A new guide from the National Institute of Standards and Technology (NIST) aims to make EHRs more usable and safer.

The guide outlines ways to identify critical areas of risk and methods for improving user-centered design. The organization presents an "empirical rationale" to drive standardized patient safety-focused usability guidelines and offers recommendations to eliminate "never events" and associated patient harm by working proactively to mitigate root causes of EHR use errors caused by suboptimal design and implementation.

"The ultimate goal is to drive and empower effective and safe human performance in the use of EHRs," NIST officials wrote. 

The researchers used five different methods of data collection and found three major problems associated with EHRs causing suboptimal and unsafe patient care: identification of information, consistency of information; integrity of information. Recurring issues include unintended actions; the likelihood of use errors; and a "high level" of user frustration.

"Ultimately, the data from this study demonstrate that during safety-critical tasks and times, patient safety is negatively affected, in part because mistakes and critical use errors occur more frequently and because users are highly frustrated, and thus more likely to employ workarounds, such as relying upon supplemental artifacts, e.g., paper ‘shadow charts’ or whiteboards," according to the guide.

Access the guide.