Report - Drummond Group

Transcription

Test Results Summary for 2014 Edition EHR Certification
Version EHR-Test-144 Rev 01-Nov-2014
ONC HIT Certification Program
Part 1: Product and Developer Information
1.1 Certified Product Information
Product Name:
WritePad EHR
Product Version:
9.0
Domain:
Ambulatory
Test Type:
Complete EHR
1.2 Developer/Vendor Information
Developer/Vendor Name:
Addison Health Systems, Inc.
Address:
4823 Broadway St. Addison, TX 75001
Website:
http://www.writepad.com
Email:
[email protected]
Phone:
1-800-496-2001
Developer/Vendor Contact:
[email protected]
Page 1 of 11
Part 2: ONC-Authorized Certification Body Information
2.1 ONC-Authorized Certification Body Information
ONC-ACB Name:
Drummond Group
Address:
13359 North Hwy 183, Ste B-406-238, Austin, TX 78750
Website:
www.drummondgroup.com
Email:
[email protected]
Phone:
817-294-7339
ONC-ACB Contact:
Bill Smith
This test results summary is approved for public release by the following ONC-Authorized Certification
Body Representative:
Bill Smith
ONC-ACB Authorized Representative
Certification Committee Chair
Function/Title
2/6/2015
Signature and Date
2.2 Gap Certification
The following identifies criterion or criteria certified via gap certification
§170.314
x
(a)(1)
(a)(17)
x
(d)(5)
x
(a)(6)
(b)(5)*
x
(d)(6)
x
(a)(7)
(d)(1)
x
(d)(8)
x
(d)(9)
x
(f)(1)
*Gap certification allowed for Inpatient setting only
No gap certification
Page 2 of 11
2.3 Inherited Certification
The following identifies criterion or criteria certified via inherited certification
§170.314
(a)(1)
(a)(14)
(c)(3)
(f)(1)
(a)(2)
(a)(15)
(d)(1)
(f)(2)
(a)(3)
(a)(16) Inpt. only
(d)(2)
(f)(3)
(a)(4)
(a)(17) Inpt. only
(d)(3)
(f)(4) Inpt. only
(a)(5)
(b)(1)
(d)(4)
(a)(6)
(b)(2)
(d)(5)
(f)(5) Optional &
Amb. only
(a)(7)
(b)(3)
(d)(6)
(a)(8)
(b)(4)
(d)(7)
(f)(6) Optional &
Amb. only
(a)(9)
(b)(5)
(d)(8)
(g)(1)
(a)(10)
(b)(6) Inpt. only
(d)(9) Optional
(g)(2)
(a)(11)
(b)(7)
(e)(1)
(g)(3)
(a)(12)
(c)(1)
(e)(2) Amb. only
(g)(4)
(a)(13)
(c)(2)
(e)(3) Amb. only
x No inherited certification
Page 3 of 11
Part 3: NVLAP-Accredited Testing Laboratory Information
Report Number: JPD-110414-2146
Test Date(s): 4/9/2014, 5/2/2014, 6/12/2014, 10/28/2014, 11/4/2014
3.1 NVLAP-Accredited Testing Laboratory Information
ATL Name:
Drummond Group EHR Test Lab
Accreditation Number:
NVLAP Lab Code 200979-0
Address:
13359 North Hwy 183, Ste B-406-238, Austin, TX 78750
Website:
www.drummondgroup.com
Email:
[email protected]
Phone:
512-335-5606
ATL Contact:
Beth Morrow
For more information on scope of accreditation, please reference NVLAP Lab Code 200979-0.
Part 3 of this test results summary is approved for public release by the following Accredited Testing
Laboratory Representative:
Jim Dow
ATL Authorized Representative
Signature and Date
Test Proctor
Function/Title
Portland OR
Location Where Test Conducted
2/6/2015
3.2 Test Information
3.2.1 Additional Software Relied Upon for Certification
Additional Software
Applicable Criteria
DrFirst Rcopia
a.2, a.8, a.10, b.3
Microsoft Excel
a.14
Functionality provided
by Additional Software
ePrescribing
Exporting
No additional software required
Page 4 of 11
3.2.2 Test Tools
Version
Test Tool
Cypress
x
x
2.4.1
ePrescribing Validation Tool
1.0.4
HL7 CDA Cancer Registry Reporting Validation Tool
1.0.3
HL7 v2 Electronic Laboratory Reporting (ELR) Validation Tool
1.8
x
HL7 v2 Immunization Information System (IIS) Reporting Validation
Tool
1.8
x
HL7 v2 Laboratory Results Interface (LRI) Validation Tool
1.7
x
HL7 v2 Syndromic Surveillance Reporting Validation Tool
1.7
x
Transport Testing Tool
179
x
Direct Certificate Discovery Tool
3.0.2
No test tools required
3.2.3 Test Data
Alteration (customization) to the test data was necessary and is described in
Appendix [insert appendix letter]
No alteration (customization) to the test data was necessary
3.2.4 Standards
3.2.4.1 Multiple Standards Permitted
The following identifies the standard(s) that has been successfully tested
where more than one standard is permitted
Criterion #
Standard Successfully Tested
x
(a)(8)(ii)(A)(2)
x
(a)(13)
§170.204(b)(1)
HL7 Version 3 Implementation
Guide: URL-Based
Implementations of the
Context-Aware Information
Retrieval (Infobutton) Domain
§170.207(a)(3)
IHTSDO SNOMED CT®
International Release July
2012 and US Extension to
SNOMED CT® March 2012
Release
§170.204(b)(2)
Guide: Context-Aware
Knowledge Retrieval
(Infobutton) Service-Oriented
Architecture Implementation
Guide
§170.207(j)
HL7 Version 3 Standard:
Clinical Genomics; Pedigree
Page 5 of 11
Criterion #
Standard Successfully Tested
x
(a)(15)(i)
(a)(16)(ii)
§170.204(b)(1)
Guide: URL-Based
Implementations of the
Context-Aware Information
Retrieval (Infobutton) Domain
§170.210(g)
§170. 210(g)
Network Time Protocol
Version 4 (RFC 5905)
The code set specified at 45
CFR 162.1002(c)(2) (ICD-10CM) for the indicated
conditions
§170.207(i)
(b)(7)(i)
Guide: Context-Aware
Knowledge Retrieval
(Infobutton) Service-Oriented
Architecture Implementation
Guide
§170.207(i)
(b)(2)(i)(A)
§170.204(b)(2)
CFR 162.1002(c)(2) (ICD-10CM) for the indicated
conditions
x
§170.207(a)(3)
IHTSDO SNOMED CT®
Release
x
§170.207(a)(3)
IHTSDO SNOMED CT®
Release
Annex A of the FIPS Publication 140-2
(e)(1)(i)
[list encryption and hashing algorithms]
AES
SHA1
(e)(1)(ii)(A)(2)
§170.210(g)
x
§170. 210(g)
Annex A of the FIPS Publication 140-2
(e)(3)(ii)
[list encryption and hashing algorithms]
AES
SHA1
x
Common MU
Data Set (15)
§170.207(a)(3)
IHTSDO SNOMED CT®
Release
§170.207(b)(2)
CFR 162.1002(a)(5) (HCPCS
and CPT-4)
None of the criteria and corresponding standards listed above are
applicable
3.2.4.2 Newer Versions of Standards
Page 6 of 11
The following identifies the newer version of a minimum standard(s) that
has been successfully tested
Newer Version
Applicable Criteria
No newer version of a minimum standard was tested
3.2.5 Optional Functionality
Criterion #
Optional Functionality Successfully Tested
(a)(4)(iii)
Plot and display growth charts
(b)(1)(i)(B)
Receive summary care record using the standards specified at
§170.202(a) and (b) (Direct and XDM Validation)
(b)(1)(i)(C)
Receive summary care record using the standards specified at
§170.202(b) and (c) (SOAP Protocols)
(b)(2)(ii)(B)
Transmit health information to a Third Party using the standards
specified at §170.202(a) and (b) (Direct and XDM Validation)
(b)(2)(ii)(C)
Transmit health information to a Third Party using the standards
specified at §170.202(b) and (c) (SOAP Protocols)
(f)(3)
Ambulatory setting only – Create syndrome-based public health
surveillance information for transmission using the standard
specified at §170.205(d)(3) (urgent care visit scenario)
Common MU
Data Set (15)
Express Procedures according to the standard specified at
§170.207(b)(3) (45 CFR162.1002(a)(4): Code on Dental Procedures
and Nomenclature)
Common MU
Data Set (15)
Express Procedures according to the standard specified at
§170.207(b)(4) (45 CFR162.1002(c)(3): ICD-10-PCS)
x No optional functionality tested
Page 7 of 11
3.2.6 2014 Edition Certification Criteria* Successfully Tested
Criteria #
Version
TP** TD***
Criteria #
Version
TP
TD
(c)(3)
1.6
(d)(1)
1.2
(a)(1)
1.2
x
(a)(2)
1.2
x
(a)(3)
1.2
1.4
x
(d)(2)
1.5
x
(a)(4)
1.4
1.3
x
(d)(3)
1.3
x
(a)(5)
1.4
1.3
x
(d)(4)
1.3
(a)(6)
1.3
1.4
(d)(5)
1.2
(a)(7)
1.3
1.3
(d)(6)
1.2
x
(a)(8)
1.2
(d)(7)
1.2
x
(a)(9)
1.3
1.3
(d)(8)
1.2
x
(a)(10)
1.2
1.4
(d)(9) Optional
1.2
x
(a)(11)
1.3
x
(e)(1)
1.8
1.5
x
(a)(12)
1.3
x
(e)(2) Amb. only
1.2
1.6
x
(a)(13)
1.2
x
(e)(3) Amb. only
1.3
x
(a)(14)
1.2
(f)(1)
1.2
1.2
x
(a)(15)
1.5
x
(f)(2)
1.3
1.7.1
(a)(16) Inpt. only
1.3
x
(f)(3)
1.3
1.7
(a)(17) Inpt. only
1.2
(f)(4) Inpt. only
1.3
1.7
x
(b)(1)
1.7
1.4
x
(b)(2)
1.4
1.6
(f)(5) Optional &
Amb. only
1.2
1.2
x
(b)(3)
1.4
1.2
x
(b)(4)
1.3
1.4
(f)(6) Optional &
Amb. only
1.3
1.0.3
x
(b)(5)
1.4
1.7
(g)(1)
1.7
1.9
(b)(6) Inpt. only
1.3
1.7
x
(g)(2)
1.7
1.9
x
(b)(7)
1.4
1.6
x
(g)(3)
1.3
x
(c)(1)
1.6
1.6
x
(g)(4)
1.2
x
(c)(2)
1.6
1.6
1.5
x
x
1.2
1.6
No criteria tested
*For a list of the 2014 Edition Certification Criteria, please reference
http://www.healthit.gov/certification (navigation: 2014 Edition Test Method)
**Indicates the version number for the Test Procedure (TP)
***Indicates the version number for the Test Data (TD)
Page 8 of 11
3.2.7 2014 Clinical Quality Measures*
Type of Clinical Quality Measures Successfully Tested:
Ambulatory
x
Inpatient
No CQMs tested
*For a list of the 2014 Clinical Quality Measures, please reference http://www.cms.gov
(navigation: 2014 Clinical Quality Measures)
CMS ID
Version
CMS ID
x
2
v3
x
22
v2
117
x
50
v2
122
x
x
90
Ambulatory CQMs
Version CMS ID
v3
Version
CMS ID
136
155
137
x
138
Version
x
v2
156
v2
157
52
123
139
158
56
124
140
159
61
125
141
160
62
126
142
161
64
127
143
163
128
144
164
129
145
x
165
v2
x
166
v3
65
v3
66
x
68
v3
130
146
x
69
v2
131
147
167
74
132
148
169
75
133
149
177
77
134
153
179
82
135
154
182
CMS ID
Version
CMS ID
Inpatient CQMs
Version CMS ID
Version
CMS ID
9
71
107
172
26
72
108
178
30
73
109
185
31
91
110
188
32
100
111
190
53
102
113
55
104
114
60
105
171
Version
Page 9 of 11
3.2.8 Automated Numerator Recording and Measure Calculation
3.2.8.1 Automated Numerator Recording
Automated Numerator Recording Successfully Tested
(a)(1)
(a)(9)
(a)(16)
(b)(6)
(a)(3)
(a)(11)
(a)(17)
(e)(1)
(a)(4)
(a)(12)
(b)(2)
(e)(2)
(a)(5)
(a)(13)
(b)(3)
(e)(3)
(a)(6)
(a)(14)
(b)(4)
(a)(7)
(a)(15)
(b)(5)
x Automated Numerator Recording was not tested
3.2.8.2 Automated Measure Calculation
Automated Measure Calculation Successfully Tested
x
(a)(1)
x
(a)(9)
(a)(16)
(b)(6)
x
(a)(3)
x
(a)(11)
(a)(17)
x
(e)(1)
x
(a)(4)
x
(a)(12)
x
(b)(2)
x
(e)(2)
x
(a)(5)
x
(a)(13)
x
(b)(3)
x
(e)(3)
x
(a)(6)
x
(a)(14)
x
(b)(4)
x
(a)(7)
x
(a)(15)
x
(b)(5)
Automated Measure Calculation was not tested
3.2.9 Attestation
Attestation Forms (as applicable)
Appendix
x Safety-Enhanced Design*
A
x Quality Management System**
B
x Privacy and Security
C
*Required if any of the following were tested: (a)(1), (a)(2), (a)(6), (a)(7), (a)(8), (a)(16),
(b)(3), (b)(4)
**Required for every EHR product
3.3 Appendices
Attached below.
Page 10 of 11
Test Results Summary Change History
Test Report ID
Description of Change
Date
2014 Edition Test Report Summary
Page 11 of 11
USER CENTER DESIGN REPORT –
TEST REPORT UPDATE
This test report was updated in December 2015 to satisfy User Center Design Report specifications by
ONC.
The new Test Report ID is amended as follows:
“Part 3: NVLAP-Accredited Testing Laboratory Information: Report Number” plus the suffix “_Dec2015”.
APPENDIX A – SAFETEY ENHANCED DESIGN
1
EHR Usability Test Report of
WritePad EHR v.9
Report based on ISO/IEC 25062:2006 Common Industry Format for Usability Test Reports
WritePad EHR v9
Date of Usability Test:
12/16/14-12-23-14
Date of Report:
12/29/14
Report Prepared By:
Ryan Lord
TABLE OF CONTENTS
Table of Contents
TABLE OF CONTENTS ............................................................................................................................................ 1
Executive Summary............................................................................................................................................... 3
CPOE Tasks .................................................................................................................................................... 4
Drug-Drug/Drug-Allergy Interaction Tasks ................................................................................................... 4
Medication List Tasks .................................................................................................................................... 5
Medication Allergy List Tasks ........................................................................................................................ 5
Electronic Prescribing Tasks .......................................................................................................................... 5
Clinical Information Reconciliation Tasks ..................................................................................................... 5
Clinical Decision Support Tasks ..................................................................................................................... 5
Major Findings .................................................................................................................................................. 6
Areas for Improvement..................................................................................................................................... 6
Introduction .......................................................................................................................................................... 6
Method ................................................................................................................................................................. 6
Participants ....................................................................................................................................................... 6
Study Design ..................................................................................................................................................... 7
Tasks ................................................................................................................................................................. 7
Procedures ........................................................................................................................................................ 8
Test Location ..................................................................................................................................................... 8
2
Test Environment.............................................................................................................................................. 8
Test Forms and Tools ........................................................................................................................................ 9
Participant Instructions..................................................................................................................................... 9
Usability Metrics ............................................................................................................................................... 9
Data Scoring ........................................................................................................................................................ 11
Results ................................................................................................................................................................. 13
Data Analysis and Reporting ........................................................................................................................... 13
CPOE Tasks .................................................................................................................................................. 13
Drug-Drug/Drug-Allergy Interaction Tasks ................................................................................................. 13
Medication List Tasks .................................................................................................................................. 13
Medication Allergy List Tasks ...................................................................................................................... 14
Electronic Prescribing Tasks ........................................................................................................................ 14
Clinical Information Reconciliation Tasks ................................................................................................... 14
Clinical Decision Support Tasks ................................................................................................................... 14
Effectiveness ....................................................................................................................................................... 15
Efficiency ............................................................................................................................................................. 15
Satisfaction ......................................................................................................................................................... 15
Major Findings .................................................................................................................................................... 15
Areas for Improvement....................................................................................................................................... 15
Appendices ......................................................................................................................................................... 15
Participant Demographics............................................................................................................................... 15
Informed Consent ........................................................................................................................................... 16
Moderator’s Guide.......................................................................................................................................... 16
Checklist ...................................................................................................................................................... 16
Orientation.................................................................................................................................................. 17
Task 1: Create an electronic prescription. .................................................................................................. 17
Task 2: View Drug-Drug Allergy Alert.......................................................................................................... 18
Task 3: Record Medication Order ............................................................................................................... 18
Task 4: Record Medication Allergy ............................................................................................................. 19
Task 5: Record Medication List ................................................................................................................... 20
Task 6: Change Medication Order .............................................................................................................. 20
Task 7: Change Medication List .................................................................................................................. 21
Task 8: Change Medication Allergy ............................................................................................................. 22
Task 9: Access Medication Order ................................................................................................................ 22
3
Task 10: Access Medication List .................................................................................................................. 23
Task 11: Access Allergy List ......................................................................................................................... 24
Task 12: Adjust Severity Level of Drug-Drug Interactions........................................................................... 24
Task 13: Record Radiology/Imaging Order ................................................................................................. 25
Task 14: Record Lab Order .......................................................................................................................... 26
Task 15: Change Lab Order ......................................................................................................................... 26
Task 16: Change Radiology/Imaging order ................................................................................................. 27
Task 17: Access Radiology/Imaging Order .................................................................................................. 27
Task 18: Access Lab Order .......................................................................................................................... 28
Task 19: Clinical Decision Support – Problem List ...................................................................................... 29
Task 20: Clinical Decision Support – Medication List .................................................................................. 29
Task 21: Clinical Decision Support – Allergy List ......................................................................................... 30
Task 22: Clinical Decision Support – Demographics ................................................................................... 31
Task 23: Clinical Decision Support – Lab Tests............................................................................................ 31
Task 24: Clinical Decision Support – Vital Signs .......................................................................................... 32
Task 25: Clinical Decision Support – Locate Reference Information .......................................................... 33
Task 26: Adjust Clinical Decision Support Settings ..................................................................................... 33
Task 27: Clinical Information Reconciliation – Medication List .................................................................. 34
Task 28: Clinical Information Reconciliation – Allergy List.......................................................................... 35
Task 29: Clinical Information Reconciliation – Problem List ....................................................................... 36
Executive Summary
A usability test of WritePad EHR v9, an ambulatory electronic health record, was conducted between
12/9/2014 and 12/23/2014. The purpose of this test was to test and validate the usability of the current user
interface, and provide evidence of usability in the EHR Under Test (EHRUT).
During the usability test, 5 healthcare providers matching the target demographic criteria served as
participants and used the EHRUT in simulated, but representative tasks.
This study collected performance data on 29 tasks typically conducted on an EHR in these major categories:





CPOE
Drug-drug and Drug-allergy interaction checks
Electronic prescribing
Medication lists
Allergy Lists
4


Clinical information reconciliation
Clinical decision support
During the 90 minute one-on-one usability test, each participate was greeted by the administrator and asked
to review and sign an informed consent/release (Appendix 3) and instructed they could withdraw at any
time. Participants had prior experience with the EHR and received brief instruction prior to completing each
task. The administrator instructed participants to complete a series of tasks (one at a time) using the EHRUT.
During the testing, the administrator timed the test and recorded user data electronically. The administrator
did not give the participant assistance in how to complete the task. Participant screens and audio were
recorded for subsequent analysis.
The following types of data were collected for each participant:






Number of tasks successfully completed within the allotted time without assistance
Time to complete the tasks
Number and types of errors
Path deviations
Participant verbalizations
Participant ratings of the system
All participant data was de-identified – no correspondence could be made from the identity of the participant
to the data collected. Following the conclusion of the testing, participants were asked to complete a post-test
questionnaire. Various recommended metrics, in accordance with the examples set forth in the NIST Guide to
the Processes Approach for Improving the Usability of Electronic Health Records, were used to evaluate the
usability of the EHRUT. Following is a summary of the performance and rating data collected on the EHRUT.
CPOE Tasks
N
Task Success
Task Time
Path
Deviations
Observed
Errors
#
% Succeeded
Mean
SD
Mean
SD
Record Medication Order
5
100.0
47.2
19.8
1
0
0.0
4.2
1.3
Change Medication Order
5
100.0
25.2
11.1
0
0
0.0
5
0.0
Access Medication Order
5
100.0
6.0
2.0
0
0
0.0
5
0.0
Record Laboratory Order
5
100.0
11.2
3.3
1
0
0.0
4.4
1.3
Change Laboratory Order
5
100.0
12.0
3.4
0
0
0.0
5
0.0
Access Laboratory Order
5
100.0
2.6
1.7
0
0
0.0
5
0.0
Record
Radiology/imaging Order
Change
Access Radiology/imaging
Order
5
80.0
13.3
2.6
0
0.2
0.4
4.6
0.9
5
100.0
12.0
2.8
0
0
0.0
5
0.0
5
100.0
2.6
1.7
0
0
0.0
5
0.0
Path
Deviations
Observed
Errors
Mean
SD
Rating
Drug-Drug/Drug-Allergy Interaction Tasks
N
Task Success
#
% Succeeded
Task Time
Mean
SD
Mean
Rating
SD
Mean
SD
5
Create drug-drug and
drug-allergy interventions
prior to CPOE completion
Adjustment of severity
level of drug-drug
interventions
5
100.0
44.0
12.3
0
0
0.0
5
0.0
5
100.0
60.0
18.1
0
0.2
0.4
5
0.0
N
Task Success
Errors
#
% Succeeded
Path
Deviations
Observed
Mean
SD
Mean
SD
Record Medication List
5
100.0
47.2
20.7
1
0
0.0
4.2
0.8
Change Medication List
5
100.0
25.2
12.4
0
0
0.0
4.8
0.5
Access Medication List
5
100.0
6
2.3
0
0
0.0
5
0.0
Path
Deviations
Observed
Errors
Mean
SD
Mean
SD
Medication List Tasks
Task Time
Mean
SD
Rating
Medication Allergy List Tasks
N
Task Success
#
% Succeeded
Task Time
Mean
SD
Rating
Record Allergy List
5
100.0
45.4
10.3
0
0
0.0
4.6
1
Change Allergy List
5
100.0
21
2.9
0
0
0.0
4.8
1
Access Allergy List
5
100.0
6
1.9
0
0
0.0
5
0
Path
Deviations
Observed
Errors
Mean
SD
Mean
SD
1
0.8
0.8
3
1.6
Path
Deviations
Observed
Errors
Mean
SD
Mean
SD
Electronic Prescribing Tasks
Create Electronic
Prescription
N
Task Success
#
% Succeeded
5
60.0
Task Time
Mean
216.3
SD
181.7
Rating
Clinical Information Reconciliation Tasks
Reconcile patient’s active
medication list with
another source
problem list with another
source
medication allergy list
with another source
N
Task Success
Task Time
#
% Succeeded
5
100.0
49.6
27.1
0
0.2
0.4
3.8
0.4
5
100.0
34.6
10.9
0
0.4
0.5
4.2
0.4
5
100.0
29.2
6.7
1
0
0.0
4.2
0.4
Path
Deviations
Observed
Errors
Mean
SD
Mean
SD
0
0
0
5
0
Mean
SD
Rating
Clinical Decision Support Tasks
Problem List
Interventions
N
Task Success
#
% Succeeded
5
100.0
Task Time
Mean
3.8
SD
0.8
Rating
6
Medication List
Interventions
Medication Allergy List
Interventions
Demographics
Interventions
Lab Tests and Results
Interventions
5
100.0
3.8
0.8
0
0
0
5
0
5
100.0
3.8
0.8
0
0
0
5
0
5
100.0
3.8
0.8
0
0
0
5
0
5
100.0
3.8
0.8
0
0
0
5
0
Vital Signs Interventions
Identify User Diagnostic
and Therapeutic
Reference Information
Configuration of CDS
interventions by user
5
100.0
3.8
0.8
0
0
0
5
0
5
100.0
25.2
15.5
0
0
0
5
0
2
100.0
49
5.7
1
0
0
3.5
0.7
Major Findings


Users’ ratings for WritePad EHR v9 fall in the range of systems considered “easy to use.”
All users were able to complete every task successfully, except as noted below.
Areas for Improvement



Users that were unfamiliar with the web interface provided to electronically prescribe failed to send
prescriptions after creating them. Changing this interface is outside of the scope of WritePad EHR,
but additional training materials should be provided when users implement the system.
The New/Edit/Delete buttons in the Orders interface should be more obvious to users, or extraneous
interface elements – such as the empty order window – should be removed until one of these
buttons is clicked or an existing order selected.
A more directed, wizard-style interface should be considered for modifying the Clinical Decision
Support parameters.
Introduction
The EHRUT tested for this study was WritePad EHR v9, an ambulatory EHR designed to present medical
information to healthcare providers in ambulatory settings that focus on physical medicine and
rehabilitation. The EHRUT consists of a client/server application that is installed either in-house at a clinic or
via a hosted remote desktop environment. The usability tested attempted to represent realistic exercises and
conditions.
The purpose of this study was to test and validate the usability of the current user interface, and provide
evidence of usability in the EHR Under Test (EHRUT). To this end, measures of effectiveness, efficiency and
user satisfaction, such the time required to complete typical user tasks, were captured during the usability
testing.
Method
Participants
A total of 5 participants were tested on the EHRUT. Participants in the test were chiropractors and pain
management doctors. Participants were recruited from existing users of the EHR, but had no direct
7
connection to the development or organization producing the EHRUT. Participants were not from the testing
or supplier organization. Participants were given brief instruction on the tasks they were expected to perform
similar to those end users would have received.
For the test purposes, end users of the EHRUT were identified that represented a sample of the EHR user
base. Participant names were replaced with IDs so that individual data could not be tied back to identities.
Five participants were recruited and all were present for the study.
Participants were scheduled for 90 minute sessions to complete the tasks, with each user receiving brief
training on the task at hand prior to testing. This testing was similar to the training each end user would
receive for these tasks.
Study Design
Overall, the objective of this test was to uncover areas where the application performed well – that is,
effectively, efficiently, and with satisfaction – and areas where the application failed to meet the needs of the
participants. The data from this test may serve as a baseline for future tests with an updated version of the
same EHR and/or comparison with other EHRs provided the same tasks are used. In short, this testing serves
as both a means to record or benchmark current usability, but also to identify areas where improvements
must be made.
During the usability test, participants interacted with WritePad EHR v9. Each participant used the same
system that was provided online, and was provided with the same instructions. The system was evaluated for
effectiveness, efficiency and satisfaction as defined by measures collected and analyzed for each participant:






Number of tasks successfully completed within the allotted time without assistance
Time to complete the tasks
Number and types of errors
Path deviations
Participant verbalizations
Participant ratings of the system
Additional information about the various measures can be found in Section 3.9 on Usability Metrics.
Tasks
A number of tasks were constructed that would be realistic and representative of the kinds of activities a user
might do with this EHR, including:





CPOE
o Recording, changing, and accessing medication orders
o Recording, changing, and accessing lab orders
o Recording, changing, and accessing radiology/imaging orders
Drug-drug and Drug-allergy interaction checks
o Interaction with drug-drug and drug-allergy interventions
o Adjustment of the severity level of drug-drug and drug-allergy interventions
Electronic prescribing
o Creating an electronic prescription
Medication lists
o Recording, changing, and accessing medication lists
Allergy Lists
8


o Recording, changing, and accessing allergy lists
Clinical information reconciliation
o Reconciling a patient’s active medication list with another source
o Reconciling a patient’s active allergy list with another source
o Reconciling a patient’s active problem list with another source
Clinical decision support
o Problem list interventions
o Medication list interventions
o Allergy list interventions
o Demographics interventions
o Lab tests and results interventions
o Identifying reference information
o Configuration of the clinical decision support system.
Procedures
Participants were instructed to connect to the remote testing system after their identity was verified.
Participants were then assigned a participant ID. Each participant then reviewed and signed an informed
consent and release form.
The test administrator monitored the test and provided the instructions as well as the tasks. Additionally the
administrator monitored task times, obtained post task rating data, and took notes on participant comments
as well as tracking errors and path deviations. Recordings were made to assist with data collection.
Participants were instructed to perform the tasks (see specific instructions below):



As quickly as possible making as few errors and deviations as possible.
Without assistance; after instructions were provided, the administrator was not allowed to give
further help on the task other than clarification.
Without using a think aloud technique.
Participants received a copy of each task. Timing began once the administrator finished reading the task. The
task time was stopped once the participant indicated they had successfully completed the task. Scoring is
discussed below in Section 3.9.
Following the session, the administrator conducted a post-test interview and thanked each individual for
their participation.
Participants’ information, task success rate, time, errors, deviations, responses, and comments were
recorded into a spreadsheet.
Test Location
Tests were conducted remotely on a controlled system, a typical deployment for WritePad EHR v9 end users.
This setup allowed for control of user data and system speed. Participants were instructed to set aside a time
they would be undisturbed for the test, and each confirmed that this was the case.
Test Environment
The EHRUT would typically be used in a healthcare office or facility. In this instance, the testing was
conducted by allowing users to interact with a computer that they typically use in such a setting. All users
9
were connected to the same instance of a remote, cloud-based deployment. For testing, users connected to
a system running Windows Server 2008 R2 using a mouse and keyboard when interacting with the EHRUT.
Test Forms and Tools
During the usability test, various documents and instruments were used, including:
1. Informed Consent
2. Moderator’s Guide
3. Post-Test Questionnaire
Examples of these documents can be found in Appendices 3-5, respectively. The Moderator’s Guide was
devised so as to be able to capture required data.
The participant’s interaction with the EHRUT was captured and recorded digitally with screen capture
software running on the test machine. Verbal comments were captured using audio recording software.
Participant Instructions
The administrator reads the following instructions aloud to the each participant (also see the full moderator’s
guide in Appendix [B4]):
Thank you for participating in this study. Your input is very important. Our session today will last about 90
minutes. During that time you will use an instance of an electronic health record. I will ask you to complete a
few tasks using this system and answer some questions. You should complete the tasks as quickly as possible
making as few errors as possible. Please try to complete the tasks on your own following the instructions very
closely. Please note that we are not testing you, we are testing the system, therefore if you have difficulty all
this means is that something needs to be improved in the system. I will be here in case you need specific help,
but I am not able to instruct you or provide help in how to use the application during the tasks.
Overall, we are interested in how easy the system is to use, what in it would be useful to you, and how we
could improve it. All feedback is important, so please be honest with your opinions. The session will be
recorded, but all information that you provide will be kept confidential and your name will not be associated
with your comments at any time. Should you feel it necessary you are able to withdraw at any time during the
testing.
For each task, I will read the description to you and say “Begin.” At that point, please perform the task and
say “Done” once you believe you have successfully completed the task. I would like to request that you not
talk aloud or verbalize while you are doing the tasks. I will ask you your impressions about the task once you
are done.
Participants were then given 29 tasks to complete. Tasks are listed in the moderator’s guide in Appendix [B4].
Usability Metrics
According to the NIST Guide to the Processes Approach for Improving the Usability of Electronic Health
Records, EHRs should support a process that provides a high level of usability for all users. The goal is for
users to interact with the system effectively, efficiently, and with an acceptable level of satisfaction. To this
end, metrics for effectiveness, efficiency and user satisfaction were captured during the usability testing. The
goals of the test were to assess:
1. Effectiveness of WritePad EHR v9 by measuring participant success rates and errors
2. Efficiency of WritePad EHR v9 by measuring the average task time and path deviations
3. Satisfaction with WritePad EHR v9 by measuring ease of use ratings.
10
11
Data Scoring
Measures
Effectiveness:
Task Success
Rationale and Scoring
A task was counted as a “Success” if the participant
was able to achieve the correct outcome, without
assistance, on a per task basis.
The total number of successes were calculated for
each task and then divided by the total number of
times that task was attempted. The results are
provided as a percentage.
Task times were recorded for successes. Observed
task times divided by the optimal time for each task
is a measure of optimal efficiency.
Effectiveness:
Task Failures
Optimal task performance time, as benchmarked by
expert performance under realistic conditions, is
recorded when constructing tasks.
If the participant abandoned the task, did not reach
the correct answer or performed it incorrectly, or
reached the end of the allotted time before
successful completion, the task was counted as a
“Failure.”
No task times were taken for errors.
The total number of errors was calculated for each
task and then divided by the total number of times
that task was attempted. Not all deviations would
be counted as errors.
This should also be expressed as the mean number
of failed tasks per participant. On a qualitative
level, an enumeration of errors and error types
should be collected.
12
Measures
Efficiency:
Task Deviations
Efficiency:
Task Time
Satisfaction:
Task Rating
Rationale and Scoring
The participant’s path (i.e., steps) through the
application was recorded. Deviations occur if the
participant, for example, went to a wrong screen,
clicked on an incorrect menu item, followed an
incorrect link, or interacted incorrectly with an onscreen control. This path was compared to the
optimal path. The number of steps in the observed
path is divided by the number of optimal steps to
provide a ratio of path deviation.
It is strongly recommended that task deviations be
reported. Optimal paths (i.e., procedural steps)
should be recorded when constructing tasks.
Each task was timed from when the administrator
said “Begin” until the participant said, “Done.” If he
or she failed to say “Done,” the time was stopped
when the participant stopped performing the task.
Only task times for tasks that were successfully
completed were included in the average task time
analysis. Average time per task was calculated for
each task. Variance measures (standard deviation
and standard error) were also calculated.
Participant’s subjective impression of the ease of
use of the application was measured by
administering both a simple post-task question as
well as a post-session questionnaire. After each
task, the participant was asked to rate “Overall, this
task was:” on a scale of 1 (Very Difficult) to 5 (Very
Easy). These data are averaged across participants.
Common convention is that average ratings for
systems judged easy to use should be 3.3 or above.
To measure participants’ confidence in and
likeability of the WritePad EHR v9 overall, the
testing team administered the System Usability
Scale (SUS) post-test questionnaire. Questions
included, “I think I would like to use this system
frequently,” “I thought the system was easy to use,”
and “I would imagine that most people would learn
to use this system very quickly.” See full System
Usability Score questionnaire in Appendix 5.1
13
Results
Data Analysis and Reporting
The results of the usability test were calculated according to the methods specified in the Usability Metrics
section above. No participants failed to follow session and task instructions and had their data excluded from
the analyses.
The usability testing results for the EHRUT are detailed below.
The results should be seen in light of the objectives and goals outlined in Section 3.2 Study Design. The data
should yield actionable results that, if corrected, yield material, positive impact on user performance.
CPOE Tasks
N
Task Success
Task Time
Path
Deviations
Observed
Errors
#
% Succeeded
Mean
SD
Mean
SD
Record Medication Order
5
100.0
47.2
19.8
1
0
0.0
4.2
1.3
Change Medication Order
5
100.0
25.2
11.1
0
0
0.0
5
0.0
Access Medication Order
5
Record Laboratory Order
5
100.0
6.0
2.0
0
0
0.0
5
0.0
100.0
11.2
3.3
1
0
0.0
4.4
1.3
Change Laboratory Order
5
100.0
12.0
3.4
0
0
0.0
5
0.0
Access Laboratory Order
5
100.0
2.6
1.7
0
0
0.0
5
0.0
Record
Change
Access Radiology/imaging
Order
5
80.0
13.3
2.6
0
0.2
0.4
4.6
0.9
5
100.0
12.0
2.8
0
0
0.0
5
0.0
5
100.0
2.6
1.7
0
0
0.0
5
0.0
Path
Deviations
Observed
Errors
Mean
SD
Mean
SD
Mean
SD
Rating
Drug-Drug/Drug-Allergy Interaction Tasks
N
Task Success
#
% Succeeded
5
100.0
44.0
12.3
0
0
0.0
5
0.0
5
100.0
60.0
18.1
0
0.2
0.4
5
0.0
N
Task Success
Errors
#
% Succeeded
Path
Deviations
Observed
Mean
SD
Mean
SD
Record Medication List
5
100.0
47.2
20.7
1
0
0.0
4.2
0.8
Change Medication List
5
100.0
25.2
12.4
0
0
0.0
4.8
0.5
Access Medication List
5
100.0
6
2.3
0
0
0.0
5
0.0
Create drug-drug and
drug-allergy interventions
prior to CPOE completion
Adjustment of severity
level of drug-drug
interventions
Task Time
Mean
SD
Rating
Medication List Tasks
Task Time
Mean
SD
Rating
14
Medication Allergy List Tasks
N
Task Success
Task Time
Path
Deviations
Observed
Errors
#
% Succeeded
Mean
SD
Mean
SD
Record Allergy List
5
100.0
45.4
Change Allergy List
10.3
0
0
0.0
4.6
1
5
100.0
Access Allergy List
21
2.9
0
0
0.0
4.8
1
5
100.0
6
1.9
0
0
0.0
5
0
Path
Deviations
Observed
Errors
Mean
SD
Mean
SD
1
0.8
0.8
3
1.6
Path
Deviations
Observed
Errors
Mean
SD
Mean
SD
Mean
SD
Rating
Electronic Prescribing Tasks
Create Electronic
Prescription
N
Task Success
#
% Succeeded
5
60.0
Task Time
Mean
216.3
SD
181.7
Rating
Clinical Information Reconciliation Tasks
medication list with
another source
problem list with another
source
medication allergy list
with another source
N
Task Success
Task Time
#
% Succeeded
5
100.0
49.6
27.1
0
0.2
0.4
3.8
0.4
5
100.0
34.6
10.9
0
0.4
0.5
4.2
0.4
5
100.0
29.2
6.7
1
0
0.0
4.2
0.4
Path
Deviations
Observed
Errors
Mean
SD
Mean
SD
Mean
SD
Rating
Clinical Decision Support Tasks
N
Task Success
Task Time
#
% Succeeded
Problem List
Interventions
Medication List
Interventions
Medication Allergy List
Interventions
Demographics
Interventions
Lab Tests and Results
Interventions
5
100.0
3.8
0.8
0
0
0
5
0
5
100.0
3.8
0.8
0
0
0
5
0
5
100.0
3.8
0.8
0
0
0
5
0
5
100.0
3.8
0.8
0
0
0
5
0
5
100.0
3.8
0.8
0
0
0
5
0
Vital Signs Interventions
Identify User Diagnostic
and Therapeutic
Reference Information
Configuration of CDS
interventions by user
5
100.0
3.8
0.8
0
0
0
5
0
5
100.0
25.2
15.5
0
0
0
5
0
2
100.0
49
5.7
1
0
0
3.5
0.7
Mean
SD
Rating
15
Effectiveness
All users were able to complete every task successfully other than the following:


Create electronic prescription
Record radiology/imaging order
These tasks reflected the unfamiliarity of some users with the web interface in the electronic prescribing
prescription. One participant had difficulty with the lab interface when attempting to use it for the first time,
unable to remember to click the “New” button to create a new order.
Efficiency
All tasks were completed by all users in a reasonable time. Improvement in task completion time would be
expected as users repeated tasks.
Satisfaction
The results from the SUS (System Usability Scale) scored the subjective satisfaction with the system based on
performance with these tasks to be between 60 and 100%, with only three tasks falling below 80%. Broadly
interpreted, scores under 60 represent systems with poor usability; scores over 80 would be considered
above average.
Major Findings


Users’ ratings for WritePad EHR v9 fall in the range of systems considered “easy to use.”
All users were able to complete every task successfully, except as noted below.
Areas for Improvement



Users that were unfamiliar with the web interface provided to electronically prescribe failed to send
prescriptions after creating them. Changing this interface is outside of the scope of WritePad EHR,
but additional training materials should be provided when users implement the system.
The New/Edit/Delete buttons in the Orders interface should be more obvious to users, or extraneous
interface elements – such as the empty order window – should be removed until one of these
buttons is clicked or an existing order selected.
A more directed, wizard-style interface should be considered for modifying the Clinical Decision
Support parameters.
Appendices
Participant Demographics
Gender
16
Men
Women
Total Participants
4
1
5
Occupation/Role
Provider – MD-PMR
Provider – Multidisciplinary
Provider – Chiropractic
Total Participants
1
1
3
5
Informed Consent
Addison Health Systems, Inc. would like to thank you for participating in this study. The purpose of this study
is to evaluate an electronic health records system. If you decide to participate, you will be asked to perform
several tasks using the prototype and give your feedback. The study will last about 90 minutes.
Agreement
I understand and agree that as a voluntary participant in the present study conducted by Addison Health
Systems, Inc. I am free to withdraw consent or discontinue participation at any time. I understand and agree
to participate in the study conducted and recorded by Addison Health Systems, Inc. I understand and consent
to the use of the recording by Addison Health Systems, Inc. I understand that the information and recording
is for research purposes only and that my name and image will not be used for any purpose other than
research. I relinquish any rights to the recording and understand the recording may be copied and used by
Addison Health Systems, Inc. without further permission.
I understand and agree that the purpose of this study is to make software applications more useful and
usable in the future. I understand and agree that the data collected from this study may be shared with
outside of Addison Health Systems, Inc. and Addison Health Systems, Inc.’s clients. I understand and agree
that data confidentiality is assured, because only de-identified data – i.e., identification numbers not names –
will be used in analysis and reporting of the results.
I agree to immediately raise any concerns or areas of discomfort with the study administrator. I understand
that I can leave at any time.
Please check one of the following:
 YES, I have read the above statement and agree to be a participant.
 NO, I choose not to participate in this study.
Signature:
Date:
Moderator’s Guide
Checklist


Prior to testing
o Confirm schedule with Participants
o Ensure EHRUT lab environment is running properly
o Ensure lab and data recording equipment is running properly
Prior to each participant:
o Reset application
17



o Start session recordings with Go To Meeting
Prior to each task:
o Reset application to starting point for next task
After each participant:
o End session recordings with Go To Meeting
After all testing
o Back up all recording and data files
Orientation
Thank you for participating in this study. Our session today will last about 90 minutes. During that time you
will take a look at an electronic health record system. I will ask you to complete a few tasks using this system
and answer some questions. We are interested in how easy (or how difficult) this system is to use, what in it
would be useful to you, and how we could improve it. You will be asked to complete these tasks on your own
trying to do them as quickly as possible with the fewest possible errors or deviations. Do not do anything
more than asked. If you get lost or have difficulty, I cannot answer questions nor help you with anything to do
with the system itself. Please save your detailed comments until the end of a task or the end of the session as
a whole when we can discuss freely.
Your feedback is being collected to improve the system, so please be honest with your opinions.
The product you will be using today is version 9 of the WritePad EHR. Some of the data may not make sense
as it is placeholder data. We are recording the audio and screenshots of our session today. All of the
information that you provide will be kept confidential and your name will not be associated with your
comments at any time.
Do you have any questions or concerns?
Task 1: Create an electronic prescription.
Take the participant to the patient select screen.
The patient needs a prescription for 100mg of Advil. Please create and electronically send this prescription.
Success?
Comments
Time (seconds)
Optimal Path
Select Patient Open Summary Screen Open Prescriptions  eRx button  Search medication name 
Select Medication  Confirm SIG  Confirm Prescription Creation  Enter signature password  Send
button
Deviations/Observations
Errors and Verbalizations
Comments
18
Rating
Score
Administrator Notes
Notes and Comments
Task 2: View Drug-Drug Allergy Alert
The patient needs a prescription for 100mg of Advil, but is allergic to ibuprofen. Please trigger this alert.
Success?
Comments
Time (seconds)
Optimal Path
Select Patient Open Summary Screen Open Prescriptions  eRx button  Search medication name 
Select Medication  View Alert
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 3: Record Medication Order
The patient is currently taking 2 ml of morphine. Please add this item to the patient’s active medication list.
Success?
Comments
Time (seconds)
19
Optimal Path
Select Patient Open Summary Screen Open Prescriptions  eRx button  Manage Medications 
Search medication name  Select Medication  Confirm SIG  Continue button
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 4: Record Medication Allergy
The patient is allergic to sulfa. Please add this item to the patient’s active allergy list.
Success?
Comments
Time (seconds)
Optimal Path
Select Patient Open Summary Screen Open Prescriptions  eRx button  Manage Allergies  Search
allergy name  Confirm Allergy selection  Continue button
Comments
Rating
20
Score
Administrator Notes
Notes and Comments
Task 5: Record Medication List
The patient is currently taking 2 ml of morphine. Please add this item to the patient’s active medication list.
Success?
Comments
Time (seconds)
Optimal Path
Select Patient Open Summary Screen Open Prescriptions  eRx button  Manage Medications 
Search medication name  Select Medication  Confirm SIG  Continue button
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 6: Change Medication Order
Take the participant to the prescribe screen.
The patient is currently taking 2 ml of morphine. Please change this to 4 ml of morphine.
Success?
Comments
Time (seconds)
21
Optimal Path
Manage Medications  Modify on morphine  Change to 4 ml  Continue
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 7: Change Medication List
The patient is currently taking 2 ml of morphine. Please change this to 4 ml of morphine.
Success?
Comments
Optimal Path
Manage Medications  Modify on morphine  Change to 4 ml  Continue
Comments
Rating
Score
Time (seconds)
22
Administrator Notes
Notes and Comments
Task 8: Change Medication Allergy
The patient is allergic to sulfa. Add the reaction “difficulty breathing” to this allergy.
Success?
Comments
Time (seconds)
Optimal Path
Manage Allergies  Modify on sulfa  Select reaction: difficulty breathing  Continue
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 9: Access Medication Order
View the patient’s active medication orders.
Success?
Optimal Path
Comments
Time (seconds)
23
Select Patient Open Summary Screen Open Prescriptions
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 10: Access Medication List
Take the participant to the Patient Select Screen.
View the patient’s active medication list.
Success?
Comments
Optimal Path
Select Patient Open Summary Screen Open Prescriptions
Comments
Rating
Score
Administrator Notes
Time (seconds)
24
Notes and Comments
Task 11: Access Allergy List
View the patient’s active medication allergies.
Success?
Comments
Time (seconds)
Optimal Path
Select Patient Open Summary Screen Open Allergies
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 12: Adjust Severity Level of Drug-Drug Interactions
Adjust the options so that your practice location will only see drug-drug contraindication warnings.
Success?
Comments
Time (seconds)
Optimal Path
Additional Options  Preferences --- Location  Change drug-drug interventions to “Contraindicated Only”
 Click “Make Changes”
25
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 13: Record Radiology/Imaging Order
The patient is to be scheduled for a lumbar MRI. Please record this order.
Success?
Comments
Time (seconds)
Optimal Path
Select Patient Orders tab  New button  Select “Lumbar MRI”  Select “Radiology” checkbox  Save
button
Comments
Rating
Score
Administrator Notes
Notes and Comments
26
Task 14: Record Lab Order
The patient is to be scheduled for a CBC. Please create this lab order.
Success?
Comments
Time (seconds)
Optimal Path
Select Patient Orders tab  New button  Select “CBC Lab”  Save button
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 15: Change Lab Order
The patient’s lab order has been completed. Please indicate that the order is complete.
Success?
Comments
Time (seconds)
Optimal Path
Select Patient Orders tab  Select “CBC Lab”  Edit button  Change status to “Completed”  Save
button
27
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 16: Change Radiology/Imaging order
The patient’s radiology order has been completed. Please indicate that the order is complete.
Optimal Path
Select Patient Orders tab  Select “Lumbar MRI”  Edit button  Change status to “Completed”  Save
button
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 17: Access Radiology/Imaging Order
28
Please access the patient’s list of radiology/imaging orders.
Success?
Comments
Time (seconds)
Optimal Path
Select Patient  Orders tab
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 18: Access Lab Order
Please access the patient’s list of lab orders.
Success?
Comments
Optimal Path
Select Patient Orders tab
Comments
Time (seconds)
29
Rating
Score
Administrator Notes
Notes and Comments
Task 19: Clinical Decision Support – Problem List
Please complete the patient’s visit and make note of any clinical decision support alerts related to the
patient’s problem list.
Success?
Comments
Time (seconds)
Optimal Path
Select Patient Open Summary Screen  Update button  View CDS alerts
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 20: Clinical Decision Support – Medication List
patient’s medication list.
30
Success?
Comments
Time (seconds)
Optimal Path
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 21: Clinical Decision Support – Allergy List
patient’s allergy list.
Success?
Comments
Optimal Path
Comments
Time (seconds)
31
Rating
Score
Administrator Notes
Notes and Comments
Task 22: Clinical Decision Support – Demographics
patient’s demographics.
Success?
Comments
Time (seconds)
Optimal Path
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 23: Clinical Decision Support – Lab Tests
patient’s lab tests and results.
32
Success?
Comments
Time (seconds)
Optimal Path
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 24: Clinical Decision Support – Vital Signs
patient’s vital signs.
Success?
Comments
Optimal Path
Comments
Time (seconds)
33
Rating
Score
Administrator Notes
Notes and Comments
Task 25: Clinical Decision Support – Locate Reference Information
Please complete the patient’s visit and make note of any clinical decision support alerts related to the visit.
Locate the reference information for these alerts.
Success?
Comments
Time (seconds)
Optimal Path
Select Patient Open Summary Screen  Update button  View CDS alerts  Info button  Scroll to
reference information.
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 26: Adjust Clinical Decision Support Settings
34
Adjust the clinical decision support parameters so that alerts are triggered when a patient has a systolic blood
pressure of 200.
Success?
Comments
Time (seconds)
Optimal Path
Select Patient Settings menu Clinical Decision Support  Select Vital Signs alert  Edit button 
Change systolic blood pressure to 200  Save button
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 27: Clinical Information Reconciliation – Medication List
Import a CCDA file for a patient and reconcile the patient’s medication list with the current information in the
EHR. Select the first medication from each list to be included in the final list.
Success?
Comments
Time (seconds)
Optimal Path
Select Patient  Labs/Xfers tab  Clinical Reconciliation  Import CCDA button  Browse to file  Open
button  Medications button  Select CCDA Medication list item 1  Add to Final List button  Select
Existing Medication list item 2  Add to Final List button  Save button
35
Comments
Rating
Score
Administrator Notes
Notes and Comments
Task 28: Clinical Information Reconciliation – Allergy List
Import a CCDA file for a patient and reconcile the patient’s allergy list with the current information in the
EHR. Select the first allergy from each list to be included in the final list.
Success?
Comments
Time (seconds)
Optimal Path
button  Allergies button  Select CCDA Allergies list item 1  Add to Final List button  Select Existing
Allergy list item 2  Add to Final List button  Save button
Comments
Rating
Score
Administrator Notes
Notes and Comments
36
Task 29: Clinical Information Reconciliation – Problem List
Import a CCDA file for a patient and reconcile the patient’s problem list with the current information in the
EHR. Select the first problem from each list to be included in the final list.
Success?
Comments
Time (seconds)
Optimal Path
button  Problem list button  Select CCDA problem list item 1  Add to Final List button  Select Existing
problem list item 2  Add to Final List button  Save button
Comments
Rating
Score
Administrator Notes
Notes and Comments
APPENDIX B – QUALITY MANAGEMENT SYSTEM
APPENDIX C – PRIVACY AND SECURITY

Report - Drummond Group

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