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EMR Design Principles Cheat Sheet (DRAFT) by [deleted]

Principles for Designing an EMR

This is a draft cheat sheet. It is a work in progress and is not finished yet.


The American Medical Inform­atics Associ­ation Task Force on Usability has laid out 14 usability principles for the design of electronic medical records as part of its report on enhancing patient safety by improving usability of EHR systems in the Journal of the American Medical Inform­atics Associ­ation.

The Princi­ples, according to the AMIA

1. Con­sis­tency: Design consis­tency & standards utiliz­ation
2. Visibi­lity: System state visibility
3. Match: System & world match
4. Minima­lism; Minimalist design
5. Memory: Memory load minimi­zation
6. Feedback: Inform­ative feedback
7. Fle­xib­ility: Flexible & custom­izable
8. Mes­sage: Useful error messages
9. Error : Use error prevention
10. Closure: Clear closure
11. Re­ver­sib­ility: Reversible actions
12. La­nguage: User language utiliz­ation
13. Control: User control
14. Do­cum­ent­ation: Help & docume­ntation

EMR Usability Principles

The following principles of software usability can be applied directly to the develo­pment and evaluation of EHR/EMR systems:

1. Simplicity
2. Natura­lness
3. Consis­tency
4. Forgiv­eness & Feedback
5. Effective Use of Language
6. Efficient Intera­ctions
7. Effective Inform­ation Presen­tation
8. Preser­vation of Context
9. Minimize Cognitive Load

EHR/EMR Usability Attributes

Ways to Improve Usability

An American Medical Inform­atics Associ­ation Task Force on Usability recomm­ended 10 ways to improve the usability of electronic health record systems in the Journal of the American Medical Inform­atics Associ­ation.

The task force, which included repres­ent­atives from academia, clinical settings and industry, aimed to increase safety and quality through improved usability of EHR systems. They examined the litera­ture, vendor experi­ences with EHR design, implem­ent­ations and made 10 recomm­end­ations across four areas: human factors health inform­ation technology research, health IT policy, industry and the clinician end-user of EHR software.

Usability Recomm­end­ations

Human factors health IT research
1. Prioritize standa­rdized use cases.
2. Develop a core set of measures for adverse events related to health IT use.
3. Research and promote best practices for safe implem­ent­ation of EHR.
Health IT policy
4. Standa­rdi­zation and intero­per­ability across EHR systems should take account of usability concerns.
5. Establish an adverse event reporting system for health IT and voluntary health IT event reporting.
6. Develop and dissem­inate an educat­ional campaign on the safe and effective use of EHR.
7. Develop a common user interface style guide for select EHR functi­ona­lities.
8. Perform formal usability assess­ments on patien­t-s­afety sensitive EHR functi­ona­lities.
Clinical end-user
9. Adopt best practices for EHR system implem­ent­ation and ongoing manage­ment.
10. Monitor how IT systems are used and report IT-related adverse events.