The Agency for Healthcare Research and Quality (AHRQ) has just released a report on vendor practices regarding electronic health record (EHR) usability. Usability involves the ease of use and effectiveness of a product. The AHRQ notes that usability does not receive the same attention as software features and technical standards. Recent research found that little evidence has been collected on EHR usability in practice.

The report, "Electronic Health Record Usability: Vendor Practices and Perspectives," focuses on the importance of usability in product development. The agency brought together experts in the field to understand the vendor perspectives and to provide recommendations.

The report uses information garnered from interviews with small, medium and large vendors. It presents several challenges, including the fact that usability is a key competitive factor with vendors. Therefore, collaboration between vendors on usability is "almost nonexistent." In addition, vendors collect but tend not to share reported usability-related incidents ("bugs") and product-enhancement requests. No procedure exists to standardize classification and reporting of EHR usability issues. Vendors also disagree as to best methods for ensuring usability standards. However, vendors are interested in an independent body that could develop standards for EHR usability.
The report provides the following recommendations, based upon the experts' evaluations:

-- Vendors should be encouraged to address key shortcomings in current processes and practices related to the usability of their products--including formal user-design processes and more diversity in end-users involved in the testing and evaluation process.

--The diversity of end-user feedback in design and testing should include those with limited previous experience and those with disabilities.

--Support an independent body for vendor collaboration and standards development to overcome the general tendency against collaboration.

--Develop standards and best practices for use of customization during EHR deployment.

--Encourage formal usability testing early in the design and development phase as a best practice.

--Research and development of qualitative/quantitative tools that evaluate and report EHR ease of learning, effectiveness, and satisfaction.

--Increase research and development of best practices supporting designing for patient safety.

--Design certification programs for EHR usability focusing on objective and important aspects of system usability.

The report may be found at: http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_11699_911984_0_0_18/EHRVendorPractices&Perspectives

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