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CC BY 4.0 · Appl Clin Inform 2023; 14(03): 494-502
DOI: 10.1055/a-2074-1665
Research Article

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

Brian Lefchak
1   NewYork-Presbyterian Hospital, New York, New York, United States
2   Department of Pediatrics, Weill Cornell Medical Center, New York, New York, United States
,
Susan Bostwick
2   Department of Pediatrics, Weill Cornell Medical Center, New York, New York, United States
,
Sarah Rossetti
3   Department of Biomedical Informatics, Columbia University, New York, New York, United States
4   Columbia University School of Nursing, New York, New York, United States
,
Kenneth Shen
1   NewYork-Presbyterian Hospital, New York, New York, United States
2   Department of Pediatrics, Weill Cornell Medical Center, New York, New York, United States
,
Jessica Ancker
5   Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
,
Kenrick Cato
4   Columbia University School of Nursing, New York, New York, United States
,
Erika L. Abramson
2   Department of Pediatrics, Weill Cornell Medical Center, New York, New York, United States
5   Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
,
Charlene Thomas
5   Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
,
Linda Gerber
5   Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
,
Amanda Moy
3   Department of Biomedical Informatics, Columbia University, New York, New York, United States
,
Mohit Sharma
5   Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
,
Jonathan Elias
1   NewYork-Presbyterian Hospital, New York, New York, United States
5   Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
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Abstract

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, 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 This article characterizes 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 A total of 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.

Conclusion 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.

Keywords

electronic health records - user-centered design - medical informatics applications - job satisfaction

Protection of Human and Animal Subjects

There was minimal risk from study participants and all aspects were approved by the Columbia University College of Physicians and Surgeons and Weill Cornell Medical College Institutional Review Boards.


Supplementary Material



Publication History

Received: 05 January 2023

Accepted: 19 March 2023

Accepted Manuscript online:
14 April 2023

Article published online:
28 June 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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