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National survey of user-reported usability of electronic medical record software in ophthalmology in Germany

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Abstract

Purpose

A nationwide, comparative survey of the physician-reported usability of electronic medical record (EMR) software used by ophthalmologists in Germany using the System Usability Scale (SUS) as a standardized metric.

Methods

A cross-sectional survey of members of the German Ophthalmological Society (DOG) and professional association of ophthalmologists (BVA) was conducted in May 2022. All 7788 physician members of both societies were invited to participate in an anonymous online-survey by individualized links. User-reported usability of the participants main software used for electronic medical recordkeeping was assessed using the SUS (range 0–100).

Results

A total of 881 participants with 51 different EMRs completed the entire questionnaire. Mean EMR-SUS score was 65.7 (SD ± 23.5). Significant differences in mean SUS of several EMR programs were observed with a range of 31.5 to 87.2 in programs with 10 or more responses. 31.8% of all main program SUS ratings were below 50 points. Female gender was associated with 4.02 higher SUS score (95% CI 0.46–7.59). Main program SUS was positively correlated with overall work-related satisfaction and work environment SUS but negatively correlated with the number of programs in the work environment. The SUS of the entire digital work environment including all programs used daily was closely correlated with the main EMR SUS, but not the number of programs used.

Conclusion

Our survey revealed a fragmented pattern of EMR use by ophthalmologists in Germany with many competing software products and widely diverging mean System Usability Scale scores. A considerable share of ophthalmologists report EMR usability below what is commonly considered acceptable.

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Acknowledgements

We would like to thank Dr. Philip Gass of the German Ophthalmology Society and Mr. Christian Gante of the professional association of ophthalmologists for their contributions to the research proposal and support in the preparation of the survey. We thank Mrs. Birgit Mele from the Office of the German Ophthalmology Society for her support in the technical preparation and execution of the electronic survey.

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Authors and Affiliations

  1. Department of Ophthalmology, Asklepios Klinik Nord – Heidberg, Hamburg, Germany

    Lars Fuhrmann & Marc Schargus

  2. Department of Ophthalmology, Heinrich-Heine University, Düsseldorf, Germany

    Marc Schargus

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  1. Lars Fuhrmann
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Correspondence to Lars Fuhrmann.

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Ethical approval

As the study was an anonymized survey of professionals, an institutional ethical approval was not necessary in accordance with local regulations.

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Informed consent was obtained from all individual participants included in the study.

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Supplementary information

ESM 1

Suppl. Table 1: Comparisons of EMR SUS, only EMRs used by 10 or more participants and comparisons with p<0.05 are displayed (DOCX 15 kb)

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Fuhrmann, L., Schargus, M. National survey of user-reported usability of electronic medical record software in ophthalmology in Germany. Graefes Arch Clin Exp Ophthalmol 261, 3325–3334 (2023). https://doi.org/10.1007/s00417-023-06139-5

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