Electronic Health Record Vendor Adherence to Usability Certification Requirements and Testing Standards.

Electronic Health Record Vendor Adherence to Usability Certification Requirements and Testing Standards Manyelectronichealthrecords (EHRs)havepoorusability, leading to user frustration and safety risks.1 Usability is the extent to which the technology helps users achieve their goals in a satisfying, effective, and efficient manner within the constraints and complexities of their work environment.2 The US Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology (ONC) has established certification requirements to promote usability practices by EHR vendors as a part of the meaningful use program. To develop a certified EHR, vendors are required to attest to using user-centered design (UCD), a process that places the cognitive and information needs of the frontline user at the forefront of software development, and to conduct formal usability testing on 8 different EHR capabilities to ensure the product meets performance objectives.3 Third-party ONC-authorized certification bodies are responsible for certifying EHR products. Vendors are required to provide a written statement naming the UCD process they used anddescribing theprocess if it is not a recognized industrystandard.3Vendorsmustalsoprovidewrittenresultsof their usability tests, including thenumber, clinical background, and demographics of the participants. The ONC has endorsed guidelines from theNational Institute of Standards andTechnology stipulating thatusability testing should includeat least 15 representativeend-userparticipants.4Reportsmustbemade public once the product is certified. We analyzed these reports to determine whether usability certification requirements and testing standards were met.