With EHR adoption skyrocketing and the health IT market shifting unpredictably as physicians search for systems tailored to meet their needs, vendors need to do more than just convince a practice that an EHR is a good thing to have. They need to design and execute a product that puts usability at the forefront, ensuring that workflows are smooth and intuitive, and frustrations are kept to a minimum.
Last week, KLAS Research named Massachusetts-based athenahealth to its top spot in its 2013 ambulatory EHR usability report, lauding the cloud-based EHR provider’s attention to effectiveness and efficiency. EHRintelligence spoke to Jasmine Gee, Director of Product Marketing at athenahealth, about some of the considerations that go in to designing their highly-rated athenaClinicals EHR.
How do you consider the needs of the physician when developing an EHR product?
One thing that we focus on is building something that will actually allow physicians to do their job in a way that is unobtrusive and allows them to feel that they are seeing patients and that they’re not some data entry people who are trying to solve some government regulatory program.
Our approach is really based on results. One thing that we can do, because we’re in the cloud and everyone is using the same version of our software, is use athenaClinicals to figure out where providers are succeeding and where they’re failing in the workflow, and use that data to figure out what aspects of the system we need to change. We have a great crew of user experience experts and designers, but first and foremost, we use that data to really focus on the changes we need to make to make it usable.
What are physicians asking for in an EHR?
They’re asking for them to not do a lot of work. With meaningful use being the big impetus for most people to be on an EHR, for the most part they feel like data entry people. So what they want to do is do key things in the EHR – enter prescriptions, send orders, document the visit – but they want it to feel natural and not this computer screen that’s preventing them from doing their job well.
How much do physicians really vary in the way they want to complete their workflows?
The process of a clinical consult itself is pretty standard, but it’s how the physician documents the visit that’s actually really variable. Some physicians like to use templates; some like to dictate. Some draw on pieces of paper and scan them in to the EHR. What we try to do is give physicians complete flexibility in that component of the exam. You document the way that makes sense to you. But as a patient, everything leading up to seeing the physician and everything after you see the physician is pretty routine.
What about hybrid paper-EHR workflows? Do you think they really work effectively?
We think the paper component of a hybrid workflow is okay as long as there isn’t critical data there like drug-drug interactions, allergies, and dosage alerts. If you want to write down the care protocol for a patient on a piece of paper, that’s fine. But we believe that certain things need to be captured as structured data: height and weight and blood pressure, the prescriptions, and allergies. That’s what drives a lot of the things that will make EHRs great and actually make patient care safer. If physicians aren’t careful with these hybrid workflows, though, they’re going to get themselves into a trap. It’s something that we watch really, really closely.
What’s the most important thing to think about when designing an EHR workflow?
We try to focus on the areas of the system where the physician spends the most time, and we try to figure out where we can strip out extra time. We really believe in delegation. Within an office, people need to work to their highest level of training. Physicians are trained to examine and diagnose patients, but there are other people in the office like medical assistants and nurses who can do things like take blood pressure, record complaints.
So we ask, “What is a physician really good at?” Okay, let’s make sure that workflow makes sense. What are nurses and medical assistants really good at? What are front desk people good at? We really do believe very strongly that by taking the work away from the physician if they don’t really need to do it, that’s the best way to achieve usability, which is also efficiency, and the ability to see patients and interact with patients and not feel that there are all these things that you have to jump through in order to do that.
