As our healthcare system, spurred on by the Health Information Technology for Economic and Clinical Health (HITECH) Act, begins to embrace health information technology (HIT), focusing on system usability becomes more important. The push to install EHRs has encouraged many health networks to adopt systems while putting minimal thought into the need for user-friendly software and adaptive workflows that effectively use HIT tools. However, the LIS has been around much longer than the EHR, and it was adopted to improve the productivity and workflow in the lab; it is not the result of a government mandate. So LIS usability should be advanced well beyond the EHR, right? It turns out that on average, this is not the case. We have good news, though: Orchard® Harvest™ is not your average LIS. It stands out among its competitors because at Orchard Software, we listen to our customers to improve usability.
Overall LIS Usability Not Much Better than the EHR
A plethora of data bemoans the poor usability of EHRs, pointing to the fact that EHRs were initially designed for billing rather than patient-centered care. While there is much less data about LIS usability, a recent article in the Journal of Pathology Informatics describes LIS usability research. The survey described was distributed among LIS users to inquire about their likes and dislikes in relation to their LIS. Authors Althea Mathews and David Marc (2017) surveyed LIS users in hospitals across the United States using the System Usability Scale (SUS) to evaluate user-friendliness of various LISs. Surprisingly, even with years of development ahead of the EHR, overall LIS usability was relatively low—the average SUS score was 59.7, compared to a benchmark of 68.
The benchmark score was derived from previous usability studies, so for this evaluation, scores above 68 were considered above average. All our years listening to our customers and making product changes has paid off because Harvest stood out significantly in this non-biased, non-sponsored scientific study, with an overall score of 78.7, well above the benchmark. Interestingly, when the researchers looked at years of experience to try and address the disparity, it did not explain why Harvest stood out so far ahead of its competition.
The Clear Winner is Harvest
Harvest’s mean SUS score was significantly greater than those of Cerner Millennium, Epic Beaker, MEDITECH, SCC SoftLab, and Sunquest. Raw scores were converted into percentile ranks and assigned a letter grade with Harvest scoring a B+ compared to “failing” Ds across the board for other LIS products (See Table 2 from the Mathews and Marc 2017 paper). Scores were compared with KLAS rankings to further validate accuracy (see Figure 1 from the Mathews and Marc 2017 paper).
Most Difficult LIS Tasks
In regard to the overall low usability scores, the three tasks ranked most difficult were running ad hoc laboratory management reports, copying results to additional recipients, and creating QC reports. Of interest, some of the usability issues listed for LISs correlated with those commonly cited for EHRs (e.g., too many clicks, “GUI shortcomings,” interfacing, slowness, and copying results to additional recipients).
Thank You to All Our Customers Who Helped Make Harvest Better
Harvest is such a strong LIS because of the partnership we have with our clients. By listening to your requests and “learning the lab,” we have been able to make a product that lab users intuitively and effectively use to make their jobs easier and to increase the lab’s contribution to patient care. As we all know, when systems are cumbersome to use, “workarounds” are created to circumvent the system that can also lead to safety issues or missing data. We would like to take this opportunity to thank you—our loyal customers—for your ongoing support and input that have made Harvest such a valuable tool for the laboratory.
Orchard Software is committed to keeping you informed and being a trusted resource you can turn to for industry-related education. As always, we welcome your feedback. Follow us on Twitter at @OrchardSoftware, and feel free to respond to this post by emailing us at firstname.lastname@example.org.
Mathews, A., & Marc, D. (2017). Usability evaluation of laboratory information systems. Journal of Pathology Informatics,8(40). http://dx.doi.org/10.4103/jpi.jpi_24_17
Kim Futrell, BS, MT(ASCP)
December 14, 2017