Electronic Medical Records Review of Usability

 A literature search was conducted using PubMed with keywords “EMR” OR “electronic medical records” OR “EHR” OR “electronic health records” AND “usability” and identified 1091 potential articles. Only 551 met the inclusion criteria. On review, only three articles focusing on EMR/EHR and usability were included for the review.

 

Health-care Information and Management System Society defines usability as the effectiveness, efficiency, and satisfaction experienced by EMR users in their work to achieve specific tasks in different environments. There is a lack of standardization of EMR worldwide, and hence there is no ideal method to evaluate the usability of an EMR. The EMR vendors define their usability criteria and methods. Effective usability evaluations of EMR systems can help prevent the implementation of suboptimal EMR systems and improve EMR interfaces for health-care provider use. Compromised EMR system usability can significantly negatively affect clinical settings and EMR adoption.

 

Ellsworth et al.[10] conducted a systematic review of EHR usability evaluations. The study showed a dearth of valid usability evaluations in the development of systems at various stages. Most of the studies in this review have used survey or think-aloud methods for usability evaluations.

 

Ratwani et al.[28] concluded that there are misalignments between literature and stakeholders’ perspectives regarding usability, safety challenges, and practices during EMR implementation. It also pointed out the lack of availability of tools for frontline workers that appear in the literature. The cost of implementing the EMR is not considered in the literature when offering best practices. Improving the partnerships between developers, stakeholders, and health organizations is critically important when it comes to safety and usability. Five key areas were identified in a review on usability, and they include.

 

Ease of learning, efficiency, effectiveness, and cognitive load, can have a bearing on the ratings for EMR usability.[29] Ease of learning, cognitive load, and effectiveness can impact usability ratings of EMR systems.[29] An essential component of EMR systems is the ease of learning. By incorporating the cognitive load into the EMR system design, EMR can become effective. The users are more likely to adapt to EMR in a shorter duration. Cognitive load is defined as how intuitive information and functionality are presented within the EMR system.[29]

 

Currently, standardized methods for assessing the usability of EMR systems are lacking. Standardized usability evaluations can make it easy to compare the different EMR systems. Collaborative work between stakeholders and developers can improve EMR usability and safety.

This study considers only the literature, which was in the English language. There may also be studies that may not have been reported, particularly negative ones. There is also a lack of systematic studies in certain areas as this is an evolving area. Systematic studies can help a better evaluation and understanding of EMR.

 

Looking to the future, health-care systems are attempting to integrate multiple data sources such as community practitioners’ data with hospital-based EMR data. In addition, patients also have their health-care record systems’ personal health record (PHR). Research is underway in integrating and interpreting the data in the PHR.

 

Nowadays, EMR data are stored on cloud-based systems, which have medical-legal implications. If the data are stored in another country, a governmental agency in that country can access the data without valid consent through a judicial process. EMRs are also becoming a target of ransomware attacks.

 

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Review Source: 

Electronic Medical Records – A Review of Cost-Effectiveness,... : Journal of Psychiatry Spectrum (lww.com)




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