The Myth of “Too Many EHR Clicks”

I’ve regularly talked about the myth of “too many clicks.” Long time readers may remember my piano analogy. That analogy is just as good today as it was 3+ years ago. I still think the key to clicks is providing consistent response and training.

While I still love that analogy, the Usability People offered another great insight into the myth of “too many clicks”:

Multiple clicks are not a deterrent to usability and user satisfaction, in fact there are many occasions where having more clicks may actually improve usability.

In our experience facilitating a large number of usability tests, people don’t complain about having too many clicks. Making the click is automatic.

The crux of the matter is that each click represents a decision point within a workflow. It isn’t too many clicks, it is too many decisions!

I love this added layer of insight into making something usable. The clicks aren’t the issue as much as the number of decision points that are available and how clearly those decision points are marked. In many respects this goes back to proper EHR training again, but it can also be due to really poor design as well.

Would it be wrong to say that the key is to make those clicks meaningful?

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

9 Comments

  • There is no global “too many clicks” count that anyone has condemned for EHRs. Users see that tasks take too long, so the issue is more one of inefficiency.

    Here is a personal example of too many clicks due to poor design…

    Each month I pay two credit card accounts. On the CC1 website, logging in brings one immediately to a screen with current activity, statement balance, and a prominent “PAY” button. Pressing the Pay button then opens a second screen. Here, there are three choices, pay off the entire amount, amount due, or a third amount of one’s choosing. Only one choice requires any typing. The date the payment is to be submitted is automatically set for “Today.” Total clicks after log-in to pay bill = 2 (to pay suggested amount, today).

    On the CC2 website, log-in takes one to a second screen filled with information and requires an additional click to get to the screen with current activity, statement balance, etc. Clicking the “Pay” button, then opens another screen on a different website dedicated to payments where one has to select a date from a calendar widget, then click the “Pay” button to pay the suggested amount. Going back to the screen with activity and balance requires two more clicks.

    I can pay CC1 within 10 seconds after logging in and be done. That site is now my gold standard. For me, more than two clicks to pay a CC bill is “too many clicks.”

    Usability is a very personal measure. We all have preferred ways of doing things and anything that changes how we work feels wrong. The key to better EHR usability? Avoid one-size-fits-all thinking. http://ehrscience.com/2015/09/21/a-usability-conundrum-whether-it-is-ehrs-or-hospital-gowns-one-size-never-fits-all/

  • “Would it be wrong to say that the key is to make those clicks meaningful?”

    No it wouldn’t, in fact it just might be the right thing to say. As far as I am concerned this is not a myth, but an actual problem that comes with poor design.

  • Please be careful about using phrases like “make those clicks meaningful”. It may spur some governmental agency into creating a huge program like Meaningful Clicks. 🙂

  • To me, the deeper issue involves “flow”, or the rhythm of my work. I am trying to orchestrate paying attention to the patient, medical decision making, and documentation. The “clicks” cause brief pauses in that flow; the more pauses, which are just long enough to be disruptive but not long enough to allow another task or in depth decision to be made, the less efficient and more disjointed is the experience of patient care. I do think that we can come up with technology/emr system that produces better flow-but then I believe you need a programmer with the humility to sit side by side with both clinician and patient together. The programmers and trainers from some of the emr companies that I have encountered have egos that rival the most arrogant of physicians in my medical profession (I am a physician). We need neither.

  • Forget data entry, if CMS or ONC wants data entry, then pay me for a data entry person to do it. Physicians are the worst data entry people as that is exactly why we DIDN’T go into data entry professions. Thats why its still a mess. Plus you want me to be good at data synthesis, not tapping it out on a computer. And you want me to be good at being…hold on…an actual orthopaedic surgeon. I know a ton of people will scoff at me, at how entering data is part of my profession, but I disagree. Shame on our medical leaders for not putting up more of a fight. As providers, we can only do one thing to protest, and that is not to participate in MU or PQRS and take our lumps until someone has to explain to patients that there are no providers left, that we were driven to extinction by all these regulations. Its too bad, because people are leaving medicine at a rate that I have not seen in 2 decades of practice.

  • John, You’re overcomplicating this.

    Economists have a concept called “ceteris paribus”, or simply “all other things being equal or held constant”. It’s a way of isolating one factor when there are many potential decision/evaluation parameters.

    Ceteris paribus:
    Fewer clicks = good
    More clicks = bad

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