Test Results Summary for 2014 Edition EHR Certification Version EHR-Test-144 Rev 17-Feb-2014
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ONC HIT Certification Program
Test Results Summary for 2014 Edition EHR Certification
Part 1: Product and Developer Information
1.1 Certified Product Information
Product Name: Cyfluent
Product Version: 3.1
Domain: Ambulatory
Test Type: Complete EHR
1.2 Developer/Vendor Information
Developer/Vendor Name: Cyfluent
Address: 400 East Joppa Road Towson MD 21286
Website: www.cyfluent.com
Email: [email protected]
Phone: 410-823-2201
Developer/Vendor Contact: Larry Walsh
Test Results Summary for 2014 Edition EHR Certification Version EHR-Test-144 Rev 17-Feb-2014
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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
Certification Committee Chair
ONC-ACB Authorized Representative Function/Title
6/20/2014
Signature and Date
2.2 Gap Certification
The following identifies criterion or criteria certified via gap certification
§170.314
(a)(1) (a)(17) (d)(5) (d)(9)
(a)(6) (b)(5)* (d)(6) (f)(1)
(a)(7) (d)(1) (d)(8)
*Gap certification allowed for Inpatient setting only
x No gap certification
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2.3 Inherited Certification
The following identifies criterion or criteria certified via inherited certification
§170.314
x (a)(1) x (a)(14) (c)(3) x (f)(1)
x (a)(2) x (a)(15) x (d)(1) x (f)(2)
x (a)(3) (a)(16) Inpt. only x (d)(2) x (f)(3)
x (a)(4) (a)(17) Inpt. only x (d)(3) (f)(4) Inpt. only
x (a)(5) x (b)(1) x (d)(4)
(f)(5) Optional & Amb. only x (a)(6) x (b)(2) x (d)(5)
x (a)(7) x (b)(3) x (d)(6)
(f)(6) Optional & Amb. only x (a)(8) x (b)(4) x (d)(7)
x (a)(9) x (b)(5) x (d)(8) (g)(1)
x (a)(10) (b)(6) Inpt. only (d)(9) Optional x (g)(2)
x (a)(11) x (b)(7) x (e)(1) x (g)(3)
x (a)(12) (c)(1) x (e)(2) Amb. only x (g)(4)
x (a)(13) (c)(2) x (e)(3) Amb. only
No inherited certification
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Part 3: NVLAP-Accredited Testing Laboratory Information
Report Number: TEB-06162014-2846
Test Date(s): 6/16/2014
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:
Timothy Bennett
Test Proctor
ATL Authorized Representative Function/Title
6/20/2014
Nashville, TN Signature and Date Location Where Test Conducted
3.2 Test Information
3.2.1 Additional Software Relied Upon for Certification
Additional Software Applicable Criteria Functionality provided by Additional Software
Emdeon a.2, b.3 e-Prescribing, drug interaction checks
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Additional Software Applicable Criteria Functionality provided by Additional Software
No additional software required
3.2.2 Test Tools
Test Tool Version
x Cypress 2.4.1
x ePrescribing Validation Tool 1.0.3
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
1.7.1
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 174
x Direct Certificate Discovery Tool 2.1
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
(a)(8)(ii)(A)(2)
§170.204(b)(1)
HL7 Version 3 Implementation Guide: URL-Based Implementations of the Context-Aware Information Retrieval (Infobutton) Domain
§170.204(b)(2)
HL7 Version 3 Implementation Guide: Context-Aware Knowledge Retrieval (Infobutton) Service-Oriented Architecture Implementation Guide
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Criterion # Standard Successfully Tested
(a)(13)
x §170.207(a)(3)
IHTSDO SNOMED CT® International Release July 2012 and US Extension to SNOMED CT® March 2012 Release
§170.207(j)
HL7 Version 3 Standard: Clinical Genomics; Pedigree
(a)(15)(i)
x §170.204(b)(1)
HL7 Version 3 Implementation Guide: URL-Based Implementations of the Context-Aware Information Retrieval (Infobutton) Domain
§170.204(b)(2)
HL7 Version 3 Implementation Guide: Context-Aware Knowledge Retrieval (Infobutton) Service-Oriented Architecture Implementation Guide
(a)(16)(ii) §170.210(g)
Network Time Protocol Version 3 (RFC 1305)
§170. 210(g)
Network Time Protocol Version 4 (RFC 5905)
(b)(2)(i)(A)
§170.207(i)
The code set specified at 45 CFR 162.1002(c)(2) (ICD-10-CM) for the indicated conditions
x §170.207(a)(3)
IHTSDO SNOMED CT® International Release July 2012 and US Extension to SNOMED CT® March 2012 Release
(b)(7)(i)
§170.207(i)
The code set specified at 45 CFR 162.1002(c)(2) (ICD-10-CM) for the indicated conditions
x §170.207(a)(3)
IHTSDO SNOMED CT® International Release July 2012 and US Extension to SNOMED CT® March 2012 Release
(e)(1)(i)
Annex A of the FIPS Publication 140-2
[list encryption and hashing algorithms]
AES SHA-1
(e)(1)(ii)(A)(2) §170.210(g)
Network Time Protocol Version 3 (RFC 1305)
x §170. 210(g)
Network Time Protocol Version 4 (RFC 5905)
(e)(3)(ii)
Annex A of the FIPS Publication 140-2
[list encryption and hashing algorithms]
AES SHA-1
Common MU Data Set (15)
x §170.207(a)(3)
IHTSDO SNOMED CT® International Release July 2012 and US Extension to SNOMED CT® March 2012 Release
§170.207(b)(2)
The code set specified at 45 CFR 162.1002(a)(5) (HCPCS and CPT-4)
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Criterion # Standard Successfully Tested
None of the criteria and corresponding standards listed above are applicable
3.2.4.2 Newer Versions of Standards
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
x (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)
x (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)
No optional functionality tested
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3.2.6 2014 Edition Certification Criteria* Successfully Tested
Criteria # Version
Criteria # Version
TP** TD*** TP TD
(a)(1) 1.2 1.5 x (c)(3) 1.6 1.6
(a)(2) 1.2 (d)(1) 1.2
(a)(3) 1.2 1.4 (d)(2) 1.5
(a)(4) 1.4 1.3 (d)(3) 1.3
(a)(5) 1.4 1.3 (d)(4) 1.3
(a)(6) 1.3 1.4 (d)(5) 1.2
(a)(7) 1.3 1.3 (d)(6) 1.2
(a)(8) 1.2 (d)(7) 1.2
(a)(9) 1.3 1.3 (d)(8) 1.2
(a)(10) 1.2 1.4 (d)(9) Optional 1.2
(a)(11) 1.3
(e)(1) 1.8 1.5
(a)(12) 1.3 (e)(2) Amb. only 1.2 1.6
(a)(13) 1.2 (e)(3) Amb. only 1.3
(a)(14) 1.2 (f)(1) 1.2 1.2
(a)(15) 1.5 (f)(2) 1.3 1.7.1
(a)(16) Inpt. only 1.3 1.2 (f)(3) 1.3 1.7
(a)(17) Inpt. only 1.2 (f)(4) Inpt. only 1.3 1.7
(b)(1) 1.7 1.4
(f)(5) Optional & Amb. only
1.2 1.2 (b)(2) 1.4 1.6
(b)(3) 1.4 1.2
(f)(6) Optional & Amb. only
1.3 1.0.3 (b)(4) 1.3 1.4
(b)(5) 1.4 1.7 (g)(1) 1.7 1.9
(b)(6) Inpt. only 1.3 1.7 (g)(2) 1.7 1.9
(b)(7) 1.4 1.6 (g)(3) 1.3 x (c)(1) 1.6 1.6 (g)(4) 1.2
x (c)(2) 1.6 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)
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3.2.7 2014 Clinical Quality Measures*
Type of Clinical Quality Measures Successfully Tested:
x Ambulatory
Inpatient
No CQMs tested
*For a list of the 2014 Clinical Quality Measures, please reference http://www.cms.gov (navigation: 2014 Clinical Quality Measures)
Ambulatory CQMs
CMS ID Version CMS ID Version CMS ID Version CMS ID Version
x 2 v3 x 90 v3 x 136 v3 x 155 v2
x 22 v2 x 117 v2 x 137 v2 x 156 v2
x 50 v2 x 122 v2 x 138 v2 x 157 v2
x 52 v2 x 123 v2 x 139 v2 x 158 v2
x 56 v2 x 124 v2 x 140 v2 x 159 v2
x 61 v3 x 125 v2 x 141 v3 x 160 v2
x 62 v2 x 126 v2 x 142 v2 x 161 v2
x 64 v3 x 127 v2 x 143 v2 x 163 v2
x 65 v3 x 128 v2 x 144 v2 x 164 v2
x 66 v2 x 129 v3 x 145 v2 x 165 v2
x 68 v3 x 130 v2 x 146 v2 x 166 v3
x 69 v2 x 131 v2 x 147 v2 x 167 v2
x 74 v3 x 132 v2 x 148 v2 x 169 v2
x 75 v2 x 133 v2 x 149 v2 x 177 v2
x 77 v2 x 134 v2 x 153 v2 x 179 v2
x 82 v1 x 135 v2 x 154 v2 x 182 v3
Inpatient CQMs
CMS ID Version CMS ID Version CMS ID Version CMS ID Version
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
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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.
Test Results Summary for 2014 Edition EHR Certification Version EHR-Test-144 Rev 17-Feb-2014
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Test Results Summary Document History
Version Description of Change Date
17-Feb-2014 Edited: section header page 3; contact info page 4
17-Feb-2014
10-Feb-2014 Modified layout 10-Feb-2014
20-Nov-2013 Updated test tool sections 20-Nov-2013
25-Oct-2013 Corrected numbering of 3.2.8 section 25-Oct-2013
15-Oct-2013 Modified layout slightly 15-Oct-2013
01-Oct-2013 Initial Version 01-Oct-2013
2014 Edition Test Report Summary
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”.
5-Dec-13
EHR Usability Test Report
EHR Usability Test Report of Cyfluent, Version 3.0
Report based on ISO/IEC 25062:2006 Common Industry Format for Usability Test Reports
Cyfluent Version 3.0
Date of Usability Test: 12/03/2013
Date of Report: 12/05/2013
Report Prepared By: Cyfluent
Elaine Law, VP of Operations
210-823-1614
400 Joppa Road
Towson, MD 21204
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Table of Contents
EXECUTIVE SUMMARY ................................................................................................................................ 3
INTRODUCTION ............................................................................................................................................ 8
PARTICIPANTS .......................................................................................................................................... 8
STUDY DESIGN ......................................................................................................................................... 9
TASKS .......................................................................................................................................................... 9
PROCEDURES ......................................................................................................................................... 11
TEST LOCATION ...................................................................................................................................... 11
TEST ENVIRONMENT............................................................................................................................. 12
PARTICIPANT INSTRUCTIONS ............................................................................................................ 12
USABILITY METRICS .............................................................................................................................. 14
DATA SCORING ........................................................................................................................................... 14
RESULTS ....................................................................................................................................................... 16
DATA ANALYSIS AND REPORTING.................................................................................................... 16
DISCUSSION OF THE FINDINGS ........................................................................................................ 19
EFFECTIVENESS ................................................................................................................................ 19
EFFICIENCY ......................................................................................................................................... 19
SATISFACTION .................................................................................................................................... 19
MAJOR FINDINGS ............................................................................................................................... 20
AREAS FOR IMPROVEMENT ........................................................................................................... 20
APPENDICES ............................................................................................................................................... 21
Appendix 1: PARTICIPANT DEMOGRAPHICS ................................................................................... 22
Appendix 2: SYSTEM USABILITY SCALE QUESTIONNAIRE ......................................................... 23
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EXECUTIVE SUMMARY
A usability test of Cyfluent Version 3.0, Ambulatory was conducted December 3-5 via WebEx by Cyfluent. 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 and users matching the target demographic criteria served as participants and used the EHRUT in simulated, but representative tasks. This study collected performance data on 27 tasks typically conducted on an EHR:
1) 170.314(a)(1) Computerized provider order entry
a) Create a lab order
b) Enter lab results
c) View radiology images
2) 170.314(a)(2) Drug-drug, drug-allergy interaction checks
a) View drug-drug and drug-allergy interaction checks
3) 170.314(a)(6) Medication list
a) Issue a reported medication
4) 170.314(a)(7) Medication allergy list
a) Enter medication allergies
5) 170.314(a)(8) Clinical decision support
a) Select an existing patient record and perform actions that generate CDS interventions, triggered
based each of the following data categories within that patient record and at least one
combination of data from two or more of the following data categories:
i) Problem list
ii) Medication list
iii) Medication allergy list
iv) Demographics
v) Laboratory tests and values/results
vi) Vital signs
6) 170.314(b)(3) Electronic prescribing
7) 170.314(b)(4) Clinical information reconciliation
During the 60 minute one-on-one usability test, each participant was greeted by the
administrator. Participants had prior experience with the EHR. The administrator introduced
the test, and instructed participants to complete a series of tasks (given one at a time) using the
EHRUT. During the testing, the administrator timed the test and, along with the data logger(s)
recorded user performance data on paper and electronically. The administrator did not give the
participant assistance in how to complete the task.
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Participant screens, head shots 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’s verbalizations
Participant’s satisfaction 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 and were not compensated for their time. 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 rating data
collected on the EHRUT.
Task N Task
Success Path Deviation Task
Time Errors Task
ratings
# Mean (SD)
Deviations (Observed/Optimal)
Mean (SD)
Mean (SD)
Mean (SD)
1. Enter a reported medication of Avandia 2 mg
5 1.0 40/40 58 0 4.8
2. Change the reported medication from Avandia 2 mg to Avandia 4 mg
5 1.0 51/40 62 0 4.4
3. Access the Avandia 4 mg medication
5 1.0 5/5 6.8 0 5.0
4. Open the most recent encounter for patient
5 1.0 13/5 24 0 5.0
5. Enter a lab order of Creatinine 24 Hour
5 1.0 21/20 26.4 0 5.0
6. Edit the lab order of Creatinine 24 hours and add results value of 8
5 1.0 25/20 33.8 0 5.0
7. Access the lab order of Creatinine 24 hours
5 1.0 12/10 15 0 4.8
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Task N Task Success
Path Deviation Task Time
Errors Task ratings
# Mean (SD)
Deviations (Observed/Optimal)
Mean (SD)
Mean (SD)
Mean (SD)
8. Enter a radiology order of Chest X-Ray
5 1.0 21/20 17 0 5.0
9. Edit a radiology order of Chest X-Ray and assign to Medical Assistant
5 1.0 21/20 25.2 0 5.0
10. Access the Chest X-Ray radiology order
5 1.0 16/10 17.4 0 5.0
11. Enter a prescription for Hydrocodone to view DUR Warning for drug-allergy interaction for prescriber William Mayfield
5 1.0 45/30 79.4 0 4.8
12. Enter a prescription for Phenelzine to view DUR warning for drug-drug interaction for prescriber William Mayfield
5 1.0 31/30 33.0 0 4.8
13. Adjust the DUR preferences for William Mayfield
5 1.0 34/20 50.4 0 5.0
14. Enter a reported medication to Simvastatin 10 Mg
5 1.0 47/45 53
0 4.8
15. Change reported medication from Simvastatin 10 Mg to reported Simvastatin 20 Mg
5 1.0 43/35 45.8 0 4.8
16. Access simvastatin 20 mg reported medication
5 1.0 10/5 11.0 0 5.0
17. Record allergy to Carbamazepine with reaction of skin rash
5 1.0 22/20 27.2 0 5.0
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Task N Task Success
Path Deviation Task Time
Errors Task ratings
# Mean (SD)
Deviations (Observed/Optimal)
Mean (SD)
Mean (SD)
Mean (SD)
18. change allergy from Carbamazepine to Codeine
5 0.8 14/12 17.8 0.2 5.0
19. Access Codeine Allergy
5 1.0 5/5 6.2 0 5.0
20. Acknowledge Avandia Alert
5 1.0 15/15 13.4 0 5.0
21. Acknowledge Fasting Blood Glucose Alert
5 1.0 15/15 11 0 5.0
22. Open Therapeutic Reference Information for Diabetes Alert
5 1.0 14/10 29.6 0 5.0
23. Create a gender based alert in administration
5 0.8 33/24 56.25 0.2 5.0
24. Issue a prescription for Hydrochlorothiazide 50 Mg for provider William Mayfield
5 1.0 52/35 63.0 0 5.0
25. Reconcile patient’s active medication list
5 0.6 14/12 22.3 0.4 5.0
26. Reconcile patient’s active problem list
5 1.0 15/15 21.8 0 5.0
27. Reconcile patient’s allergy list
5 1.0 25/25 13.8 5 5.0
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The results from the System Usability Scale scored the subjective satisfaction with the system
based on performance with these tasks to be: 96%.
In addition to the performance data, the following qualitative observations were made:
1) Major findings a) 18. Change allergy from Carbamazepine to Codeine
b) 23. Create a gender based alert in administration
c) 25. Reconcile patient’s active medication list
2) Areas for improvement a) 2. Change the reported medication from Avandia 2 mg to Avandia 4 mg
b) 11. Enter a prescription for Hydrocodone to view DUR Warning for drug-allergy interaction for
prescriber William Mayfield
c) 24. Issue a prescription for Hydrochlorothiazide 50 Mg for provider William Mayfield
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INTRODUCTION
The EHRUT tested for this study was Cyfluent, Version 3.0. Designed to present medical
information to healthcare providers in Ambulatory settings, the EHRUT consists of an Electronic
Health Record. The usability testing 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 as electronic prescribing were captured
during the usability testing.
METHOD
PARTICIPANTS
A total of 5 participants were tested on the EHRUT(s). Participants in the test were Physicians,
Nurses, Administrators and Billing specialists. Participants were recruited by Elaine Law,
Cyfluent, and were not compensated for their time. In addition, participants had no direct
connection to the development of or organization producing the EHRUT(s). Participants were
not from the testing or supplier organization. Participants were given the opportunity to have the
same orientation and level of training as the actual end users would have received.
Recruited participants had a mix of backgrounds and demographic characteristics conforming to
the recruitment screener. The following is a table of participants by characteristics, including
demographics, professional experience, computing experience and user needs for assistive
technology. Participant names were replaced with Participant IDs so that an individual’s data
cannot be tied back to individual identities.
Part ID
Gender
Occupation/
role
Professional Experience
Computer Experience
Product
Experience
Assistive Technology
Needs 1 User 1 Female Precertification Office Assistant
10 Years Experienced 6 months None
2 User 2 Female Asst Office Mgr. and Med. Coder
14 Years Experienced 6 months None
3 User 3 Female RN and Office Manager 20 Years Experienced 2 years None
4 User 4 Male Physician/Owner 35 Years Experienced 2 years None
4 User 5 Female Certified Ophthalmic Tech. 17 Years Experienced 2 years None
Five participants (matching the demographics in the section on Participants) were recruited and
five participated in the usability test. Zero participants failed to show for the study.
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Participants were scheduled for 60 minute sessions without time in between each session for
debrief by the administrator(s) and data logger(s), and to reset systems to proper test
conditions. A spreadsheet was used to keep track of the participant schedule, and included
each participant’s demographic characteristics as provided by Cyfluent.
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 1 EHR. Each participant used the system in
the same location, 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
1. Time to complete the tasks
2. Number and types of errors
3. Path deviations
4. Participant’s verbalizations (comments)
5. Participant’s satisfaction 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
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activities a user might do with this EHR, including:
6.
7. Enter a REPORTED medication of AVANDIA 2 MG
8. Change the REPORTED medication from AVANDIA 2 MG to AVANDIA 4 MG via
Emdeon Rx
9. Access the AVANDIA 4 MG medication via Emdeon Rx
10. Open the most recent encounter for patient
11. Enter a lab order of CREATININE 24 HOUR
12. Edit the lab order of CREATININE 24 HOURS and ADD RESULTS VALUE OF 8
13. Access the lab order of CREATININE 24 HOURS
14. Enter a radiology order of CHEST X-RAY via Assessment/Plan
15. Edit a radiology order of Chest X-Ray and assign to Medical Assistant
16. Access the CHEST X-RAY radiology order
17. Enter a prescription for HYDROCODONE to view DUR WARNING for drug-allergy
interaction for prescriber William Mayfield
18. Enter a prescription for PHENELZINE to view DUR warning for drug-drug interaction for
prescriber William Mayfield
19. Adjust the DUR preferences for William Mayfield
20. Enter a REPORTED medication to SIMVASTATIN 10 MG
21. Change REPORTED medication from SIMVASTATIN 10 MG to REPORTED
SIMVASTATIN 20 MG
22. Access SIMVASTATIN 20 MG reported medication
23. Record ALLERGY to CARBAMAZEPINE with REACTION of SKIN RASH
24. Change ALLERGY from CARBAMAZEPINE to CODEINE
25. Access CODEINE Allergy
26. Acknowledge Avandia Alert
27. Acknowledge Fasting Blood Glucose Alert
28. Open Therapeutic Reference Information for Diabetes Alert
29. CREATE a gender based alert in administration
30. Issue a prescription for HYDROCHLOROTHIAZIDE 50 MG for provider WILLIAM
MAYFIELD.
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31. RECONCILE patient’s active MEDICATION list
32. RECONCILE patient’s active PROBLEM list
33. RECONCILE patient’s ALLERGY list
34.
Tasks were selected based on their frequency of use, criticality of function, and those that may
be most troublesome for users.
PROCEDURES
Upon arrival, participants were greeted; their identity was verified and matched with a name on
the participant schedule. To ensure that the test ran smoothly, one staff member participated in
this test and recorded for later data logging. The usability testing staff conducting the test was
experienced usability practitioners with five years of experience and thorough knowledge of the
system.
The administrator moderated the session including administering instructions and tasks. The
administrator also monitored task times, obtained post-task rating data, and took notes on
participant comments. A recording was used to capture the data on task success, path
deviations, number and type of errors, and comments.
Participants were instructed to perform the tasks (see specific instructions below):
1. As quickly as possible making as few errors and deviations as possible.
2. Without assistance; administrators were allowed to give immaterial guidance and
clarification on tasks, but not instructions on use.
For each task, the participants were given a written copy of the task. Task timing began once
the administrator finished reading the question. The task time was stopped once the participant
indicated they had successfully completed the task. Scoring is discussed below in Section 3.9.
Participants' demographic information, task success rate, time on task, errors, deviations and
verbal responses were recorded into a spreadsheet. Participants were thanked for their time.
TEST LOCATION
The test facility included a web conference, computer for the participant, and recording
computer for the administrator. Only the participant and administrator were in the test room. All
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observers and the data logger worked from a separate room where they could see the
participant’s screen and face shot, and listen to the audio of the session. To ensure that the
environment was comfortable for users, noise levels were kept to a minimum with the ambient
temperature within a normal range. All of the safety instruction and evacuation procedures were
valid, in place, and visible to the participants.
TEST ENVIRONMENT
The EHRUT would be typically be used in a healthcare office or facility. In this instance, the
testing was conducted in various facilities. For testing, the computer used various laptops
running various operating systems. The participants used a mouse and keyboard when
interacting with the EHRUT.
The EHRUT used various screen sizes, resolutions and color settings based on the participants’
equipment. The application was set up by Cyfluent. The application itself was running on the
internet using a test database on a wireless connection. Technically, the system performance
was representative to what actual users would experience in a field implementation.
PARTICIPANT INSTRUCTIONS
The administrator reads the following instructions aloud to the each participant:
Thank you for participating in this study. Your input is very important. Our session today will last
about 60 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.
Overall, 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. I did not have any involvement in its creation, so
please be honest with your opinions. All of the information that you provide will be kept
confidential and your name will not be associated with your comments at any time. Should you
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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 task. I will ask you
your impressions about the task once you are done.
Participants were then given 27 tasks to complete:
1. Enter a REPORTED medication of AVANDIA 2 MG
2. Change the REPORTED medication from AVANDIA 2 MG to AVANDIA 4 MG via
Emdeon Rx
3. Access the AVANDIA 4 MG medication via Emdeon Rx
4. Open the most recent encounter for patient
5. Enter a lab order of CREATININE 24 HOUR
6. Edit the lab order of CREATININE 24 HOURS and ADD RESULTS VALUE OF 8
7. Access the lab order of CREATININE 24 HOURS
8. Enter a radiology order of CHEST X-RAY via Assessment/Plan
9. Edit a radiology order of Chest X-Ray and assign to Medical Assistant
10. Access the CHEST X-RAY radiology order
11. Enter a prescription for HYDROCODONE to view DUR WARNING for drug-allergy
interaction for prescriber William Mayfield
12. Enter a prescription for PHENELZINE to view DUR warning for drug-drug interaction for
prescriber William Mayfield
13. Adjust the DUR preferences for William Mayfield
14. Enter a REPORTED medication to SIMVASTATIN 10 MG
15. Change REPORTED medication from SIMVASTATIN 10 MG to REPORTED
SIMVASTATIN 20 MG
16. Access SIMVASTATIN 20 MG reported medication
17. Record ALLERGY to CARBAMAZEPINE with REACTION of SKIN RASH
18. Change ALLERGY from CARBAMAZEPINE to CODEINE
19. Access CODEINE Allergy
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20. Acknowledge Avandia Alert
21. Acknowledge Fasting Blood Glucose Alert
22. Open Therapeutic Reference Information for Diabetes Alert
23. CREATE a gender based alert in administration
24. Issue a prescription for HYDROCHLOROTHIAZIDE 50 MG for provider WILLIAM
MAYFIELD.
25. RECONCILE patient’s active MEDICATION list
26. RECONCILE patient’s active PROBLEM list
27. RECONCILE patient’s ALLERGY list
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 Cyfluent by measuring participant success rates and errors
2. Efficiency of Cyfluent by measuring the average task time and path deviations
3. Satisfaction with Cyfluent by measuring ease of use ratings
DATA SCORING
The following table (Table 1) details how tasks were scored, errors evaluated, and the time data
analyzed.
Measures Rationale and Scoring
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Effectiveness:
Task Success
A task was counted as a “Success” if the participant was able to achieve the correct outcome, without assistance, within the time allotted 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. Optimal task performance time, as benchmarked by expert performance under realistic conditions, is recorded when constructing tasks. Target task times used for task times in the Moderator’s Guide must be operationally defined by taking multiple measures of optimal performance and multiplying by some factor that allows some time buffer because the participants are presumably not trained to expert performance. Thus, if expert, optimal performance on a task was seconds then allotted task time performance was seconds. This ratio should be aggregated across tasks and reported with mean and variance scores. Effectiveness:
Task Failures
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 “Failures.” 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.
Efficiency:
Task Deviations
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 on-screen 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. Efficiency:
Task Time
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.
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Satisfaction:
Task Rating
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 Cyfluent EHR overall, the testing team administered the System Usability Scale (SUS) post-test questionnaire.
Table 1 - Details of how observed data were scored.
RESULTS
DATA ANALYSIS AND REPORTING
The results of the usability test were calculated according to the methods specified in the
Usability Metrics section above. Participants who failed to follow session and task instructions
had their data excluded from the analyses. The usability testing results for the EHRUT are
detailed below (see Table2 ). 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.
Task N Task Success
Path Deviation Task Time
Errors Task ratings
# Mean (SD)
Deviations (Observed/Optimal)
Mean (SD)
Mean (SD)
Mean (SD)
28. Enter a reported medication of Avandia 2 mg
5 1.0 40/40 58 0 4.8
29. Change the reported medication from Avandia 2 mg to Avandia 4 mg
5 1.0 51/40 62 0 4.4
30. Access the Avandia 4 mg medication
5 1.0 5/5 6.8 0 5.0
31. Open the most recent encounter for patient
5 1.0 13/5 24 0 5.0
32. Enter a lab order of Creatinine 24 Hour
5 1.0 21/20 26.4 0 5.0
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Task N Task Success
Path Deviation Task Time
Errors Task ratings
# Mean (SD)
Deviations (Observed/Optimal)
Mean (SD)
Mean (SD)
Mean (SD)
33. Edit the lab order of Creatinine 24 hours and add results value of 8
5 1.0 25/20 33.8 0 5.0
34. Access the lab order of Creatinine 24 hours
5 1.0 12/10 15 0 4.8
35. Enter a radiology order of Chest X-Ray
5 1.0 21/20 17 0 5.0
36. Edit a radiology order of Chest X-Ray and assign to Medical Assistant
5 1.0 21/20 25.2 0 5.0
37. Access the Chest X-Ray radiology order
5 1.0 16/10 17.4 0 5.0
38. Enter a prescription for Hydrocodone to view DUR Warning for drug-allergy interaction for prescriber William Mayfield
5 1.0 45/30 79.4 0 4.8
39. Enter a prescription for Phenelzine to view DUR warning for drug-drug interaction for prescriber William Mayfield
5 1.0 31/30 33.0 0 4.8
40. Adjust the DUR preferences for William Mayfield
5 1.0 34/20 50.4 0 5.0
41. Enter a reported medication to Simvastatin 10 Mg
5 1.0 47/45 53
0 4.8
42. Change reported medication from Simvastatin 10 Mg to reported Simvastatin 20 Mg
5 1.0 43/35 45.8 0 4.8
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Task N Task Success
Path Deviation Task Time
Errors Task ratings
# Mean (SD)
Deviations (Observed/Optimal)
Mean (SD)
Mean (SD)
Mean (SD)
43. Access simvastatin 20 mg reported medication
5 1.0 10/5 11.0 0 5.0
44. Record allergy to Carbamazepine with reaction of skin rash
5 1.0 22/20 27.2 0 5.0
45. change allergy from Carbamazepine to Codeine
5 0.8 14/12 17.8 0.2 5.0
46. Access Codeine Allergy
5 1.0 5/5 6.2 0 5.0
47. Acknowledge Avandia Alert
5 1.0 15/15 13.4 0 5.0
48. Acknowledge Fasting Blood Glucose Alert
5 1.0 15/15 11 0 5.0
49. Open Therapeutic Reference Information for Diabetes Alert
5 1.0 14/10 29.6 0 5.0
50. Create a gender based alert in administration
5 0.8 33/24 56.25 0.2 5.0
51. Issue a prescription for Hydrochlorothiazide 50 Mg for provider William Mayfield
5 1.0 52/35 63.0 0 5.0
52. Reconcile patient’s active medication list
5 0.6 14/12 22.3 0.4 5.0
53. Reconcile patient’s active problem list
5 1.0 15/15 21.8 0 5.0
54. Reconcile patient’s allergy list
5 1.0 25/25 13.8 5 5.0
The results from the SUS (System Usability Scale) scored the subjective satisfaction with the
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system based on performance with these tasks to be: 96%. Broadly interpreted, scores under
60 represent systems with poor usability; scores over 80 would be considered above average.
DISCUSSION OF THE FINDINGS
EFFECTIVENESS
Based on the success, failure and path deviation data the following items were unable to be
completed by some participants.
18. Change allergy from Carbamazepine to Codeine
23. Create a gender based alert in administration
25. Reconcile patient’s active medication list
EFFICIENCY
Based on the observations of the task time and deviation data the following items took an
average of over 60 seconds to complete:
2. Change the reported medication from Avandia 2 mg to Avandia 4 mg
11. Enter a prescription for Hydrocodone to view DUR Warning for drug-allergy interaction for prescriber
William Mayfield
24. Issue a prescription for Hydrochlorothiazide 50 Mg for provider William Mayfield
SATISFACTION
Based on the task ratings and SUS results data the following items received a less than perfect
rating. An average score of 4.8 for the entire system relates to a relative 96% user satisfaction
rating which is well above average. Broadly interpreted, scores under 60 represent systems with
poor usability; scores over 80 would be considered above average.
The following items had an average user rating of 4.4:
2. Change the reported medication from Avandia 2 mg to Avandia 4 mg
The following items had an average user rating of 4.8:
1. Enter a reported medication of Avandia 2 mg
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7. Access the lab order of Creatinine 24 hours
11. Enter a prescription for Hydrocodone to view DUR Warning for drug-allergy interaction for prescriber
William Mayfield
12. Enter a prescription for Phenelzine to view DUR warning for drug-drug interaction for prescriber William
Mayfield
14. Enter a reported medication to Simvastatin 10 Mg
15. Change reported medication from Simvastatin 10 Mg to reported Simvastatin 20 Mg
MAJOR FINDINGS
There were a few key areas that were unable to be completed.
18. Change allergy from Carbamazepine to Codeine
23. Create a gender based alert in administration
25. Reconcile patient’s active medication list
AREAS FOR IMPROVEMENT
Based on the observations of the task time and deviation data the following items took an
average of over 60 seconds to complete:
2. Change the reported medication from Avandia 2 mg to Avandia 4 mg
11. Enter a prescription for Hydrocodone to view DUR Warning for drug-allergy interaction for prescriber
William Mayfield
24. Issue a prescription for Hydrochlorothiazide 50 Mg for provider William Mayfield
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APPENDICES
The following appendices include supplemental data for this usability test report. Following is a list
of the appendices provided:
1: Participant demographics 2: System Usability Scale Questionnaire
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Appendix 1: PARTICIPANT DEMOGRAPHICS
The report should contain a breakdown of the key participant demographics. A representative list is
shown below.
Following is a high-level overview of the participants in this study.
Gender
Men 1 Women 4 Total (participants) 5
Occupation/Role
RN/BSN 2 Physician 1 Admin Staff 2 Total (participants) 5
Years of Experience
Years experience 19 Facility Use of EHR All paper 0 Some paper, some electronic
0
All electronic 5 Total (participants) 5
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Appendix 2: SYSTEM USABILITY SCALE QUESTIONNAIRE
Orientation (5 minutes)
Thank you for participating in this study. Our session today will last 60 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 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.
The product you will be using today is Cyfluent, Version 3.0.
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?
Preliminary Questions (5 minutes)
What is your job title / appointment?
How long have you been working in this role?
What are some of your main responsibilities?
Tell me about your experience with electronic health records.
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User User 1 User 2 User 3 User 4 User 5
Do you have any questions or concerns?
No
No No No No
What is your job title/appointment? Precertification Office Assistant
Assistant Office Manager and Medical Coder
Registered Nurse and Office Manager
Physician/Owner Certified Ophthalmic Technician
How long have you been working in this role?
10 Years
14 Years 20 Years 35 Years Since 1996 17
What are some of your main responsibilities?
Training Electronic Medical Record, precertification.
Surgical report coding, data entry into Cyfluent EHR, data entry into ProtoMED for billing services.
Besides doing patient care I also help with the billing, all the EOBs, referrals. I manage the office and staffing.
I run the whole show.
I work patients up for the doctors and handle all the EHR implementation and training.
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User User 1 User 2 User 3 User 4 User 5
Tell me about your experience with electronic health records.
A little rocky to start, but now it’s going well.
This is my first experience with Cyfluent. We started in July.
We’ve been using an Electronic Health Record since August 2004 and we just upgraded our system.
Well I’ve actually had 3 different programs over the years. A company in Canada they said would integrate with any program I had. Because of proprietary reasons the billing would not open up the program for the Electronic Health Record without charging me about $20,000 to run an interface so that came and went. And then the second company I bought had a business that got picked up and I didn’t want to convert so I looked around and found Protomed and then they had a problem with the EMR people and actually got bought out so they brought up their own company Cyfluent and I signed on with them.
Currently using Cyfluent and have used one previously.
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User User 1 User 2 User 3 User 4 User 5
This is the application you will be working with. Have you heard of it?
Yes Started it in July. Yes. Yes. Yes.
If so, tell me what you know about it It has everything that we need and it is set up now as our paper charts used to be.
I know who they are affiliated with for billing and really that’s all I know about it.
I know that it’s an electronic record and it’s pretty easy to use.
I’ve been using it in my own office for several years.
I’ve been currently using it.
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User User 1 User 2 User 3 User 4 User 5
Please don’t click on anything just yet. What do you notice? What are you able to do here? Please be specific.
Right away you see the patient’s name and date of birth. It has everything that is very important to us… prescriptions, allergies, everything that is most important is on the top right side in patient alerts which are some of the most important things in our office which would tell us any alerts the patient might have.
The first thing I notice is I always go to the patient’s name and picture and my eyes are always drawn to the prescriptions first on the left side. The second thing I notice is I go to patient alerts.
I notice that it’s a summary of the patient’s chart. It has the patient’s name, birthdate, prescriptions, problems list, and social history. It has everything I need to get started.
Well I can go into prescriptions, allergies, problems, social history, family history, insurance, patient health history. I can look at it all and review everything that is there. I can go into documents and pull in documents that I’ve scanned in to the patient’s chart. Obviously, this is patient alerts. I can enter patient contacts. It shows my encounters past and current. It shows vitals and I can have my staff put that in and body measurements and of course that’s necessary for meaningful use which is so important for us physicians so we can get our 1% kicker and we don’t get dinged 2% by Medicare. There’s obviously a lot more here than I use on an everyday basis but that other doctors might use. We can change the position of these sections like
I am able to go into the patient’s complete health record medication, allergies, problems list, social history etc. and view encounter for the day.
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User User 1 User 2 User 3 User 4 User 5
Enter a REPORTED medication of AVANDIA 2 MG
8 steps
8 steps 8 steps 8 steps 8 steps
Task Time 44 seconds 57 seconds 120 seconds 45 seconds 24 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5
4 5 5 5
Change the REPORTED medication from AVANDIA 2 MG to AVANDIA 4 MG via Emdeon Rx
9 steps
15 steps 9 steps 10 steps 8 steps
Task Time 35 seconds 81 seconds 93 seconds 75 seconds 28 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5
4 5 4 4
Access the AVANDIA 4 MG medication via Emdeon Rx
1 step
1 step 1 step 1 step 1 step
Task Time 2 seconds 4 seconds 8 seconds 13 seconds 7 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5
5 5 5 5
Open the most recent encounter for patient
3 steps
3 steps 3 steps 3 steps 1 step
Task Time 16 seconds 20 seconds 33 seconds 48 seconds 3 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task
5
5 5 5 5
Enter a lab order of CREATININE 24 HOUR
4 steps
4 steps 4 steps 5 steps 4 steps
Task Time 22 seconds 26 seconds 43 seconds 27 seconds 14 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5
5 5 5 5
Edit the lab order of CREATININE 24 HOURS and ADD RESULTS VALUE OF 8
4 steps
7 steps 5 steps 4 steps 5 steps
Task Time 20 seconds 59 Seconds 38 seconds 32 seconds 20 seconds
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User User 1 User 2 User 3 User 4 User 5
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5 5 5
Access the lab order of CREATININE 24 HOURS
2 steps 2 steps 2 steps 4 steps 2 steps
Task Time 7 seconds 4 seconds 19 seconds 37 seconds 8 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 4 5 5 5
Enter a radiology order of CHEST X-RAY via Assessment/Plan
5 steps 5 steps 5 steps 1 step 5 steps
Task Time 15 seconds 15 seconds 28 seconds 13 seconds 14 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5 5 5
Edit a radiology order of Chest X-Ray and assign to Medical Assistant
4 steps 4 steps 4 steps 5 steps 4 steps
Task Time 20 seconds 24 seconds 25 seconds 46 seconds 11 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5 5 5
Access the CHEST X-RAY radiology order
2 steps 2 steps 2 steps 8 steps 2 steps
Task Time 8 seconds 9 seconds 16 seconds 50 seconds 4 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5 5 5
Enter a prescription for HYDROCODONE to view DUR WARNING for drug-allergy interaction for prescriber William Mayfield
6 steps 6 steps 9 steps 17 steps 7 steps
Task Time 32 seconds 50 seconds 115 seconds 165 seconds 35 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 4 5 5 5
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User User 1 User 2 User 3 User 4 User 5
Enter a prescription for PHENELZINE to view DUR warning for drug-drug interaction for prescriber William Mayfield
6 steps 6 steps 6 steps 6 steps 7 steps
Task Time 22 seconds 26 seconds 47 seconds 33 seconds 37 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5 5 4
Adjust the DUR preferences for William Mayfield
4 steps 4 steps 4 steps 15 steps 7 steps
Task Time 24 seconds 26 seconds 58 seconds 122 seconds 22 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5 5 5
Enter a REPORTED medication to SIMVASTATIN 10 MG
9 steps 9 steps 11 steps 9 steps 9 steps
Task Time 40 seconds 43 seconds 92 seconds 45 seconds 45 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 4 5 5 5
Change REPORTED medication from SIMVASTATIN 10 MG to REPORTED SIMVASTATIN 20 MG
10 steps 7 steps 9 steps 10 steps 7 steps
Task Time 35 seconds 41 seconds 61 seconds 62 seconds 30 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 4 5 5 5
Access SIMVASTATIN 20 MG reported medication
1 step 1 step 3 steps 2 steps 3 steps
Task Time 4 seconds 7 seconds 27 seconds 10 seconds 7 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5 5 5
Record ALLERGY to CARBAMAZEPINE with REACTION of SKIN RASH
4 steps 4 steps 4 steps 6 steps 4 steps
Task Time 22 seconds 21 seconds 22 seconds 54 seconds 17 seconds
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User User 1 User 2 User 3 User 4 User 5
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5 5 5
Change ALLERGY from CARBAMAZEPINE to CODEINE
3 steps 3 steps 3 steps – fail 4 steps 4 steps
Task Time 17 seconds 9 seconds 23 seconds 33 steps 7 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5
5 5 5 5
Access CODEINE Allergy 1 step
1 step 1 step 1 step 1 step
Task Time 7 seconds 4 seconds 7 seconds 9 seconds 4 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5
5 5 5 5
Acknowledge Avandia Alert 3 steps
3 steps 3 steps
3 steps 3 steps
Task Time 14 seconds 10 seconds 22 seconds 16 steps 5 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5
5 5
Acknowledge Fasting Blood Glucose Alert
3 steps 3 steps 3 steps
3 steps 3 steps
Task Time 10 seconds 17 seconds 13 seconds 10 seconds 5 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5 5 5
Open Therapeutic Reference Information for Diabetes Alert
2 steps 2 steps 4 steps 4 steps 2 steps
Task Time 7 seconds 7 seconds 71 seconds 56 seconds 7 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5
5 5
CREATE a gender based alert in administration
9 steps 9 steps 9 steps
6 steps – FAIL 6 steps
Task Time 32 seconds 89 seconds 85 seconds 39 seconds 19 seconds
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User User 1 User 2 User 3 User 4 User 5
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5 5 5
Issue a prescription for HYDROCHLOROTHIAZIDE 50 MG for provider WILLIAM MAYFIELD.
7 steps 7 steps 19 steps 9 steps 10 steps
Task Time 40 seconds 38 seconds 117 seconds 81 seconds 39 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5 5 5
RECONCILE patient’s active MEDICATION list
4 steps 4 steps 2 steps – FAIL 6 steps – FAIL 6 steps
Task Time 27 seconds 23 seconds 27 seconds 132 seconds 17 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5 5 5
RECONCILE patient’s active PROBLEM list
3 steps 3 steps 3 steps
3 steps 3 steps
Task Time 10 seconds 10 seconds 24 seconds 58 seconds 7 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5 5 5
RECONCILE patient’s ALLERGY list 3 steps 3 steps 3 steps 3 steps 3 steps
Task Time 32 seconds 9 seconds 14 seconds 9 seconds 5 seconds
On a scale of 1 to 5 with 1 being very difficult and 5 being very easy how would you rate this task?
5 5 5 5 5
Overall Impressions/Comments: None No, I’m happy with it.
Only that the system is pretty easy to use, everything is laid out easy and it’s in a nice order.
No, not really No
The Language of Electronic Healthcare
3737 Columbia Pike
Arlington, VA 22204
www.cyfluent.com
877.266.6016
Are you Cyfluent?
Date: 12/9/2013 To: Drummond Group Re: Cyfluent MU2 Testing – Audit Logs
Cyfluent does not allow users direct access to audit logs – audit logs cannot be altered by end-users.
Direct access to all data including audit logs is prohibited outside of the protected Cyfluent Chart application. Access to the Cyfluent application is controlled via userid, password, and facilityID combination over an HTTPS connection. The only access end-users can have to the Cyfluent audit logs is from within the User Interface (UI), specifically ADMIN access for queries against the audit files. NO USER CAN ALTER AUDIT LOGS. NO USER CAN GAIN ACCESS TO THE NATIVE RECORDS.
Direct access to audit logs can be made by qualified engineers, but even in this case, the logs are protected and audited by triggers that will provide information regarding access to specific records.
Regards,
Lawrence R. Walsh President, Cyfluent Inc.
Arlington, VA Towson, MD San Antonio, TX St. Petersburg, FL Taipai, Taiwan Shanghai, China