Some electronic health record vendors are not following usability testing standards or meeting federal user-centered design rules, even though they have been certified as meeting meaningful use program requirements, according to a study published Tuesday in the Journal of the American Medical Association, Health Data Management reports (Slabodkin, Health Data Management, 9/9).

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.

Details of Study

For the study, researchers reviewed reports for 41 of the 50 EHR vendors with the most customers attesting to meaningful use between April 1, 2013, and Nov. 30, 2014 (Ratwani et al., JAMA, 9/8).

The researchers also examined the Office of the National Coordinator for Health IT's 2014 Certification Edition rules (Health Data Management, 9/9).

Study Findings

About one-third of vendors in the study did not meet ONC's certification requirement of delineating their user-centered design processes, Healthcare IT News reports.

Lead study author Raj Ratwani, scientific director at MedStar Health's National Center for Human Factors, in a statement said, "The reason ... ONC requires EHR vendor products to be certified as having followed UCD processes -- an approach that puts the cognitive workflow and information needs of the clinical user at the forefront of design and development -- is to ensure EHRs support clinical staff as they perform their work and reduce the potential for error and patient harm" (McCann, Healthcare IT News, 9/9).

Researchers also found that:

• 63% of vendors in the study did not enroll at least 15 users -- the recommended number -- in tests of their products;
• 17% lacked physician participants in usability testing for systems meant for physician use; and
• 12% of vendor reports were not detailed enough to ascertain whether physicians were involved.

Ratwani said the divergence from standards might be a significant force behind:

• Physician dissatisfaction; and
• Poor usability (Health Data Management, 9/9).