Background: Usability gaps between current and future improved Electronic Health Record (EHR) system designs exist due to insufficient incorporation of User-Centered Design (UCD) principles during System Development Life Cycle (SDLC).Objectives: To evaluate the usability aspects of a commonly used EHR system specific to clinical notes usage from attendings’ and residents’ standpoints by analyzing objective measures of users’ performance and their subjective perceptions employing mixed methods approach.Methods: Usability of a commercial, inpatient EHR clinical notes documentation interface was analyzed from standpoints of two provider groups employing two standardized patient cases. Both objective and subjective data were collected from attending (n=6) and resident physicians (n=8) through usability testing employing a mixed method approach.Results: The study results suggested that (i) EHR usability and desirability is influenced by user characteristics, (ii) workloads associated with H&P and progress notes writing are perceived differently between two groups, (iii) repeated task performance improves user efficiency and (iv) user performance is correlated to their subjective system assessments.Conclusion: Understanding usability of clinical documentation interface from perspectives of two different user groups, provides interface designers with an opportunity to develop an EHR system centered on UCD principles
