A usability and safety analysis of electronic health records: a multi-center study.

MedStar author(s):
Citation: Journal of the American Medical Informatics Association. 25(9):1197-1201, 2018 09 01.PMID: 29982549Institution: MedStar Institute for Innovation | MedStar Washington Hospital CenterDepartment: Emergency MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Medical Errors | *Medical Records Systems, Computerized | *Task Performance and Analysis | Diagnostic Imaging | Electronic Health Records | Humans | Medical Order Entry Systems | User-Computer InterfaceYear: 2018ISSN:
  • 1067-5027
Name of journal: Journal of the American Medical Informatics Association : JAMIAAbstract: To characterize the variability in usability and safety of EHRs from two vendors across four healthcare systems (2 Epic and 2 Cerner). Twelve to 15 emergency medicine physicians participated from each site and completed six clinical scenarios. Keystroke, mouse click, and video data were collected. From the six scenarios, two diagnostic imaging, laboratory, and medication tasks were analyzed. There was wide variability in task completion time, clicks, and error rates. For certain tasks, there were an average of a nine-fold difference in time and eight-fold difference in clicks. Error rates varied by task (X-ray 16.7% to 25%, MRI: 0 to 10%, Lactate: 0% to 14.3%, Tylenol: 0 to 30%; Taper: 16.7% to 50%). The variability in time, clicks, and error rates highlights the need for improved implementation optimization. EHR implementation, in addition to vendor design and development, is critical to usable and safe products.All authors: Arnold R, Fairbanks RJ, Hettinger AZ, Hodgkins M, Khairat S, Miller K, Ratwani RM, Savage E, Will AFiscal year: FY2019Digital Object Identifier: Date added to catalog: 2018-07-30
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Journal Article MedStar Authors Catalog Article 29982549 Available 29982549

To characterize the variability in usability and safety of EHRs from two vendors across four healthcare systems (2 Epic and 2 Cerner). Twelve to 15 emergency medicine physicians participated from each site and completed six clinical scenarios. Keystroke, mouse click, and video data were collected. From the six scenarios, two diagnostic imaging, laboratory, and medication tasks were analyzed. There was wide variability in task completion time, clicks, and error rates. For certain tasks, there were an average of a nine-fold difference in time and eight-fold difference in clicks. Error rates varied by task (X-ray 16.7% to 25%, MRI: 0 to 10%, Lactate: 0% to 14.3%, Tylenol: 0 to 30%; Taper: 16.7% to 50%). The variability in time, clicks, and error rates highlights the need for improved implementation optimization. EHR implementation, in addition to vendor design and development, is critical to usable and safe products.

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