Usability of electronic health record systems in UK emergency departments

Background The large volume of patients, rapid staff turnover and high
work pressure means that the usability of all systems within the Emergency
Department (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 to 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 1,647
responses from a total population of 8,794 (19%) representing 192
healthcare organisations (mainly UK National Health Service), 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 (interquartile range [IQR] 35 – 68). Individual EHR systems’ scores
ranged from 35 (IQR 26 to 53) to 65 (IQR 44 to 80). Conclusion In this
survey, no UK ED EHR system met the internationally validated standard of
acceptable usability for information technology. Better usability of
emergency department EHRs is a cheap and effective way of increasing staff
productivity.