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Boston Mini UPA EHR Discussion
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Boston Mini UPA EHR Discussion

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  • Welcome, thank you, introductions
  • Just a Who We Are slide
  • 5 minutes max
  • 5- 10 minutes for this discussion
  • This is just an intro slide
  • UCD starts with understanding the users, so…10 minutes for this discussion
  • 10 minutes for this
  • Some general concepts for you
  • Transcript

    • 1. Usability of Electronic Health Records: Interactive Discussion on How to Make Electronic Health Records Usable
      Kris EngdahlLauren ZackKaden RushfordTrisha FlanaganJannis Brea
    • 2. UX at athenahealth
      Who is athenahealth?
      We’re a cloud-based solution for practice management, electronic health records, and patient communications, serving physician practices
      Our deep service offerings are based on proprietary web-native software, a continuously updated payer knowledge-base and integrated back-office service operations.
      User Experience introduced to athenahealth in 2008
      Backed by CEO, embedded in R&D processes, tackling really interesting UX problems
      Has grown to a team of 14, providing:
      User experience design
      User research
      Product copy
      The company and the team are still growing (Come talk to us!)
    • 3. Why is EHR Usability such a hot topic?
      Healthcare is a large industry
      $2.5 trillion, 14.3 million jobs, 17.3% of GDP
      It affects all of us
      We are all once and future patients
      We pay for everyone’s healthcare, either through insurance or taxes
      Recent healthcare reform legislation encourages the adoption of EHRs
      HITECH act includes incentives for “meaningful use” of EHRs
      Government is discovering the field of usability as it evaluates EHRs
      Healthcare providers are demanding better EHR usability
      “It doesn’t look like it’s built for me” (system model != user mental model)
      Better ease of learning
      Better efficiency of use
      Poor EHR usability can put patients at risk
    • 4. Discussion:How do we define EHR Usability?
      What is an electronic health record (EHR)?
      Electronic version of paper charting, plus capacity for electronic data exchange; managed by healthcare professionals
      Used by single-physician practices, large healthcare networks, and everything in between
      Different from a personal health record, which is managed by the patient
      What is usability? (Choose your definition – here is the NIST definition)
      ISO 9421-11: “The extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context of use.”
      Discussion: How do we define “usability” specifically re: EHRs?
      What does it mean for an EHR to be usable?
      Where does patient safety fit?
    • 5. How do we apply User Centered Design to the development of EHRs?
      Essentially, just like any other UCD Process:
      Start with users
      Iteratively design and test
      Collect data after deployment
      And yet…there is something different about this arena
      Let’s discuss this, piece by piece
    • 6. Discussion: Starting with users
      Who are the users of EHRs?
      Characteristics
      Knowledge
      Context
      Goals
      Tasks
      What dimensions apply to the user population?
      How do we scope / carry out user research?
    • 7. Discussion: Iterative design and testing
      Who do we test with?
      Who are “representative” users?
      How do we get unbiased access to them?
      What do we test?
      Most EHRs are highly customized for individual practices.
      How useful is a test of a “generic” version under development?
      What tasks do we test?
      What data do we use for testing?
      Participants are always distracted by unrealistic data – so it has to be realistic
      Real data is protected by HIPAA
    • 8. Discussion: Collecting data post-deployment
      What kinds of summative evaluation are appropriate?
      Can you compare usability of different EHRs?
      How?
      Summative testing?
      With whom?
      Using what?
      What tasks?
      What contexts?
      Surveys?
      Expert reviews?
      Expert in what?
      Same questions as with testing – tasks, contexts?
    • 9. References
      General info on healthcare industry:
      http://www.bls.gov/oco/cg/cgs035.htm
      http://www.bnet.com/blog/healthcare-business/health-spending-hits-173-percent-of-gdp-in-largest-annual-jump/1117
      What’s an EHR?
      http://www.ama-assn.org/ama/pub/physician-resources/health-information-technology/health-it-basics/emrs-ehrs.page
      Government documents on EHR usability
      http://www.cchit.org/sites/all/files/CCHIT%20Usability%20Testing%20Guide%20Ambulatory%20EHRs%202011%20v6.pdf
      http://www.nist.gov/itl/hit/upload/Guide_Final_Publication_Version.pdf
      http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_907505_0_0_18/09(10)-0091-2-EF.pdf
      http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_907504_0_0_18/09(10)-0091-1-EF.pdf
      Information on EHR usability and patient safety
      http://www.bmj.com/content/330/7491/581.full
      http://www.useit.com/alertbox/20050411.html
      http://www.jointcommission.org/sentinel_event_alert_issue_42_safely_implementing_health_information_and_converging_technologies/

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