A new KLAS report, its first on ambulatory electronic medical record usability, finds that success in achieving high usability ranges from 85 percent to 55 percent. Of the EMR vendors reviewed, athenahealth ranked No. 1.

The KLAS report, Ambulatory EMR Usability 2013: More Nurture than Nature, reveals where the pain points are for providers and what they are doing to address them.

The products reviewed in the report include Allscripts Enterprise, athenahealth, Cerner, eClincialWorks, Epic, GE Healthcare CPS, Greenway, McKesson Practice Partner and NextGen.

“Meaningful use is driving the adoption of EMRs, but at times this comes at the cost of efficiency and effectiveness,” report author Mark Wagner, said in a news release. “The financial investment in EMR technology can be large for providers, but this investment pales in comparison to the outlay in effort providers are making to customize the products to achieve high usability.”

The study focused on the performance of EMRs in general as well as by medical specialty. The most recent market entrant, athenahealth, received the highest effectiveness and efficiency scores as well as the highest overall usability ratings at go live and today. Additionally, Epic was rated as being the best at guiding providers to achieve high levels of usability.

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As part of this study, KLAS conducted more than 163 interviews with physician leadership from groups with more than 25 physicians to determine the performance for each of the vendors as well as the contributing elements behind each of the ratings.

Jeremy Delinsky, athenahealth CTO, credited the company's decision to create the position of director of user experience – held by Mary Kate Foley – for athenahealth’s high usability score.

“We were building the product in our organization to get this result because we knew there was a huge unmet need in the market, where providers are really desperate for a solution that works simply out of the box, without a lot of time invested in it,” Delinsky said.

Foley “has fought the good fight to get design – interaction design and user research – as core competencies to the table in how we build our product,” Delinsky said.

“We aim for EHR usability where it matters – at the practice level, as part of the natural caregiver workflow,” athenahealth CEO Jonathan Bush said in a news release. These KLAS usability findings validate our mission and purpose.”

[See also: Q&A: athenahealth CEO Jonathan Bush.]

“I think creating a culture of caring about it was really the differentiation,” Delinsky said. "We’ve created a culture where people care about usability and view it as a key part of our mission to achieve it. It permeates everything that we do.”

Other areas where athenaClinicals is outperformed competing ambulatory EHRs include:

• Physician documentation: athenahealth clients gave the highest ratings, citing convenient combinations of clickable templates and free text fields.
• Support for mobile device: In a category where the average EMR scored 3.2 on a 5-point scale for mobile support, athenaClinicals scored highest at 4.1.
• Modifications: Less than one-third of athenaClinicals’ clients needed to do extensive modifications.