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A study by the American Medical Association (AMA) and MedStar Health National Center for Human Factors in Healthcare, published in July 2018 in the Journal of the American Medical Informatics Association (JAMIA), is the basis of the information presented in the Videos section of this site. Specifically, researchers examined usability of the two major EHR systems—Cerner and Epic—which account for a large percent of the U.S. market. Their goal was to identify adherence to basic usability principles by examining the two systems in use.

Overall, the study found large variability by clinical site in time, clicks, and error rates, with some error rates reaching 50 percent. Improved usability and safety requires shared responsibility and action from stakeholders, including patients, providers, vendors, and policymakers.

The federal government, through the Office of the National Coordinator for Health Information Technology, has put basic EHR usability and safety requirements into place, but challenges remain. These include:

  • Current federal standards may not be rigorous enough. A separate study by MedStar’s Human Factors Center found that vendors’ adherence to user-centered design practices was highly variable and that some vendors may not meet standards—yet their products are being certified. The findings were reported in the Journal of the American Medical Association in September 2015.  
  • EHR products may be configured and customized during the implementation phase, resulting in changes to the technology that do not support usability or safety. However, unlike with vehicles or medical devices, review of the final products in use is not required or common.

While the JAMIA study informing this site provided extensive written detail, the videos are being publicly released here for the first time to further depict critical EHR usability issues and promote understanding and action that will lead to improvement in the next decade of EHR use and innovation. Please see the journal article for complete methodological details and quantitative results.


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