University: Electronic Health Record System Usability Project Report

This project focuses on the usability of Electronic Health Record (EHR) systems. The project begins with a background on EHR systems and their evolution from paper-based records to electronic systems. It highlights the motivation behind the project, which is to analyze usability issues and determine steps for validation studies. The problem statement identifies poor EHR usability as a significant barrier to adoption, leading to decreased productivity and potential patient safety risks. The project scope includes reviewing, testing, and designing EHR user interfaces based on usability engineering principles, with objectives to evaluate design procedures, enhance safe use, and increase user ease. A literature review examines EHR user interface design principles like learnability, consistency, and error recovery, as well as the financial, workflow, and data privacy risks associated with EHRs. The review also covers usability testing methodologies and proposes a user interface design that separates data by healthcare divisions, incorporates secure login facilities, and includes typesetting buttons to enhance usability. The project includes a detailed work plan with identified tasks, a Gantt chart, a Work Breakdown Structure (WBS), and a cost plan to manage and execute the project effectively.

Running head: ELECTRONIC HEALTH RECORD SYSTEM
Topic- Usability of electronic health record
Name of the Student
Name of the University
Author’s Note

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Table of Contents
1. Background of the project...........................................................................................................2
2. Motivation for the project............................................................................................................2
3. Problem statement.......................................................................................................................2
4. Scope of the project.....................................................................................................................3
5. Project objectives.........................................................................................................................3
6. Analysis of related work/Literature Review................................................................................4
6.1. Review of the EHR’s user interface design..........................................................................4
6.2. Usability testing of the EHR’s system..................................................................................4
6.3. Proposal of the user interface as per the usability engineering principles............................4
7. Detailed project requirements......................................................................................................5
8. Identification of alternative solutions..........................................................................................6
9. Expected Outcomes.....................................................................................................................7
10. Identified tasks and a realistic work plan..................................................................................7
10.1 Work Plan............................................................................................................................7
10.2 Gantt chart.........................................................................................................................11
10.3 WBS...................................................................................................................................12
10.4 Cost plan............................................................................................................................12
References..................................................................................................................................15

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1. Background of the project
It is found that prior to the year 1960; all medical records were generally kept on paper
and in different manual filling system. All the reports including diagnoses, visit notes as well as
medical directions are generally written as well as maintained using paper sheets and were
mainly labeled using patient’s last name, security number and other chart numbering system. In
the mid of 1960’s an electronic system was mainly developed by Lockheed and after then other
technology as well as engineering companies generally started developing medical health record
system for hospitals. In the year 1991, institute of medicine generally implemented the result of
the study that was mainly undertaken for studying the utilization of paper record. The report
mainly helps in arguing the case of utilizing EHR as one of the key recommendation that
generally helps in improving the patient’s record. By the year 2004, the requirement of
conversion of various medical records to EHRs was mainly recognized with the creation of ONC
and health information technology. Today, EHR is considered as one of the secure as well as
effective tool that helps in maintaining patient’s health care data in order to communicate with
patients as well as for supporting the patient-physician relationship.
Electronic health record system generally assists in providing accurate as well as up to
date information to the patients. The utilization of EHR system helps in enabling quick access
within the records of the patient for more coordinated as well as efficient care. In addition to this,
use of electronic health record system also helps in securely sharing information of the patients
and further assists providers in properly diagnosing patients, reduce medical errors and more.

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2. Motivation for the project
The motivation for the project is to analyze the potential impact of usability issues of
electronic health record system and to determine systematic steps that are helpful in conducting
proper validation studies. It is identified that validation study generally helps in guiding in order
to provide help and for assuring that the user interface of the application is free from various
types of critical usability issues for supporting error-free user interaction. The project mainly
includes three step procedures that mainly incorporate validation procedure as well as evaluation
for designing human user performance testing as well as for designing evaluation. The procedure
mainly focused on enhancing safe utilization of electronic health record system for increasing the
ease of EHR utilization.
3. Problem statement
It is found that usability is one of the important factors that are generally hindering
widespread adoption of electronic health record system. Poor usability of electronic health record
system generally helps in inhibiting proper utilization of the system and in some extreme cases it
can put the patients in danger. Due to poor as well as cumbersome design of the interfaces, the
users got frustrated which can impact patient health care in a negative way. Improper usability
helps in decreasing clinical productivity, as well assists in enhancing error rate.
4. Scope of the project
The scopes of the project are categorized into in-scope as well as out-scope.
In scope: In scope of the project include:
 Reviewing user interfaces of electronic health record system

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 Testing user interface of electronic health record system
 Designing user interface as per the usability engineering principles
 Completion of project within 3 months
 Completion of project within $40,000
Out-scope: Out-scope of the project includes:
 Project stakeholder involved with the project are not elaborated
 Assumptions associated with the project is not done
5. Project objectives
The objectives of the project are as follows:
 To evaluate and validate procedures for design evaluation and human user
performance testing for an EHR system
 To enhance safe use of electronic health record system
 To increase ease of utilizing electronic health record system by users
6. Analysis of related work/Literature Review
6.1. Review of the EHR’s user interface design
The Electronic Health Record (EHR) has advantage of the design of user interface and
the user experience. According to Zahabi, Kaber, and Swangnetr (2015) there are many principle
that are related with the user interface design of EHR. EHR provides learnability, which ensures
that the software that will be designed will be easy to learn for the workers to start their work fast
with the EHR system. EHR also provides user familiarity, which states that the interface should

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be able to use the concepts and the terms that are drawn from people’s experience who are in
touch with the software. The EHR also provides consistency, which says that the interface of the
EHR must be consistent because the operations with other comparable should also be activated.
The behavior of the software should be common with no surprises while using the software
because the user will have difficulty to use the software (Hanauer et al. 2015). The principle of
EHR also states that the software should have more recoverable capability of the error that is
faced by the users. The interface of the system should give the feedback of all the errors that are
related with the software and should have the guidance to help the user. The system should have
the mechanisms for different types of user. Many safety risks are related to the EHR system.
The first risk comes is the financial risk that may arise while developing the system. The
financial cost including the implementation cost an the adoption cost is much more with EHR
system. There are many hardware and software that are to be implemented while using the
system. Maintenance cost of the system is also very high. The software must be updated from
time to time and the hardware is to be replaced on time basis. There should also be training
describing the system so that the system becomes user friendly. There is another risk that is
associated with the EHR system. The work flow in between the medical staffs and the system
providers is generally disrupted that result in productivity loss for the system. There is also a risk
of having a violation in the data of the patients. In an online system, there always lies a risk of
having data breach in the system. The data that are exchanged electronically can be hacked
which increases the concern related to the information of the patients.
The designs of the EHR have a great efficiency on the health record system. The EHR
improves the organizational efficiency of the health care in which the software is used. The staffs
that use the software can have quick access to all the records of the system. The records of the

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patients are easily accessible and time is being saved while using the software (Meeks et al.
2014). The information of the patients is available to all the staffs at same time which helps to
process and locate the information of the patient efficiently. The EHR system improves the
management of the medical practice. There are automated coding, progress notes in the system
of EHR that make the system more efficient. The headache of paperwork is reduced in using the
electronic system of health management.
6.2. Usability testing of the EHR’s system
According to Pivovarov and Elhadad (2015) to maintain the critical usability issues that
may potentially impact safety of the EHR in implementing AMIA for maintaining the safety of
the patients and produce quality care service to the patients with improved usability. As stated by
Thyvalikakath et al. (2014) the main purpose of AMIA is to stimulate the informed debate,
increase the understanding of usability of effectiveness of health, and helps to give a care of high
quality and a safer quality of work. In usability, the issues that are involved are i) effective and
safe use of the EHR, ii) usability of EHR, and iii) the medical errors that are associated with
EHR usability. Analyses to barriers that are related to physicians and the facilitators, using the
EHR system also suggests the usability system with functionality, hardware support, learning
time, speed, strategies of user development, workarounds, understand the system of EHR, and
typing proficiency. The attributes that are associated with the usability has huge range of
quantitative methods and qualitative methods.
EHRs are generally computerized health information system that are used to store ,
display, and collect the information of the patients. The EHR helps to create organized
recordings and create legible recordings (Nelson and Staggers 2016). EHRs are use to access all
the clinical information of the individual information in the system. There are economic and

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social interests in different countries, the physicians play an important role to use the EHRs.
There are many advantages of using the EHR system and different forms of technology used in
health care systems. Simpao et al. (2014) stated that the health care organizations slowly adopted
the technology of EHR. The lack in readiness mainly causes the weakness in the organization so
that they may undergo the transformation while implementing the technology of EHR. Adoption
in slow rate generally suggests the resistance among the physicians.
A new technology that is to be adopted by the healthcares helps to reduce the time
consumption, reduce the burden of using paper and pen, ad increase the efficiency of the
healthcare. The problems that decreases the efficiency of the system of EHR are misinformation,
misinterpretation, and miscommunication in between the clinic executives, end users, IS leaders,
and vendors, which basically creates barrier in selecting, utilization, marketing, implementation,
and selecting the Electronic Health Record system. From EHR, service co-ordination is expected
so that the quality of the service can be improved with safety of the system (Dinev et al. 2016).
There should be supported developing plan, improve the quality of documentation, increase
efficiency, enhance team communication, and does all the nursing tasks. There is high rate of
adoption of electronic health record in all the health care system. The Institute of Medicine has
adopted the EHR at a very high scale to improve the safety of the patients.
6.3. Proposal of the user interface as per the usability engineering principles
According to Hsiao, Hing and Ashman (2014), a proper interface design for the
electronic health record system will e proposed that helps in addressing several of the usability
deficiencies that are generally associated with electronic health record system. It is identified that
the newly proposed interface will mainly separate data as well as information as per the various
divisions of the healthcare so that the user does not have to invest much time in searching for a

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historical data of a patient (Xhafa et al. 2015). The design also include proper log in facility so
that valid user can only access the information as well as data which further helps in increasing
privacy as well as security of the system. In order to enhance usability of the users, the interface
must include typesetting buttons.
It is stated by Andrus et al. (2015) that proper typesetting buttons helps in providing
more balanced look. The design of the interface is so simple that the cost which is associated
with the design of the interface is very much less. In addition to this, the newly designed
interface so contain the review section which is useful for the users. If the users are facing any
sort of problem related with the electronic health record system then can put a complainant or
suggestion there so that the system can be improved much more (Madden et al. 2016). Moreover,
the interface will include a help option where proper procedure of logging within the system to
checking the health record history is provided so that the patients who do not know the procedure
of operation can be able to get information for accessing their account in order to access proper
information as well as data.
7. Detailed project requirements
The project requirement is mainly divided into functional and non functional
requirement.
Functional project requirement
The functional requirements of the project are as follows:

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Authentication: Proper authentication facility is provided by the electronic health record
system so that data as well as information associated with the patients as well as healthcare can
be stored successfully (Safa, Von Solms and Furnell 2016).
Administrative functions: All the administrative functions are generally managed with
the help of the electronic health record system.
Historical data: With the help of the electronic health record system, the authenticated
members can be able to access the historical data of the patients whenever necessary.
Non-functional project requirement
The non-functional requirements of the project are as follows:
Scalability: The electronic health record system is scalable which means it can
successfully handle various functions of the system for accommodating growth (Kerzner and
Kerzner 2017).
Security: The electronic health record system assists in enhancing privacy as well as
security of patient’s data so that it cannot be misused.
Manageability: All the data as well as information that are associated with the patients
are generally stored as well as managed with the help of electronic health record system so that
the care coordination of the patient will increase (Schwalbe, 2015).
Usability: The usability of the system is improved for enhancing safe use of the
electronic health record system by increasing the utilization of EHR’s by the various users

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8. Identification of alternative solutions
In order to use Electronic health record system safely and for enhancing the ease of use
for the users following solutions need to be followed:
Authentication: Proper authentication facility needs to be provided in order to secure
the data as well as information about the patients (Laudon and Laudon 2016). It is identified that
proper authentication helps in utilizing electronic health record system quite safely without
facing nay problem
Improving usability of the system: The interface usability of the system must be
improved by adopting proper steps as well as methods so that the users can easily use the system
without facing nay problem.
Workforce education and training: In order to safeguard the patient health information,
it is very much necessary for the workforce to implement proper policies as well as security
audits so that the system can be used safely (Safa, Von Solms and Furnell 2016).
Communication with users: Proper communication with the patients is helpful in
implementing steps that are beneficial for the users which further enhance ease for the users.
9. Expected Outcomes
The expected outcomes are as follows:
Enhance usability of the system: The interface usability of electronic health record
system will be improved and as a result the users can be able to use the system without facing
nay difficulty.

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Successful completion of the project within the assumed budget and time: It is
expected that the entire project will be completed within the estimated budget and time by
maintaining the project scope.
Meeting objectives of the project: The project will meet all the objectives of the project
so that the entire system will be improved for providing proper ease of use to the various users.
10. Identified tasks and a realistic work plan
10.1 Work Plan
Task Name Duration Start Finish
Usability of Electronic Health
Record System
120 days Tue 2/27/18 Mon 8/13/18
Initiation phase 10 days Tue 2/27/18 Mon 3/12/18
Developing business case 3 days Tue 2/27/18 Thu 3/1/18
Undertaking feasibility study 2 days Fri 3/2/18 Mon 3/5/18
Establishing project charter 2 days Tue 3/6/18 Wed 3/7/18
Appointing team members of
the project
3 days Thu 3/8/18 Mon 3/12/18
Milestone 1: Completion of
initiation phase
0 days Mon 3/12/18 Mon 3/12/18
Planning phase 18 days Tue 3/13/18 Thu 4/5/18
Creation of project plan 3 days Tue 3/13/18 Thu 3/15/18
Creating resource plan 3 days Fri 3/16/18 Tue 3/20/18