CCHIT EHR Certification Enters EMR Usability World

I’ve been sitting on this post for a while. I figured it was finally time that we talked an interesting development in the CCHIT EHR certification: EMR usability testing. They first presented some of the details of this testing during the CCHIT training meeting. However, they also partnered with User Centric to formulate their EHR user testing and EMR and HIPAA has had a nice connection with User Centric for a few months now.

First the good. I’m glad that CCHIT is venturing into the realm of EHR usability testing. I’ve often talked about CCHIT Certification being rather useless since just because a piece of software does a certain function doesn’t mean that it does it well or that the EMR is usable. In fact, some of the most “feature rich” EMR software is completely unusable by the majority of people. Kind of reminds me of the days of terminals. If you knew the key strokes, it was incredibly efficient. However, learning the keystrokes was so much harder than a nice graphical interface which could do the same things. Not a perfect comparison, but interesting to consider.

So, the biggest problem with CCHIT measuring an EMR’s usability is that the EMR usability rating does NOT affect the certification outcome. Also, it appears that it will be up to the EMR vendor whether they want this result published or not. I wonder if we’ll get to a place where a few EMR vendors show their usability rating and others don’t. Those that don’t we’ll have to assume scored poorly? We’ll see how all that plays out.

I admit I haven’t looked over the entire EMR usability rating process. So, I can’t say if the process is complete or effective in and of itself. Although, I do have some confidence in User Centric as a company even if they’re trying to bite off the very difficult task of measuring EMR usability.

It does look like they’ll give the EMR software a usability rating that is not just a pass fail score. A rating is a much better thing when we’re talking about a somewhat abstract concept of software usability.

I’m also concerned about the quality of the jurors that they’ll use to try and measure usability. I’m sure they’re great people with great intentions. Honestly, that’s one of the most redeeming qualities of CCHIT. They have a large base of volunteers that are very well meaning. However, I’m not sure how much confidence I have in their ability to rate a software’s usability. For that matter, I’m not sure how well I’d be able to do it and I think I’m pretty familiar with the subject.

In a related issue, when you look at the way their putting together the score, it seems pretty complicated at first look. Like I said, I don’t know the details of the methodology. However, that’s kind of the point. Even if CCHIT does post an EMR vendor’s usability score, will the listening public (Translation: doctors) be able to quickly and easily understand what that score means? Maybe it’s a simple thing to figure out. We’ll see, but the devils always in the details and if I’m selecting an EMR I want it to be usable. So, I’ll be very interested in an EMR’s usability score.

Those are just a few things I noticed with the new CCHIT EHR Usability additions. Is there some other parts of it I missed? Anything else we should know about it? Will this be a valuable addition to the CCHIT Certification? Will EMR vendors revolt against it?

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Usability for a Primary Care Provider and a Dermatologist are vastly different things
    I have spoken to lots of different physicians in a lot of different specialties, and what makes an EMR usable for one practice is not the same of another, especially when you move into the realm of specialty specific medicine. I don’t know many derms that do height, weight, head circumforance for a 2 year old with a rash, but the PCP/Pediatrician would. The same is said for an orthopaedic provider who asks a 50 year old woman if she has had an annual mammogram.

    Even if there is a “Usability Score” provided bt CCHIT, I would encourge all physicians to not jump at the numbers, review the software and see if it meets your individual needs.

  • A certification agency should consider having the various EMR vendors to agree to a more-or-less common application front end. There’s no reason for not sharing a common basic look-and-feel to a degree, so that providers could be somewhat comfortable regardless of the vendor.

  • David,
    I’ve heard this suggestion before. What I haven’t heard is a way that this would actually work and take into account all of the various specialties (for example). Even within the same specialties doctors practice medicine in very different ways. I just don’t see a cookie cutter front end working. I’d love to hear how it could.

  • The usability of a system can not be considered after the system is built and implemented. The needs of the users need to be determined prior to designing the system and the design needs to reflect those requirements. There is a methodology for designing and testing the EMR before it is built. To test it after it is built (like closing the barn door after the horse already got out) will result in a lot of unusable systems being implemented and waiting for “the next version”.

  • Ann,
    Certainly if you’re designing a system that’s the case. However, it’s reasonable to test an EMR system for usability after it’s been built. In fact, if you can do it effectively, then hopefully it can indicate to buyers which EMR systems didn’t plan for it during the design of the system.

    The problem is if this information isn’t disseminated or if the analysis isn’t done correctly.

  • How do you test a sprinter to see if he is good? You have him run a race!

    The only way to test EMR usablity is to train the doctors and then have them see a series of patients and see which EMR performs the best. Period.

    Easy to use, simple to learn, efficient, quick and makes the doctor more productive and efficient.

    How long does it take the doctor to see the patient, provide excellent care, document the note, write the prescriptions and do everything else they need to do. This is usability. This is how you test EMRs.

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