The final panel discussion today at the PDR Network sponsored PharmEHR conference was a debate among four physicians regarding their experiences using ePrescribing. In response to the question, “Has ePrescribing made your practice more efficient?”, positive responses outnumbered the negative three to one. Although ePrescribing was felt to be beneficial — particularly in relation to the renewal of multiple medications through an EHR — differences in implementation as well as practice or hospital policies reduced the overall value of the system. After a lively discussion regarding additional challenges such as the inconsistency of drug information from formularies, the conversation redirected to the most often discussed problem with EHRs: namely usability.
Released March 21, 2012: The NIST (National Institute of Standards and Technology) health IT Usability initiative is focused on establishing a framework that defines and assesses health IT usability. The goal of the research effort, being conducted in collaboration with the Office of the National Coordinator for Health Information Technology (ONC) and the Agency for Healthcare Research and Quality (AHRQ), is to create a detailed specification of an objective, repeatable procedure for measuring and evaluating the usability of health IT systems. The initiative will examine the human factors critical to designing usable EHRs and will guide industry in usability engineering practices. Click here to access the NIST resources.
Human factors and usability are significant barriers to optimized use of EHRs. A February 12 article in Health Data Management by Elizabeth Gardner began with the following paragraph:
“As long as there have been electronic health records, clinicians have complained that they’re difficult to use. These cries have often been dismissed as resistance to modern technology-ironic considering that the complainers are perfectly comfortable using robots to perform bypass surgery, zapping tumors with proton beams, or mapping brain activity with functional MRIs.”
In the article, Gardner goes on to highlight some of the usability challenges with EHRs, including the following:
- Poor interface design
- Multiple customizations creating non-standard solutions
- Older legacy systems
- Users not knowing what they need
- Overcrowded screens packed with data
- Alert and reminder fatigue causing users to switch off or ignore functions in the EHR
- And more…
What is evident is that usability is a big barrier to the successful use of EHRs. With hundreds of certified EHRs in the market, not all are going to make the cut and be successful. However, you can be sure that in addition to meeting the data exchange requirements and other key Meaningful Use criteria, the best EHRs in the future are also going to be highly usable.
Have you had experience with usability issues in your EHR? Share your experiences.