The American Medical Association and MedStar Health have developed a joint framework to determine usability among electronic health record technologies, EHR Intelligence reports (Murphy, EHR Intelligence, 10/27).

Background

Last year, AMA released a framework outlining eight priorities for making EHRs easier for providers to use, including:

• Enhancing physicians' ability to provide high-quality patient care;
• Supporting team-based care;
• Promoting care coordination;
• Reducing cognitive workload;
• Promoting data liquidity;
• Facilitating digital and mobile patient engagement; and
• Expediting user input into product design and post-implementation feedback (iHealthBeat, 9/17/14).

Joint Framework Details

The updated EHR User-Centered Design Evaluation Framework builds on the original eight-point framework and the Office of the National Coordinator for Health IT's EHR usability criteria. The new framework evaluates EHR vendor compliance with best practices according to a 15-point scale developed by MedStar Health's National Center for Human Factors in Healthcare and AMA.

In a statement, the organizations said they developed the framework because they believe that "ONC's requirements do not go far enough to encourage fully functional and usable products." They continued, "This framework can be used by the ONC to improve their certification program, and as a method to track improvements EHR vendors make as they recertify their products over time" (Walsh, Clinical Innovation & Technology, 10/27).

EHR Usability Ratings

The organizations used the framework to evaluate the usability of several EHRs.

The highest-scoring EHR vendors were:

• Allscripts, which received 15 out of 15;
• McKesson, which received 15 out of 15;
• Medical Information Technology, which received 13.5 out of 15;
• Practice Fusion, which received 13.5 out of 15;
• Cerner, which received 13 out of 15;
• MEDITECH, which received 13 out of 15; and
• Modernizing Medicine, which received 13 out of 15.

Meanwhile, the lowest-scoring EHR vendors included:

• Greenway, with a score of 7;
• GE Healthcare, with a score of 6.5; and
• eClinicalWorks, with a score of 5 (EHR Intelligence, 10/27).

Comments

Raj Ratwani -- scientific director of the National Center for Human Factors in Healthcare and a principle developer of the framework -- said, "Alignment with best practices for user-centered design and testing is a starting point that regulators and industry should meet and exceed," noting, "The framework we developed is the first step in bringing greater transparency to the usability processes of EHR vendors."

Meanwhile, AMA President Steven Stack said, "Physician experiences documented by the AMA demonstrate that most EHR systems fail to support effective and efficient clinical work, and continued issues with usability are a key factor driving low satisfaction with many EHR products." He added, "Our goal is to shine light on the low-bar of the certification process and how EHRs are designed and user-tested in order to drive improvements that respond to the urgent physician need for better designed EHR systems" (Clinical Innovation & Technology, 10/27).