'Paucity' of good EHR usability studies contributes to knowledge gap

The available studies on electronic health record usability are not standardized, conducted too late in the design process to be of good use, and otherwise deficient, according to a recent report published in the Journal of the American Medical Informatics Association (JAMIA).

The researchers, from the Mayo Clinic and elsewhere, conducted a literature search of 120 articles to evaluate methodological and reporting trends regarding the usability studies of EHRs. While there is a great need to evaluate EHR usability to prevent implementation of "suboptimal" tools, there's little guidance on how to do so and report them to guide future usability studies.

For instance, many methods to measure usability were examined, the researchers noted, including surveys, interviews, focus groups and work flow analysis. However, while surveys of end users are helpful, they didn't identify problems that could be targeted for improvement. 

Additionally, the majority of studies were performed late in the EHR system design cycle, either during or after implementation, instead of early on or throughout, where a usability issue can be more readily identified and rectified. Many studies failed to describe their study design.

Moreover, while the responsibility of conducting evaluations early in the process falls on the vendors, less than half of them were conducting industry-standard usability evaluations; a "significant" number were not using usability staff to carry out the assessments.

"[A] review of the literature on EHR evaluations demonstrates a paucity of quality published studies describing scientifically valid and reproducible usability evaluations conducted at various stages of EHR system development and how findings form these evaluations can be used to inform others in similar efforts," the authors wrote. "The lack of formal and standardized reporting of usability evaluation results is a major contributor to this knowledge gap, and efforts to improve this deficiency will be one step of moving the field of usability engineering forward."

To learn more:
- here's the abstract