Implementation of an Emergency Department Computer System: Design Features That Users Value

Abstract Background Electronic medical records (EMRs) can potentially improve the efficiency and effectiveness of patient care, especially in the emergency department (ED) setting. Multiple barriers to implementation of EMR have been described. One important barrier is physician resistance. The “ED Dashboard” is an EMR developed in a busy tertiary care hospital ED. Its implementation was exceptionally smooth and successful. Study Objectives We set out to examine the design features used in the development of the system and assess which of these features played an important role in the successful implementation of the ED Dashboard. Methods An anonymous survey of users of the ED Dashboard was conducted in January and February 2009 to evaluate their perceptions of the degree of success of the implementation and the importance of the design features used in that success. Results were analyzed using SPSS software (SPSS Inc., Chicago, IL). Results Of the 188 end-users approached, 175 (93%) completed the survey. Despite minimal training in the use of the system, 163 (93%) perceived the system as easy or extremely easy to use. Users agreed that the design features employed were important contributors to the system's success. Being alerted when new test results were ready, the use of “most common” lists, and the use of color were features that were considered valuable to users. Conclusion Success of a medical information system in a busy ED is, in part, dependent on careful attention to subtle details of system design.