Appl Clin Inform 2020; 11(04): 580-588
DOI: 10.1055/s-0040-1715828
Research Article

The Effect of Electronic Health Record Usability Redesign on Annual Screening Rates in an Ambulatory Setting

Robert P. Pierce
1  Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, United States
,
Bernie R. Eskridge
2  Department of Child Health, University of Missouri, Columbia, Missouri, United States
,
LeAnn Rehard
3  Nursing Informatics, University of Missouri Health Care, Columbia, Missouri, United States
,
Brandi Ross
4  Tiger Institute, Cerner Corporation, Columbia, Missouri, United States
,
Margaret A. Day
1  Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, United States
,
Jeffery L. Belden
1  Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, United States
4  Tiger Institute, Cerner Corporation, Columbia, Missouri, United States
› Author Affiliations

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.

Protection of Human and Animal Subjects

The project details were reviewed by the institutional review board who determined the project to be a quality improvement activity and not human subjects research and did not require additional review.




Publication History

Received: 09 April 2020

Accepted: 20 July 2020

Publication Date:
09 September 2020 (online)

Georg Thieme Verlag KG
Stuttgart · New York