The reason why many doctors find electronic health records (EHR) difficult to use might be that the software wasn’t properly tested, researchers suggest.

Current guidelines and industry standards suggest that new EHR software should be tested by at least 15 end users with a clinical background to make sure they are usable and safe before they get federal certification.

But a new study finds that many certified products did not actually conduct this user testing, or did so without clinical testers.

Despite the guidelines, “there’s no explicit requirement for end user testers to have a clinical background,” said Raj M. Ratwani of MedStar Health in Washington, DC, who worked on the study.