The NIST is seeking public comments on the draft proposal (pdf) on the “Technical Evaluation, Testing and Validation of the Usability of Electronic Health Records”. The IS community has a wealth of experience to contribute on this topic. I skimmed the draft and it is a great start but I don’t think goes deep enough. For example, figure 1 (page eight) lists a three-step process for design evaluation and human user performance testing. My concern is that usability more than just flaws in the user interface though these certainly exist in abundance. It seems that agency/affordances arising from the organizational context and professional roles won’t be explicitly acknowledged per my reading of Step One.
- Step One: During the design of an EHR, the development team incorporates the users, work settings and common workflow into the design. Two major goals for this step that should be documented to facilitate Steps Two and Three are: (a) a list of possible medical errors associated with the system usability, and (b) a working model of the design with the usability that pertains to potential safety risks.
Usability also has its origins in requirements and system design all of which are precursors to what shows up on the interface. A close look at the workaround literature shows that many instances aren’t solely due to poor usability. The IS community should be able to offer a more systems-oriented view on usability and error prevention.
The public comment period is from October 3 through November 10, 2011. Please send comments to EHRUsability@nist.gov. I hope the SIG Health community will share what you submit as your ideas will be the seeds of future research proposals that can build the healthcare IS community.