It is no secret that the usability of many healthcare IT systems are subpar and causing a lot of users headaches and anxiety. This is especially true with EMR systems. For years, I have heard complaints first hand from nurses and pharmacists about how much extra work it takes to navigate these systems. It seems an even larger voice is speaking up about it: doctors.
The American Medical Association (AMA) caught my attention recently when they released a framework for their top 8 usability priorities for EHR usability. This is coming not long after a RAND report showed increased physician dissatisfaction with EHRs, and a lot of talk about health organizations wanting to switch vendors.
The 8 recommended ares of improvement listed are (view the full report here):
- Enhance physician's ability to provide high-quality patient care
- Support team-based care
- Promote care coordination
- Offer product modularity and configurability
- Reduce cognitive workload
- Promote data liquidity
- Facilitate digital and mobile patient education
- Expedite user input into product design and post-implementation feedback
Two things caught my attention when I read the report. The first was a strong call for better User Research from the vendors. In order to reduce cognitive workload and enhancethe ability to provide high-quality care, there needs to be a real understanding of the clinical workflows that need to be supported. The AMA specifically calls out bringing user input in the product design lifecycle - that is a recommendation for User Centered Design. UX Researchers everywhere rejoice!
The other item that caught my attention was the item on product modularity and configurability. In other words, we need better interoperability between systems. This is a hot topic of discussion in the Health IT world right now. The reality is, not one piece of technology can do it all well. AMA President-elect Steven J. Stack, M.D states this nicely:
“Now is the time to recognize that requiring electronic health records to be all things to all people - regulators, payers, auditors and lawyers - diminishes the ability of the technology to perform the most critical function - helping physicians care for their patients,”
For a while it seemed usability was just checking a box or a competitive differentiator in healthcare. But there has been a push to improve health IT usability coming from the ONC and NIST standards. The AMA has a lot of influence, and now they have evidence to show this needs to be addressed. In my opinion, the AMA report is a signal that we have reached the point where good health IT usability is an expectation.
I’m glad to see this tipping point has been reached. What concerns me is how the industry is going to overcome years of technical debt to really provide usable, streamlined clinical solutions to all caregivers. It appears to be time for third party Health IT vendors to shine.