lack of EHR usability

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Angular.js Versus the Cult of Health IT Complication

Last week, I mentioned some of the cutting edge software technologies we use at MedicaSoft that many of the giants in non-healthcare industries also use. I thought this week I’d delve a little deeper into one of those technologies – Angular.js. There are many reasons to use Angular. At MedicaSoft, we use it to improve the speed of our development process. Angular enables us to develop and build features quickly and get changes in front of our clinicians for more of their feedback, resulting in less time in between product builds and releases.

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Bingo Medicine: Are EHRs Oppressive Straightjackets?

For several decades, software builders have tried to help doctors practice medicine more efficiently and more effectively. As is often the case with good intentions, the results turned out to be a mixed bag of goods, with paternalistic overtones from the helpers and mostly resentment and frustration from those supposedly being helped. Whether we want to admit it or not, the facts of the matter are that health IT and EHRs in particular have turned from humble tools of the trade to oppressive straightjackets for the practice of medicine. Somewhere along the way, the roles were reversed, and clinicians of all stripes are increasingly becoming the tools used by technology to practice medicine.

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Crash Test Dummies and Electonic Health Records

EHR vendors are quick to say that the upcoming stage 3 Meaningful Use requirements are too burdensome, that they are too difficult to complete, and they are not necessary. (see this article for example). Many EHR vendors would say let market forces take over and the Health IT industry will heal itself. The big business interests of the Healthcare industry may cry wolf (and lobby hard) against the meaningful use program and its significant enhancements to the usability program because they don’t want to spend the extra time and money to provide a healthcare system that truly follows a safety-enhanced design philosophy.

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Doctors Are Overloaded with Electronic Alerts, and That’s Bad for Patients

Shefali Luthra | The Washington Post | June 13, 2016

Some people receive constant reminders on their smartphones: birthdays, anniversaries, doctor’s appointments, social engagements. At work, their computers prompt them to meet deadlines, attend meetings and have lunch with the boss. Prodding here and pinging there, these pop-up interruptions can turn into noise to be ignored instead of helpful nudges. Something similar is happening to doctors, nurses and pharmacists. And when they’re hit with too much information, the result can be a health hazard...

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Jean Piaget & the Usability of Healthcare Software

The usability of healthcare software, or lack thereof, has been a topic of discussion for several years. The problem has become so widespread that the American Medical Association (AMA) has recently issued a framework for improving the ease of use of EHRs that, in part, includes the reduction of 'cognitive load.' Piaget’s theories can be applied to understanding some of the reasons why many EHRs are just too hard to use. They can provide guidance for finding ways to reduce the cognitive workload that so often hinders the user experience of EHR systems. Read More »

Joint Commission Issues Sentinel Event Alert On EHR Safety Risks

Press Release | The Joint Commission | March 31, 2015

Safe use of health information technology (health IT) is the focus of a new Sentinel Event Alert released today by The Joint Commission. The new alert examines the contributing factors to sentinel events that are health IT-related and includes suggested solutions to be implemented by health care organizations. It builds on Sentinel Event Alert, Issue 42, issued in 2008, which focused on safely implementing health information and converging technologies. Read More »

MedStar Research Team Links Electronic Health Record (EHR) Usability Issues to Potential Patient Harm

Press Release | Medstar Health | March 27, 2018

Specific types of electronic health record (EHR) usability issues are associated with a variety of potentially serious patient harm events, according to a study released by MedStar Health researchers with the National Center for Human Factors in Healthcare. This study, which was published today by the Journal of the American Medical Association, is the first one of its kind to reach this conclusion, and it underscores the need for more and better collaboration among EHR vendors, providers and health systems, and other stakeholders, as well as a reexamination of federal policies for improved usability.

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On the Need to Improve User-Centered Design (i.e. Design Thinking) for Healthcare IT Usability

The lack of usability of electronic health records (EHRs) and healthcare IT applications, in general, has been in the news a lot again. This time it is a research report published in the Journal of the American Medical Association (JAMA) on March 27. The study analyzed voluntary error reports associated with EHR systems and found that problems with EHR usability may have directly resulted in patient harm. Unfortunately, this situation is all too common in the healthcare industry. Numerous health care systems are designed and created ad hoc, or with a very engineering-centric approach. End users are dissatisfied and often systems or workflows are abandoned and/or dangerous work-a-rounds created. A lot of people are saying Healthcare IT needs a disruption. What HealthIT needs is to begin to learn about and understand the needs, goals, and methods of the actual end-users, like doctors, nurses, medical assistants, etc.

Readers Debate Causes of, Solutions to Limited EHR Usability

Kyle Murphy | EHRIntelligence | September 9, 2015

The advent of meaningful use is certainly responsible for increasing EHR adoption, but it hasn't ensured EHR usability and is likewise responsible oversaturating the EHR marketplace with health IT products which might have otherwise floundered without billions in EHR incentives. Recent research published in the Journal of American Medical Association (JAMA) finds that EHR usability is lacking among EHR vendors. Read More »

The EHR Debacle: Has Organized Medicine Failed Us?

By now, it should be no secret that physicians in the United States, although largely receptive to the idea of electronic health records (EHRs), are widely dissatisfied with the current state of the art, and with the way that EHR adoption is being implemented.[1] Indeed, Congress[2] has shown continuing – but sometimes seemingly perfunctory – interest in the concerns of physicians and other health care providers, and I am at this point pessimistic about seeing any results of its efforts in the near future unless a more fundamental change is made in our approach. As Einstein noted, “We cannot solve our problems with the same thinking that created them.”

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Towards a New EHR Metaphor - Or, How to Fix Unusable EHRs

News flash: docs hate Excel! In a recent study, which included researchers from Yale, the Mayo Clinic, Stanford, and the AMA, physicians rated it only at 57% on a usability rating, far below Google search (93%), Amazon (82%), or even Word (76%). But, of course, Excel wasn't their real problem; the study was aimed at electronic health records (EHRs), which physicians rated even lower: 45%, which the study authors graded an "F." If we want EHRs get better, though, we may need to start with a new metaphor for them.Lead author Edward Melnick, MD, explained the usability issue: "A Google search is easy. There's not a lot of learning or memorization; it's not very error-prone. Excel, on the other hand, is a super-powerful platform, but you really have to study how to use it. EHRs mimic that."

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