Evaluating Improvements and Shortcomings in Clinician Satisfaction With Electronic Health Record Usability

Abstract

With the widespread adoption of electronic health records (EHRs), there is increased focus on addressing the challenges of EHR usability, ie, the extent to which the technology enables users to achieve their goals effectively, efficiently, and satisfactorily.1 Poor usability is associated with clinician job dissatisfaction and burnout and could have patient safety consequences.2,3,4 The US Department of Health and Human Services Office of the National Coordinator for Health Information Technology established safety-enhanced design certification requirements for EHRs to promote usability. These requirements stipulate that vendors must conduct and report results of formal usability testing, including measuring satisfaction with the EHR system.5 Results are publicly available. While some vendors use a 5-point, ease-of-use rating scale, most vendors use the system usability scale (SUS), which is a validated posttest questionnaire that measures user satisfaction with product usability.6 The questionnaire provides a score (range, 0-100) based on a participant’s rating of 10 statements regarding a product’s usability.6 Higher scores indicate greater satisfaction with usability.6 Based on an analysis of more than 200 studies of various products in various industries, an SUS score of 68 is considered the average benchmark, and an SUS of 80 is considered the above-average benchmark.6 Recognizing the importance of satisfaction with EHR usability to clinician burnout and patient safety, reported product 2015 SUS scores for EHR systems were compared with 2014 SUS scores and with benchmarks to evaluate whether satisfaction is improving.2,3,4