Abstract
Objectives Improving the usability of electronic health records (EHR) continues to be a focus
of clinicians, vendors, researchers, and regulatory bodies. To understand the impact
of usability redesign of an existing, site-configurable feature, we evaluated the
user interface (UI) used to screen for depression, alcohol and drug misuse, fall risk,
and the existence of advance directive information in ambulatory settings.
Methods As part of a quality improvement project, based on heuristic analysis, the existing
UI was redesigned. Using an iterative, user-centered design process, several usability
defects were corrected. Summative usability testing was performed as part of the product
development and implementation cycle. Clinical quality measures reflecting rolling
12-month rates of screening were examined over 8 months prior to the implementation
of the redesigned UI and 9 months after implementation.
Results Summative usability testing demonstrated improvements in task time, error rates,
and System Usability Scale scores. Interrupted time series analysis demonstrated significant
improvements in all screening rates after implementation of the redesigned UI compared
with the original implementation.
Conclusion User-centered redesign of an existing site-specific UI may lead to significant improvements
in measures of usability and quality of patient care.
Keywords
electronic health record - interfaces - usability - quality - nurse - ambulatory setting
- primary care
