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Usability Testing Supports HIT Partnership's Copy and Paste Recommendations 

A report released by the National Institute of Standards and Technology (NIST) provides support for two of the Partnership for Health IT Patient Safety's safe practice recommendations for the use of copy and paste.

The recommendations were developed by a multistakeholder collaborative, the Partnership for Health IT Patient Safety, convened and operated by ECRI Institute. This was the Partnership's first set of safe practice recommendations.

NIST, in conjunction with the Fors Marsh Group, ECRI Institute, and the US Army Medical Research and Material Command's Telemedicine and Advanced Technology Research Center, conducted a human factors evaluation of the use of copy and paste to determine if the Partnership's recommendations were supported by provider actions and understanding.

In the just-released and publicly-available NIST report, NIST IR 8166, "Examining the Copy and Paste Function in the Use of Electronic Health Records" data overwhelmingly supported two of the Partnership's safe practice recommendations—making copy and paste materials easily identifiable and ensuring that the provenance of the material is readily available. The study indicated that clinical users could benefit greatly from training on when and how copy and paste is appropriate to use.

Participants in the study noted that preserving integrity of the information was their primary concern despite the time saving and efficiencies derived from this functionality. Loss of integrity was identified in four areas: finding the information, copying information, understanding the information, and reusing information.

"Using outdated information, truncating information, or including a large amount of potentially extraneous information can all lead to safety issues," says Lorraine Possanza, patient safety, risk and quality program director at ECRI Institute.

All of these areas call for increased attention to how and when the copy and paste functionality is used. The Partnership's safe practice recommendations and implementation toolkit, released in February 2016, provides guidance on the safe use of the copy and paste feature in the following four areas:

• provide a mechanism to make copy and paste material easily identifiable;

• ensure that the provenance of copy and paste material is readily available;

• ensure adequate staff training and education regarding the appropriate and safe use of copy and paste; and

• ensure that copy and paste practices are regularly monitored, measured, and assessed.

The NIST report also delivers human factors guidance, including several specific recommendations for "user interface design to ensure safety-related usability of the copy and paste function" to complete the above safe practice recommendations.

Source: ECRI Institute