Electronic health record usability and workload changes over time for provider and nursing staff following transition to new EHR

Karen Dunn Lopez, Chieh Li Chin, Renato Ferreira Leitão Azevedo, Varsha Kaushik, Bidisha Roy, William Schuh, Kayla Banks, Vanessa Sousa, Daniel Morrow

Research output: Contribution to journalArticlepeer-review

Abstract

The ubiquity of EHRs in healthcare means that small EHR inefficiencies can have a major impact on clinician workload. We conducted a sequential explanatory mixed methods study to: 1) identify EHR-associated workload and usability effects for clinicians following an EHR change over time, 2) determine workload and usability differences for providers (MD and Advance Practice Nurses) versus nurses (RNs and MAs), 3) determine if usability predicts workload, 4) identify potential sources of EHR design flaws. Workload (NASA-Task Load Index) and usability (System Usability Scale) measures were administered pre, 6–8 month and 30–32 months post-implementation. We found significant increase in perceived workload post-implementation that persisted for 2.5 years (p <.001). The workload increase was associated with usability ratings, which in turn may relate to EHR interface design violations identified by a heuristic evaluation. Our findings suggest further innovation and attention to interface design flaws are needed to improve EHR usability and reduce clinician workload.

Original languageEnglish (US)
Article number103359
JournalApplied Ergonomics
Volume93
DOIs
StatePublished - May 2021

Keywords

  • Electronic health records
  • Heuristic analysis
  • Medical informatics
  • Nursing informatics
  • Usability
  • Workload

ASJC Scopus subject areas

  • Human Factors and Ergonomics
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Safety, Risk, Reliability and Quality
  • Engineering (miscellaneous)

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