aim to link providers with experts in cardiology, informatics, and computer science to design, build, and test functional wireframe models that can be optimized for clinical workflow, team communication (information flow), and patient care and safety. The final product will be a set of best practice designs for EHR developers.