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Health care costs represent a significant percentage of a country's GDP. Implementing electronic medical records (EMR) systems are a popular solution to reducing costs, with the side benefit of providing better care. Unfortunately, 30% of EMR system implementations fail, often because physicians cannot use the EMRs efficiently. User experience problems, based on our experience at several clinics, are wide-spread among EMRs. These include loss of productivity and steep learning curves.

To help usability professionals contribute to the creation of more usable EMRs, we share our insights and experiences. Essential to understanding EMRs is the physician's task flow, which we explain in detail. It is also helpful to understand the different work styles of physicians, variations in the pace of work, the use of nurses, the mode and timing of data entry, and variations in needed functionality. These variances in task flow, work styles, and needed functionality lead us to propose solutions to improve the usability of EMRs focusing on: flexible navigation, personalization and customization, accessing multiple patients, delegation of responsibility among medical personnel, and enabling data variations and visualizations.

John B. Smelcer, Hal Miller-Jacobs, and Lyle Kantrovich

Journal of Usability Studies, Volume 4, Issue 2, February 2009, pp. 70-84

An international peer-reviewed journal

Practitioner's Take Away
The following list summarized take-aways that practioners can get from this article:
 
Electronic medical records (EMR) have not penetrated the medical field in spite of the benefits that all agree are possible.
One of the primary reasons for this failure is the lack of usability in the implementation of many systems.
While incorporating usability in EMR systems presents many unique challenges, these can be addressed and handled by usability professionals.
These challenges are the result of the difficulty of crafting a system that involves skilled users, complex functionality, and critical tasks.
Designers of EMR systems should consider the following:
Employ a flexible navigation scheme to accommodate the variety of specialists, environments, personnel, and individual practices.
Use appropriate defaults to reduce non-productive work load.
Enable the rapid switching between patients that is consistent with the way many physicians operate.
Allow for the delegation of appropriate responsibility to other members of the medical team.
Provide various methods of data entry that conforms with the way many physicians work.
Consider innovative visualization, integration, and manipulation techniques to assist in providing superior medical services to patients while minimizing the workload of medical personnel.

 

Practitioner's Take Away

 
The following list summarized take-aways that practioners can get from this article:
 
  • Electronic medical records (EMR) have not penetrated the medical field in spite of the benefits that all agree are possible.
  • One of the primary reasons for this failure is the lack of usability in the implementation of many systems.
  • While incorporating usability in EMR systems presents many unique challenges, these can be addressed and handled by usability professionals.
  • These challenges are the result of the difficulty of crafting a system that involves skilled users, complex functionality, and critical tasks.
  • Designers of EMR systems should consider the following:
    • Employ a flexible navigation scheme to accommodate the variety of specialists, environments, personnel, and individual practices.
    • Use appropriate defaults to reduce non-productive work load.
    • Enable the rapid switching between patients that is consistent with the way many physicians operate.
    • Allow for the delegation of appropriate responsibility to other members of the medical team.
    • Provide various methods of data entry that conforms with the way many physicians work.
    • Consider innovative visualization, integration, and manipulation techniques to assist in providing superior medical services to patients while minimizing the workload of medical personnel.

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Usability of Electronic Medical Records (1.3m)

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