ORIGINAL RESEARCH article
Front. Digit. Health
Sec. Health Informatics
This article is part of the Research TopicReshaping Health Informatics: Enhancing Digital Tools and Human Services through DesignView all articles
A Structured Framework to Improve Usability in EHR Implementation: A User-Centered Case Study in Brazilian Mental Healthcare
Provisionally accepted
Fernanda Peron Gaspary1Daniel Baio do Amaral2Cristina Vinicius Fagundes1
Luis Felipe Dias Lopes3*
JOÃO FRANCISCO POLLO GASPARY2*- 1Universidade Franciscana, Santa Maria, Brazil
- 2Instituto AuBento – Center for Teaching, Clinical Practice and Research in Orthomolecular and Translational Health Innovation, Santa Maria, Brazil
- 3Federal University of Santa Maria, Santa Maria, Brazil
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The implementation of Electronic Health Record (EHR) systems has become central to digital health transformation, yet significant usability challenges continue to constrain their effectiveness— particularly in mental healthcare contexts. This study presents a structured and user-centered framework for improving EHR usability, grounded in a case study conducted in Brazilian outpatient mental health settings. Using the Double Diamond design methodology, the research followed four iterative phases—Discover, Define, Develop, and Deliver—and engaged 21 healthcare professionals through qualitative interviews. Data were structured using the Certainties, Suppositions, and Doubts (CSD) matrix, and validated through heuristic evaluation and prototype testing. Key barriers identified included non-standardized navigation flows, poor integration with external systems, and inflexible documentation structures. In response, the study proposes design-driven solutions such as customizable templates, real-time validation features, and workflow-specific interface adjustments. The resulting framework bridges service design logic, user experience optimization, and regulatory compliance, offering a transferable model for improving EHR implementation across diverse digital health environments. By addressing both systemic usability gaps and contextual demands, this research contributes actionable insights for advancing human-centered EHR innovation.
Keywords: Digital health innovation, Electronic Health Records (EHR), Human-centered design, implementation science, interoperability, Mental healthcare, service design, usability
Received: 15 Aug 2025; Accepted: 01 Dec 2025.
Copyright: © 2025 Gaspary, Amaral, Fagundes, Lopes and GASPARY. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Luis Felipe Dias Lopes
JOÃO FRANCISCO POLLO GASPARY
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