8 seconds or less: How physician input improved usability

  • Jeanne Armstrong, M.D.
  • 05/24/2016

Physician input is vital for good Health IT design. The only way we can continue to improve adoption, usability – and ultimately patient safety – is to engage users early, often and through all stages of software design.

Involving users is one of the guiding principles of Allscripts’ user-centered design (UCD) process, the subject of a recent white paper. When building new products or improving existing solutions, we follow those best practices.

Formative testing catches mistakes before it’s too late

All too often, users don’t get a chance to weigh in until Health IT solutions are about to be released. But we take great care to conduct formative testing for our new features and solutions. This type of testing occurs with early versions of solutions, such as wireframes, sketches or prototypes.

Designers hold one-on-one sessions with actual users. They provide real-world scenarios or tasks and observe actual users as they interact with the product. Designers carefully record observations and suggestions for improvement. A great example is testing the Allscripts TouchWorks® EHR immunization feature with physicians.

Enabling physicians to complete navigation tasks in 8 seconds or less

At the end of 2015, Allscripts released a new version of TouchWorks EHR. The prior two releases focused on meeting government regulations, such as Meaningful Use Stage 2 and Electronic Prescribing of Controlled Substances (EPCS). In this version, we were able to more fully address usability issues.

For example, we conducted formative testing with physicians about the new immunization feature. One early round of testing involved physicians who completed a series of five tasks, such as identifying the number of doses given.

The goal was to enable users to complete each task in less than eight seconds and achieve a Subjective Usability Score (SUS) rating of 85 or greater. Users were able to complete tasks within the target time and the average SUS rating was 97.5.

However, the testing also identified some confusion with a specific notification that led to re-wording the alert for clarity. This feedback is extremely valuable in our efforts to continuously improve.

Making strides toward better usability

Formative testing is where we make the greatest strides with usability, not demos. We’ve found that about 40% of all usability issues related to patient safety are caught during formative testing, and this early feedback enables our team to correct these issues before releasing the product.

To learn more about our user-centered design practices, download this free white paper.

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About the author

Jeanne Armstrong, M.D., is director of solutions management for Allscripts TouchWorks® EHR and is a practicing physician at Hendricks Regional Health Immediate Care (Avon, Indiana, U.S.A.).With more than a decade of experience in healthcare IT, Dr. Armstrong has in-depth knowledge in EHR training, system configuration, content development and change management. Dr. Armstrong is board certified in Family Medicine and Clinical Informatics and completed her family medicine residency at St. Vincent Hospital in Indianapolis, Indiana. At St Vincent, she designed and facilitated a physician training program and support process for a community-based academic medical center with four (eventually five) residency programs, overhauled workflow and content to create a paperless immediate care, developed system content for multiple specialties, and helped facilitate an electronic data conversion between competing EHR systems. Dr. Armstrong earned a Certificate in Clinical Informatics, Clinician Leader from Indiana University, earned her medical degree from Indiana University School of Medicine, and holds a bachelor’s degree from Franklin College of Indiana.


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