The EHR marketplace is full of innovative systems and services aimed at helping healthcare organizations and providers deal with a variety of initiatives. From accountable care and population health management to big data and healthcare analytics, promises of new functionalities are commonplace among health IT developers and vendors.
But how will any of this increased innovation prove valuable unless the usability of current EHR systems is improved? According to family physician and usability evangelist Jeff Belden, MD, the answer question is not very much.
“The field of data visualization and cognitive and vision science are not taken advantage of very effectively yet in healthcare,” he told EHRIntelligence.com last month at HIMSS14.”When you hear talk about big data, big data is not going to help anything if you don’t display it effectively in a way that helps people answer questions they have and make decisions they need to make.”
In his roles at University of Missouri Health Care and the Tiger Institute for Health Innovation, Belden has looked closely at how improvements in EHR usability can translate into greater physician satisfaction simply by taken into account the workflows of clinicians.
“My mission is to relieve physician suffering by improving usability of the software they use,” he explains. “The problem right now is that doctors have to think really hard and what we know is that a lot of this stuff could be offloaded.”
Borne out of his frustration working with poorly designed EHR systems for more than two decades, Belden is sensitive to needs and concerns of physicians using health IT in support of their clinical workflows.
“Anytime you change the software, you better make it so much better that everybody finds that it was a positive change and that the effort was worthwhile,” he argues. “It’s real easy to make little tweaks and adjustments that shift your cheese around and then you have to learn new paths. If I have a clunky old path of workflow that works, to change it to something that’s only 15 percent better is almost never worth the effort.”
What’s important to minimizing disruption is proving the value of a given change, assuring physicians that any enhancement or refinement has been tested and approved. It is hardly the case that physicians dislike change in and of itself — they simply work to work as efficiently and effectively as possible. Anything in the way of that, be it environmental or technological, is a hindrance.
Furthermore, a lack of EHR usability could prevent new health IT tools being put into place for fear that they will add rather than subtract from a provider’s workflow. Belden offers secure messaging as an example.
“Doctors worry about that and those worries are largely unfounded,” he says. “Really what’s happening is you were getting phone calls that were probably kind of accurate and now you’re getting messages in the patient’s exact words.”
Poor execution can easily spoil a great idea. Given the number of options available to healthcare organizations and providers with respect to EHR and health IT systems, a lack of usability could very well lead to in low physician adoption and high probability that an EHR replacement will be necessary.
While usability may not have been at the forefront of EHR designers’ minds until more recently, a more knowledgeable physician community is beginning to look past the bells and whistles of a well-rehearsed product demonstration and demand more usable technology. The question remains whether EHR developers can deliver. Source
