The Office of the National Coordinator for Health Information Technology (ONC) has been tasked withmanaging the integration of usability best practices into electronic health record development but, hasprovided little guidance on how to conduct Summative Usability Testing (SUT). We reviewed three aspectsof SUT in four publicly available SUT vendor reports. Significant deviations from human factorsengineering (HFE) and user-centered design (UCD) best practices and clear methodological errors werefound in all four reports. The main sources of variation involved non-representative participant selection,instructions that led participant performance, and varied interpretation of results reporting requirements.Although ONC has made significant gains in implementing best practice UCD approaches, more explicitguidance may be needed to enhance integrity and reduce variation.
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