Catalyzing Pediatric Electronic Health Record Usability and Safety Improvements

Muthu, Naveen; Ratwani, Raj M.

doi:10.1542/peds.2020-030965

Cited by 1 publication

(4 citation statements)

References 15 publications

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“…These constructs are particularly relevant to adverse EHR outcomes identified in literature related to clinical burnout, job dissatisfaction, and adverse patient safety events. [1][2][3]18 In our study, prior clinical and EHR experience differed slightly between CU and WC groups overall, but this seems unlikely to have been responsible for the differences in usability attributed to EHR systems as these group differences were small (i.e., 4%) and somewhat inconsistent (i.e., larger representation of "less than 1 year" and "11 years or more" simultaneously for both categories). Furthermore, dedicated analysis among all ambulatory respondents demonstrated limited associations with construct usability perceptions related to care coordination, note documentation, information review, EHR learnability, and error correction or prevention as there were no significant or consistent associations identified for either OPs or non-OPs at CU or WC.…”

Section: Discussionmentioning

confidence: 53%

“…Unlike our study, which differentiated among five usability constructs across two separate EHR systems, a recent study of usability associations among nursing staff in over 300 hospitals demonstrated persistent associations between suboptimal EHR usability, staff burnout, and adverse outcomes despite averaging usability Likert scores, suggesting any aspect of negative usability can potentially offset unique advantages of different EHR designs. 18 Perhaps reflective of this implication, another study surveying clinician attitudes has demonstrated stagnant or even decreasing satisfaction with EHR usability metrics across time despite vendor improvements and updates. 19 In conclusion, potential optimism regarding the favorability of certain EHR systems on select aspects of usability perceptions must be tempered by persistent user-identified concerns related to critical cognitive constructs regardless of prior experience.…”

Section: Discussionmentioning

confidence: 99%

“…These constructs are particularly relevant to adverse EHR outcomes identified in literature related to clinical burnout, job dissatisfaction, and adverse patient safety events. 1 2 3 18 …”

Section: Discussionmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

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Assessing Usability and Ambulatory Clinical Staff Satisfaction with Two Electronic Health Records

et al. 2023

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BACKGROUND: A growing body of literature has linked usability limitations within electronic health records (EHRs) to adverse outcomes which may in turn affect EHR system transitions. NewYork-Presbyterian Hospital (NYP), Columbia University College of Physicians and Surgeons (CU) and Weill Cornell Medical College (WC) are a tripartite organization with large academic medical centers that initiated a phased transition of their EHRs to one system, EpicCare©. OBJECTIVES: To characterize usability perceptions stratified by provider roles by surveying WC ambulatory clinical staff already utilizing EpicCare© and CU ambulatory clinical staff utilizing iterations of Allscripts© before the implementation of EpicCare© campus-wide. METHODS: A customized 19-question electronic survey utilizing usability constructs based on the Health Information Technology Usability Evaluation Scale was anonymously administered prior to EHR transition. Responses were recorded with self-reported demographics. RESULTS: 1,666 CU and 1,065 WC staff with ambulatory self-identified work setting were chosen. Select demographic statistics between campus staff were generally similar with small differences in patterns of clinical and EHR experience. Results demonstrated significant differences in EHR usability perceptions among ambulatory staff based on role and EHR system. WC staff utilizing EpicCare© accounted for more favorable usability metrics than CU across all constructs. Ordering providers (OPs) denoted less usability than non-OPs. The Perceived Usefulness and User Control constructs accounted for the largest differences in usability perceptions. The Cognitive Support and Situational Awareness construct was similarly low for both campuses. Prior EHR experience demonstrated limited associations. CONCLUSIONS: Usability perceptions can be affected by role and EHR system. OPs consistently denoted less usability overall and were more affected by EHR system than non-OPs. While there was greater perceived usability for EpicCare© to perform tasks related to care coordination, documentation and error prevention, there were persistent shortcomings regarding tab navigation and cognitive burden reduction, which have implications on provider efficiency and wellness.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

“…These constructs are particularly relevant to adverse EHR outcomes identified in literature related to clinical burnout, job dissatisfaction, and adverse patient safety events. 1 2 3 18 …”

Section: Discussionmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

See 2 more Smart Citations