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The Risks of Copying and Pasting: Health Technology, Human Error, and User Experience Design

user experience / client work / health / technology / featured

If you use any kind of word processing software, chances are you are pretty familiar with the copy-and-paste functions. Using them is an easy way to avoid retyping the same information, and you probably do it without a second thought. But when it comes to electronic health records, copy-and-paste functions can potentially lead to errors in health records, putting patients at risk. On the one hand, copy-and-paste functions are vital in helping health care professionals save time and document all necessary patient information; but these functions can lead to substandard health records if providers copy and paste the wrong information, fail to update information after copying and pasting, or copy and paste extraneous information.

FMG recently completed a study to examine the ways in which health care providers use the copy-and-paste function when completing electronic health records (EHR). This research was completed in partnership with the National Institute of Standards and Technology (NIST), the ECRI Institute, and the U.S. Army Medical Research and Materiel Command’s (USAMRMC) Telemedicine and Advanced Technology Research Center. To conduct the study, FMG recruited physicians and nurses to participate in our usability lab. Participants performed routine functions using EHR software and answered questions about their use of the copy-and-paste function. Some of the main findings were:

  • Study participants worried about the integrity of information when using copy and paste.
  • Study participants noted that there was a high risk of putting the wrong information in the wrong chart.
  • Study participants believed that the copy-and-paste function allowed providers to copy too much information, leading to charts that were long and overly detailed (also known as “note bloat”).

Based on the usability findings, the final report on the study released by NIST makes several recommendations, some of which echo the guidelines previously released by the Partnership for Health IT Patient Safety. The report’s recommendations include:

  • EHRs should provide clear visual representation of the data selected for copying.
  • EHRs should encourage providers to actively review any information that was copied and pasted and to make any necessary changes.
  • EHRs should provide a “chain of custody” showing the source of any information that has been copied and pasted.
  • Certain types of information should be automatically blocked from copy-and-paste functions. These include demographic information, dates, and blood bank information.
  • Health care providers should be trained on how and when they should use copy-and-paste functions.

This study is just one example of how health technology can benefit from user experience research. Health technology is only as good as the information being fed into it, and there are specific ways that we can design health tech products to make them easier to interact with and to decrease the likelihood of mistakes. Health information technology (IT) systems and products should be intuitive, easy to use, and should have appropriate safeguards and double checks built in. User experience research can help by identifying the most common sources of user frustration, brainstorming potential solutions, and iteratively testing different prototypes. This process can help ensure that any EHR system is easy for people to use in the way they intend to—an important goal in any user experience setting, but especially in health care in which well-designed systems help save lives.

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