Emergency medicine electronic health record usability: where to from here?

Information technology (IT) usability is the degree to which software can be used by specified consumers (eg, doctors) to achieve quantified objectives (eg, manage emergency patients in an emergency department (ED)) with effectiveness, efficiency and satisfaction with each interaction.1 Usability is relevant to new learners, infrequent users and regular users, and for people with a wide variety of capabilities. The software should minimise the risk and consequences of errors, and be straightforward to use for routine tasks. Hence an IT system with high usability is simple, guides users through the least labour-intensive route, and does not require expert knowledge for use. Bloom et al present an important study on the usability of electronic health record (EHR) systems in British EDs.2 The large survey clearly demonstrates the poor usability of all systems currently deployed throughout the UK, with none of them meeting the international minimum standards required for IT in any industry. The study was not able to tell us which aspects of usability are poor. The issue of EHR usability is not new, with articles published over the years calling for improvements, describing how large sums of health money has been spent on unproven IT systems without any evidence of improvements in safety, quality or efficiency.3 The authors mention that some may feel that the concept of usability is nebulous, however, usability is well defined.2 The computer science discipline, known as Human Computer Interaction, has studied the science and developed the practice of creating usable systems for decades.4 In industry, user-centred design is a well-established engineering practice, with widely accepted protocols for delivering effective interactive systems and improving the user experience. Solutions for developing user-friendly software to manage electronic records efficiently exist and we need to ensure they are incorporated into our software. While the …