Institutional members access full text with Ovid®

Share this article on:

Development of a Tool to Measure User Experience Following Electronic Health Record Implementation

Xiao, Yan PhD; Montgomery, Donna Cook RN-BC, BSN, MBA; Philpot, Lindsey M. PhD, MPH; Barnes, Sunni A. PhD; Compton, Jan MSHA, BSN, RN; Kennerly, Donald MD, PhD

doi: 10.1097/NNA.0000000000000093

OBJECTIVE: The aim of this study was to develop a survey tool to assess electronic health record (EHR) implementation to guide improvement initiatives.

BACKGROUND: Survey tools are needed for ongoing improvement and have not been developed for aspects of EHR implementation.

METHODS: The Baylor EHR User Experience (UX) survey was developed to capture 5 concept domains: training and competency, usability, infrastructure, usefulness, and end-user support. Validation efforts included content validity assessment, a pilot study, and analysis of 606 nurse respondents. The revised tool was sent to randomly sampled EHR nurse-users in 11 acute care facilities.

RESULTS: A total of 1,301 nurses responded (37%). Internal consistency of the survey tool was excellent (Cronbach’s α = .892). Survey responses including 1,819 open comments were used to identify and prioritize improvement efforts in areas such as education, support, optimization of EHR functions, and vendor change requests.

CONCLUSION: The Baylor EHR UX survey was a valid tool that can be useful for prioritizing improvement efforts in relation to EHR implementation.

Supplemental digital content is available in the text.

Author Affiliations: Director of Human Factors and Patient Safety Research (Dr Xiao), System Director of Nursing and Patient Care Informatics (Ms Montgomery), Director of Survey Research (Dr Barnes), Health Services Researcher, STEEEP Measurement, Analytics, and Reporting (Ms Philpot), Chief Patient Safety Officer (Ms Compton), and Associate Chief Quality Officer (Dr Kennerly), Baylor Scott & White Health—North Division, Dallas, Texas.

The survey development was supported in part by Baylor Health Care System and by a grant (10510592) for Patient-Centered Cognitive Support under the Strategic Health IT Advanced Research Projects from the Office of the National Coordinator for Health Information Technology.

A presentation about the 2011 survey tool and results was made to the Healthcare Information and Management Systems Society Usability Taskforce in January 2012.

The opinions expressed here do not necessarily reflect the official position of the sponsors.

The authors declare no conflicts of interest.

Correspondence: Dr Xiao, 8080 North Central Expy, Ste 500, Dallas, TX 75206 (

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins