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. 2021 Jun;38(6):410-415.
doi: 10.1136/emermed-2020-210401. Epub 2021 Mar 3.

Usability of electronic health record systems in UK EDs

Benjamin Michael Bloom  1   2 , Jason Pott  3   2 , Stephen Thomas  2   4 , David Ramon Gaunt  5 , Thomas C Hughes  6
Affiliations

Usability of electronic health record systems in UK EDs

Benjamin Michael Bloom et al. Emerg Med J. 2021 Jun.

Abstract

Background: The large volume of patients, rapid staff turnover and high work pressure mean that the usability of all systems within the ED is important. The transition to electronic health records (EHRs) has brought many benefits to emergency care but imposes a significant burden on staff to enter data. Poor usability has a direct consequence and opportunity cost in staff time and resources that could otherwise be employed in patient care. This research measures the usability of EHR systems in UK EDs using a validated assessment tool.

Methods: This was a survey completed by members and fellows of the Royal College of Emergency Medicine conducted during summer 2019. The primary outcome was the System Usability Scale Score, which ranges from 0 (worst) to 100 (best). Scores were compared with an internationally recognised measure of acceptable usability of 68. Results were analysed by EHR system, country, healthcare organisation and physician grade. Only EHR systems with at least 20 responses were analysed.

Results: There were 1663 responses from a total population of 8794 (19%) representing 192 healthcare organisations (mainly UK NHS), and 25 EHR systems. Fifteen EHR systems had at least 20 responses and were included in the analysis. No EHR system achieved a median usability score that met the industry standard of acceptable usability.The median usability score was 53 (IQR 35-68). Individual EHR systems' scores ranged from 35 (IQR 26-53) to 65 (IQR 44-80).

Conclusion: In this survey, no UK ED EHR system met the internationally validated standard of acceptable usability for information technology.

Keywords: communications; comparative system research; data management; efficiency.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
A comparison of the adjective ratings, acceptability scores and school grading scales, in relation to the average SUS Score (adapted from Bangor et al 8). SUS, System Usability Score.
Figure 2
Figure 2
Participant inclusion diagram. *paper, inhouse, not listed in survey, left blank. EHR, electronic health record; SUS, System Usability Score.
Figure 3
Figure 3
Point and whisker plot of median SUS by EHR provider. Whisker is 95% CI. EHRs are ordered from most to least responses (left to right). Dashed line is the average across industries and products, and constitutes low margin of acceptability. EHR, electronic health record; SUS, System Usability Score.
See this image and copyright information in PMC

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