Usability testing of two ambulatory EHR navigators

Background: Despite widespread electronic health record (EHR) adoption, poor EHR system usability continues to be a significant barrier to effective system use for end users. One key to addressing usability problems is to employ user testing and user-centered design. Objectives: To understand if redesigning an EHR-based navigation tool with clinician input improved user performance and satisfaction. Methods: A usability evaluation was conducted to compare two versions of a redesigned ambulatory navigator. Participants completed tasks for five patient cases using the navigators, while employing a think-aloud protocol. The tasks were based on Meaningful Use (MU) requirements. Results: The version of navigator did not affect perceived workload, and time to complete tasks was longer in the redesigned navigator. A relatively small portion of navigator content was used to complete the MU-related tasks, though navigation patterns were highly variable across participants for both navigators. Preferences for EHR navigation structures appeared to be individualized. Conclusions: This study demonstrates the importance of EHR usability assessments to evaluate group and individual performance of different interfaces and preferences for each design.