Medical and nursing clinician perspectives on the usability of the hospital electronic medical record: A qualitative analysis

Background: Electronic medical records (EMRs) have been widely implemented in Australian hospitals. Their usability and design to support clinicians to effectively deliver and document care is essential, as is their impact on clinical workflow, safety and quality, communication, and collaboration across health systems. Perceptions of, and data about, usability of EMRs implemented in Australian hospitals are key to successful adoption.

Objective: To explore perspectives of medical and nursing clinicians on EMR usability utilising free-text data collected in a survey.

Method: Qualitative analysis of one free-text optional question included in a web-based survey. Respondents included medical and nursing/midwifery professionals in Australian hospitals (85 doctors and 27 nurses), who commented on the usability of the main EMR used.

Results: Themes identified related to the status of EMR implementation, system design, human factors, safety and risk, system response time, and stability, alerts, and supporting the collaboration between healthcare sectors. Positive factors included ability to view information from any location; ease of medication documentation; and capacity to access diagnostic test results. Usability concerns included lack of intuitiveness; complexity; difficulties communicating with primary and other care sectors; and time taken to perform clinical tasks.

Conclusion: If the benefits of EMRs are to be realised, there are good reasons to address the usability challenges identified by clinicians. Easy solutions that could improve the usability experience of hospital-based clinicians include resolving sign-on issues, use of templates, and more intelligent alerts and warnings to avoid errors.

Implications: These essential improvements to the usability of the EMR, which are the foundation of the digital health system, will enable hospital clinicians to deliver safer and more effective health care.