EHR usability: a 360-degree concept
overview & best practices

Poor usability of EHR software can increase physician burnout, leading to high turnover rates, patient safety issues, and mounting costs for healthcare providers. This correlation was discovered by researchers, such as Bates DW, Ratwani RM, Melnick ER, and other corresponding authors of industry reports. As seen in different studies approved by trustworthy institutional review boards and published in the JAMA Network, Journal of the American Medical Informatics Association (J Am Med Inform Assoc or JAMIA), Health Affairs (Health Aff), Applied Clinical Informatics (Appl Clin Inform), and National Academies Press, physicians who struggle with EHR management have higher cognitive load, are dissatisfied with their work, and tend to make erroneous medical decisions.

The Office of the National Coordinator for Health Information Technology (ONC), part of the US Department of Health and Human Services (HHS), established policies that require EHR vendors to adhere to user-centered design when engineering their products for healthcare organizations. This means adopting an iterative EHR development approach, prioritizing the needs and goals of end-users at each stage, and conducting usability testing of EHR features. The Agency for Healthcare Research and Quality (AHRQ), also a component of HHS, provides extensive funding for institutions examining the influence of EHR usability on physician well-being and patient safety. Besides, it incentivizes those developing solutions for enhancing EHR usability. Additionally, MedStar Health National Center for Human Factors in Healthcare conducts research on health IT usability and safety, as well as provides advisory and training support to healthcare organizations to help them establish reliable health IT systems.

The Institute of Medicine, now the National Academy of Medicine, asserts that the quality and proper use of healthcare software, including EHR systems, should be a shared responsibility of healthcare organizations, healthcare staff, software developers, and governmental entities. According to this principle, each party should contribute to the development of safe, usable, and reliable EHR systems, as well as ensure their appropriate usage.

The cost of enhancing EHR usability varies heavily and depends on whether you need to optimize your existing EHR system or replace it with a new one. In the first case, the expenses are determined by system complexity, the scope of optimization work, the need for custom coding, the number of users, and user training requirements. When implementing a new EHR platform, expenditures include software licensing fees, expenses to purchase and set up hardware for on-premises EHR system deployment, and costs associated with customizing the software, integrating the EHR tool with different systems, and training end-users. Depending on how many features and integrations are required, the average cost of implementing EHR software ranges from $50,000 to $500,000.