Marketing

EPIC

Usability

Engineering

Health care

Patient safety

Computer security

Literature

Systems engineering

Vendor

Economics

Computer science

Word error rate

Medical emergency

Business

Health records

Task (project management)

Artificial intelligence

Medicine

Keystroke logging

Economic growth

Human–computer interaction

USable

Multimedia

Journal of the American Medical Informatics Association

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.

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