One Doctor’s EMR Usability Wish List

In this space, we talk a lot in the abstract about how physicians feel about EMR usability. Today, though, I wanted to share with you some great observations from a piece by an angry anesthesiologist who lays out her own usability wishlist for EMRs and health IT generally.

In the piece, Dr. Shirie Leng fumes over the sheer work it takes for her to negotiate the systems she uses at her hospital. She notes that over the course of doing eight cases during a day, she’ll a) sign something electronically 32 times, b) type her user name and password into three different systems a total of 24 times and c) generate about 50 pages of paper given that the the computer record must be printed out twice.

To Dr. Leng, there’s ten steps institutions can take to eliminate much of the hassle and waste:

1. Eliminate user names and passwords:   She suggests using biometric sign-in technology.

2. Eliminate the paper:  Why print data that’s already entered into the system, she asks?

3. Make data systems compatible and 4. Make everyone statewide use the same system:  Dr. Leng says it’s crazy that we don’t have interoperability within hospitals or between different institutions.

5. Don’t make her turn the page:  “All the important information about a patient should be on the first page you open when you look at a patient,” she says. “I shouldn’t have to click six different tabs.”

6. Don’t make her repeat herself: If she does several cases the same way, with the same documentation each case, don’t make her re-enter it every single time.

7. Invest in voice-recognition software:  During patient interviews, Dr. Leng notes, she wants to look at patients and talk, not hunt and peck at the keyboard or worse, spend hours later typing in data or clicking checkboxes.

8. Go completely wireless:  Not an EMR point, but a good one nonetheless: why make doctors untangle cords and monitoring wires?

9. Hire a typist if you need one:  Don’t turn nurses into data entry clerks, she argues. Right now they have massive amounts of data entry piled onto their plate.

10. Triple back-up the system:  Paper doesn’t crash but computers do, she notes.

So there you have it, a list of EMR and health IT concerns straight from a practicing physician. I think all her points deserve attention.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.


  • Thanks for the post, My one thought is instead of forcing docs to use one system why not force on standard of data storage and let the EHR market decide how to present the data. You may want to read my blog about the “Next Generation EHR, is no EHR” Let the docs have what they want EHR presentation not EHR silos

    Jeff Brandt

  • Hi John, I didn’t say it was easy, however I do believe it will happen. Technically, it makes sense. It’s the BILLION $ company that keep pushing antiquated old Iron EHR systems on to our healthcare system that make it difficult

    Let’s talk in 5 yrs.


  • Ha!
    In answer to each one…
    1. Can I have your prescription pad doctor? As to biometric sign in, well, that’s not ready for primetime either. I say this as someone who uses facial recognition on his computer.

    2. In my own experience, legibility, eye strain and a need to get it into the hands of folks who don’t have computers or won’t use computers.

    3. HL7. Interfaces.

    4. HA! Can you imagine the legislative efforts going on there? And how cheaply some of the state legislatures can be bought? And it won’t happen without deep involvement of the states in providing healthcare at all levels. In short, she wants to repeat the British experience 50 different times?

    5. Try scrolling up and down a long web page for information and get back to us.

    6. OK, a point there. But macros and default entries can be built in many systems.

    7. Another point. Dragon can be useful.

    8. See experiences with wireless and pacemakers and security.

    9. Scribes.

    10. I think what she really means is regular and thorough backups, plus tests of said backups.

  • #7 — when will NLP proliferate? if i can ask siri, why can’t i ask my EHR? easy data input, valuable statistical and administrative output. seriously, what are the $ hurdles to this and why?

    this anaesthesiologist represents an advancing tsunami of enduser frustrations…


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