There’s a great blog post on HIStalk that is a beautiful CMIO Rant. He provides some really needed perspective on the issues with EHR software. In many ways, the post reminded me of my post titled “Don’t Act Like Charting on Paper Was Fast.” In that post, I highlight the fact that far too many people are comparing EHR against doing nothing versus comparing EHR against the alternative. Those are two very different comparisons.
The money line from the CMIO rant was this one:
If we insist that all clicks are wasted time, then we can’t have a conversation about usability, because under the prescription pad scenario, the only usable computer is one you don’t have to use at all.
I love when you take something to the extreme. It’s true that we all want stuff to just happen with no work. That’s perfect usability. However, that’s just not the reality (at least not yet). If we want the data to be accurate and to be recorded, then it takes human intervention (ie. clicks). Some clicking is necessary.
The CMIO goes on to say that the key to EHR usability is expectations. I thought that was an interesting word to describe EHR usability. I’ve written about this topic before when I compared the number of EHR clicks to the keys on a piano. In that article I suggested that the number of clicks wasn’t the core issue. If we could create EHR software that was hyper responsive (like a piano key), was consistent in its response speed, and we provided proper training, then having a lot of EHR clicks wasn’t nearly as big an issue.
Not that this should be an excuse for EHR vendors to make crappy software. They should still do what they can to minimize clicks where possible. However, the bigger problem is that we haven’t achieved all three of these goals. So, we’ll continue to hear many people complaining about all the EMR clicks.