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EMR usability and patient safety: a national survey of physicians
Open accessAbstract
Despite widespread adoption of electronic medical records (EMRs), concerns persist regarding their usability and implications for patient safety. This national cross-sectional survey assessed physicians’ perceptions of EMR usability across safety-relevant domains. Among 1933 respondents from diverse care settings, 56% reported that their EMR did not enhance patient safety, and 50% perceived their system as inefficient. Usability ratings averaged 52% of the maximum score. Statistically significant differences were observed between EMRs in outpatient (η² = 0.13) and hospital (η² = 0.37) settings. Multilevel modeling attributed 38% of the variance in usability ratings to differences between EMRs, 51% to hospital-level variation within EMRs, and 11% to physician-level differences. Canonical discriminant analysis identified key differentiating usability features, including system response times, excessive alerts, prevention of data entry errors, and support for collaboration. These findings underscore substantial limitations in current EMR systems and reinforce the value of comparative usability assessments to inform targeted improvements in digital health infrastructure.
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A national study of 8274 U.S. physicians reported a mean EHR usability score of 45.9 on the System Usability Scale, equivalent to a failing grade.
“A national study of 8274 U.S. physicians reported a mean EHR usability score of 45.9 on the System Usability Scale, equivalent to a failing grade (“F”), which reflects widespread dissatisfaction with EHR design and workflow integration12–15.”
From When better data meets better design: How EHR data usability and system usability shape physicians' cognitive load (2026) · cites this paper as [15]
The Discussion identifies this as a Swiss national survey, not a study of U.S. physicians. The Results report a mean usability rating of 52.2% of the maximum possible score using the SURE scale, while the paper reports 1,933 respondents—not 8,274 or a mean System Usability Scale score of 45.9. No failing-grade designation is reported for its score. (LLM, conf=0.90)
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References 30 · Cited by 17
Research works printed but not linked: 23
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Metadata
- Authors
- Schwappach, D., Hautz, W., Krummrey, G., Pfeiffer, Y., & Ratwani, R. M.
- Affiliations
- University of Bern (CH)
- Bern University of Applied Sciences (CH)
- University of Basel (CH)
- Georgetown University (US)
- Corresponding author
- Schwappach, David
- Venue
- npj Digital Medicine
- Published
- 2025-05-15
- Volume
- 8
- Issue
- 1
- Pages
- 282-282
- ISSN
- 2398-6352 (ISSN-L)
- PMC
- PMC12081653
- OpenAlex
- W4410415053
- Cited by
- 17
- References
- 30
- Citations by year
- 2026: 15 · 2025: 2
- FWCI
- 13.37
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- npj Digital Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Swiss Medical Association (no id)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Medicine › Surgery › Healthcare Technology and Patient Monitoring
- Keywords
- electronic health records, EMR usability, patient safety, physician perceptions, system response time, clinical alerts, data entry errors, collaboration support, digital health infrastructure
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