Today’s the final day for providing feedback on meaningful use to ONC. I find it a little bit ironic that as ONC and healthcare IT in general is stirring about the words “meaningful use” I find a survey by Nuance that shows that 90% of doctors are “concerned” about the usability of EHR.
This figure probably isn’t surprising to any of you out there that have worked in the EHR industry for a while. The usability of the EHR has been one of the big barriers to EHR implementation for quite some time.
I hope that no one is naive enough to think that requiring a bunch of features and reports to show “meaningful use” or “certified EHR” that we’re somehow going to make EHR software more usable. In fact, the opposite may be more likely.
I can just see in my minds eye a bunch of EHR programmers slapping in some half baked code in order to satisfy some “meaningful use” or “certified EHR” criteria. Yes, it probably will meet the criteria, but at what cost to the end user? I’ve very rarely known quickly created software to be very usable. Understanding and implementing usable software takes thoughtful planning to execute correctly. Someone who understands how to simplify the process while still implementing the necessary features.
In the rat race for EHR stimulus money, I predict that usability of EHR systems will actually decline rather than improve.
John, We at User Centric agree with you. If doctors can’t use technology, it doesn’t work! We strive to improve usability through solid research-based user testing of EHRs through:
– Guidelines and Design Patterns
Guidance to the field that promotes high earnability, positive transfer of training, consistency of approach, without stifling creativity or competitive advantage
Design patterns based upon best practices
Visualizations
Efficient, effective methods of representing data that return high value to users
– Measurements
Creation of reliable and valid techniques for measuring user experience and reporting on real user performance outcomes in a meaningful way.
Our goal is to help promote EHR innovation through user research on these and other healthcare IT solutions. Adoption is not going to drastically increase if doctors are not able to use these systems but there are many things (some simple, some more complex) that we can do to help. We need to bring in the right people and backgrounds who have been doing this for years and years.
– HIT Usability/User Centric
Twitter – HITusability
I agree they need to be easier to use. One of the items I have written about is the Common User Interface project from the UK. It can be adapted as a front end anywhere is and free from Code Plex. Graham over at EMR update has done quite a bit of work with it with his Synapse EMR. I did a write up on Graham and his work not too long ago.
Why not have a dynamic Silverlight and easy to use interface that is the same everywhere, or very similar as far as finding and and entering data, the back ends and all the programming can remain the same, just the UI changes. In the ink below I made a video where I am using the demo, not bad and there’s a version for hospitals and small practices too. I think it is a good idea as I spoke with one doctor who had to learn 5 different EMR systems to get through residency.
http://ducknetweb.blogspot.com/2008/05/microsoft-common-user-interface-for.html
Hey Barbara,
The idea of a single interface is interesting. I’m just not sure how that single interface can be nice and flexible for all the various specialties and styles of practice that people employ. It almost seems like it needs to be the other way around. All the data is standardized and the interfaces could all be tweaked by anyone. Basically do what twitter has done with their API.
There will be NO MEANINGFUL USE without Usability! Period! If it takes the doctor too long to doucment a note, he or she will “game” the system. Garbage in and garbage out. Doctors will use the system to get paid and act as a reminder cue so they can care for the patient. All the other data entry functions will sit idle or garbage will be entered. The docs will drive the govt, executives and quality people crazy! And these IDIOTS will deserve it.
Usability should be TOP concern!
BTW, there are some EMRs that are very usable, are CCHIT certified and will satisfy “meaningful use” (whatever that turns out to be). The “trick” will be to find those system and purchase them for your practice.
Start the search NOW. I will take some time.
Considering only those organized efforts meant to do good, American doctors function at the heart of a system with the highest relative cost, lowest efficiency and greatest trouble for its clients of any in the world. We are going to have to have a different kind of health care system in America or as they say “go broke trying”. That system, whatever it is, will be whatever it is because it is sufficient to the circumstances, which are dire. Whether any set of individuals who are part of this system likes what that is or not, well, they have only to look to themselves in wondering why the preemptive rush to change. I’m all for better and more useful EMR according to the experience of doctors. Make it quick though. Things are going to happen fast. My expectation is that doctors will come out of this much better than they went in – as they need to, because of their centrality to health care. However, with respect to deference in the matter of achieving change, we’re going to put all those prerogatives that got us in this mess in your hat and hand it to you.
I’m a computer programming student interested in developing EHR/EMR software. Good “meaningful use” software can be built only if providers are part of the specification writing phase. If they aren’t, then “Garbage in, garbage out.”
Local technical schools can play a role in this.