Safety-enhanced Design

EHR Safety-enhanced design (§170.315.g.3) (aka Usability) Testing for ONC 2015 Certification

The Office of the National Coordinator for Health Information Technology has made several enhancements to the Safety-enhanced (aka usability) testing portion of the certification criteria.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established a Merit-based Incentive Payment System (MIPS) that, in part, is based upon compliance with certain rules. The following describes what is required to obtain the ONC 2015 Edition Certification for Safety-enhanced Design (§170.315.g.3) for an EHR.

The top 5 EHR usability problems and how to fix them!

This year at HIMSS in Las Vegas there was no shortage of talk about the “lack of usability” in EHRs.  In the final HIMSS16 show daily (Thursday March 3, 2016) there were four articles (“When EHRs cause Harm,” “5 UX steps to Healthy Clinical apps,” “Nurse: We face severe IT usability problems,” and “The leading health IT issues? Poor usability and missing safeguards”) that addressed some aspect of EHR usability.

For The Usability People, LLC the time for talk has long been over.  Many of you already know that we have been on an active campaign--by giving talks at conferences, on social media, and with our many Healthcare clients--to improve the usability of Health IT.  We don’t want more talk, we want to DO SOMETHING about this important healthcare issue.  Usability in healthcare it can save lives. 


The Shock Doctrine and Human-centered Design

So far I’ve been fortunate to have lived my life in three major metropolitan areas in the United States. Each of these different geographic locations have their own unique culture that is clearly evident in the conversations that you would often overhear when out at a restaurant or coffee shop, etc.

The best error message is one that you don't have to show!

Avoid errors by providing embedded assistance on more complex controls.

Deep within many of the systems we evaluated lies a complex, and sometimes non-standard UI control feature that is critical to performing an important task.

In the ONC 2014 Edition Summative tests, this control was usually related to the “Clinical information reconciliation task.” The control was usually some type of “Shuttle” widget where the user selects multiple items from one or more lists and places them into a single reconciled list (of Problems, Allergies, and Medications)

Let's sort this out!

A common usability problem that we've seen in many of the EHRs that we've evaluated is that default sort settings are the same for every list

Most of these systems seemed to have an ascending alphabetical sort (Things are sorted from A to Z) for all or most of the lists of items that are provided.

Developers often tell us that they set the sort order the same in each list so that there is a consistency across the application.