• Zoe M Pruitt, Jessica L Howe, Aaron Z Hettinger, and Raj M Ratwani.
• From the MedStar Health National Center for Human Factors in Healthcare, MedStar Health Research Institute Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC.
• J Patient Saf. 2021 Apr 16.

ObjectivesDespite requirements for electronic health record (EHR) vendor usability testing, usability challenges persist, contributing to patient safety concerns. We sought to identify emergency physicians' perceived EHR usability and safety strengths and shortcomings across major EHR vendor products.MethodsFifty-five emergency physicians from 4 different hospitals were interviewed. The interviews were qualitatively analyzed, and physician comments were aligned with a usability taxonomy to identify emerging themes by vendor and hospital.ResultsOf the 194 comments about usability, the 3 most commonly discussed usability topics were Workflow Support (33.5% of comments), Visual Display (20.1%), and Data Entry (14.4%). Electronic health record usability strengths were centered on Visual Display, and the most common shortcoming was the lack of Workflow Support. Fourteen cross-hospital/cross-vendor themes, 6 vendor-specific themes, and 4 hospital-specific themes were identified.ConclusionsUsability shortcomings that spanned across hospitals and vendors may suggest a need for more applied research and improved design to resolve these issues. Shortcomings that are localized to a specific product or hospital may be due to customization and may be addressable by learning from other organizations.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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