Over at the august halls of the National Institute of Standards and Technology, researchers have been compiling data on what makes EMRs usable. A year ago, in April 2011, NIST presented a draft set of usability standards. At the same hearing, a wide range of academics and scholars got up to talk about what they saw as they key issues — including whether EMR workflow should be changed to make it cost-efficient.
Since then, from what I can tell, there’s been a lot of noise but little light shed on the design specs a truly usable EMR should adhere to. There’s been some progress in the development of HIE connections between EMRs, some worthwhile work EMR return on investment and even some improvements that might leverage EMRs to help doctors collect more from patients.
Talk to many doctors, and they’ll tell you their EMR stinks. Why? Largely because workflow is still inefficient and the “click burden,” which can drive doctors through a dozen steps to get tasks handled, hasn’t been reduced any too much. Some older docs I’ve spoken with even pine for the rough-hewn EMRs of 20 to 30 years ago more, which were at least built by their colleagues.
Honestly, I don’t expect the “awkward interface” problem to go away anytime soon. But while we stew on this issue, you might be interested to learn that NIST is taking over a few related problems in which it could conceivably make a real difference.
A few months ago, NIST released the 16th and final draft of its recommendations on definition of cloud computing. (Talk about insisting on getting it right!) Not everyone in the health IT industry is even aware that NIST has kicked out a cloud standards document, which our friend Shahid Shah, “The Healthcare Guy,” is urging people to get onto their radar. Maybe this time, NIST has a chance to actually standardize before an industry runs while with its own implementations of key technology.
I think I’ll finish with Shahid’s comments on the subject, as I think he’s pretty clearly got it right:
My strong recommendation to all senior healthcare executives is that we not come up with our own definitions for cloud components – instead, when communicating anything about the cloud we should instruct our customers about NIST’s definition and then tie our product offerings to those definitions. The essential characteristics, deployment models, and service models have already been established and we should use them. When we do that, customers know that we’re not trying to confuse them and that they have an independent way of verifying our cloud offerings as real or vapor.