Usability has been a topic of considerable interest in the health IT community. This document provides NIST guidance for those developing electronic health record (EHR) applications that need to know more about processes of user-centered design (UCD). An established UCD process ensures that designed EHRs are efficient, effective, and satisfying to the user. Following the guidance in thisdocument will greatly increase the likelihood of achieving the goal of building usable user interfaces and a better user experience. One of the main purposes of this guide is to provide practical guidance on methods relating to UCD and usability testing. The intended audiences of this document are those with a role in determining the features and functions contained in the EHR and how those are represented in the user interface.