The AMIDIS Connection | Useability Challenges: A Time For Vendor, Provider Alignment
Usability is a word that pops up as people start to get serious with any technology. Discussions with the Office of the National Coordinator for Health IT, the Centers for Medicare & Medicaid Services and colleagues from across the U.S. indicate that usability in all dimensions is one of the greatest next steps for us to successfully incorporate health IT into the practice of medicine.
Because of the need to actually demonstrate physician engagement with these systems, there is no question that usability concerns are becoming more acute. The medical profession needs to play a bigger role, not only in that engagement, but in developing the products.
In the past, very specific user groups shared their feedback only with the vendor, and not with the larger care community, making this interaction the only path for user feedback. Over time, healthcare organizations have taken these various IT products and, in trying to connect them, experienced difficulties. Today, everybody is getting serious about actual consistent use of these systems, so there is no tolerance for poor usability.
When you’re talking about this highly skilled workforce—physicians—the idea of distraction goes beyond simple job satisfaction and security. It comes down to patient safety. If I’m disoriented while trying to do the right thing, it’s not going to have the same outcome as an incorrect order at McDonald’s. Any number of errors could occur because of the inability of the system to accurately translate what I want to do for my patient versus what is done on the basis of using an EHR.
Data are beginning to appear that will help drive this push for better usability. The 2011 report from the Institute of Medicine regarding increased errors in the use of EHRs is controversial. However, the reality is that the people who have been strong advocates for the incorporation of IT in medicine are seeing that we’re past due to get it right when sharing information about usability translating to safety, quality and efficiency. We need to get going.
We need some sort of clearinghouse or Consumer Reports, if you will, for health IT products. Major EHR vendors are selling products that have significant problems and users need a forum in which they can discuss such issues. Many of these products have been around so long because the bulk of the medical profession has not been engaged in the discussion of usability and effective daily use. Vendors don’t demonstrate products to physicians because physicians generally don’t make purchasing decisions and write the checks. This conflict is a result of our maturation. This is a good problem to have because it means that no one is talking past one another. We are all interested in doing the right thing and moving on with meaningful use. It is, however, a problem that will not be easy to solve. The cost of reworking these systems to make them more usable is not minimal and will not be evenly distributed across all EHRs.
The medical profession needs to understand that EHRs and other health IT systems are here to stay, so engagement over the long haul is imperative. If not, a lack of physician use is going to be attributed to bad behavior and not taken seriously by anyone—least of all, the vendors.
We need more of a dialogue. If we don’t make progress on usability, the vision of health information exchange, true interoperability and the whole notion of effective incorporation of these tools into the practice of medicine will prove to be rhetoric rather than reality. With meaningful use Stage 2 emerging, this issue is not going to go away.
Because of the need to actually demonstrate physician engagement with these systems, there is no question that usability concerns are becoming more acute. The medical profession needs to play a bigger role, not only in that engagement, but in developing the products.
In the past, very specific user groups shared their feedback only with the vendor, and not with the larger care community, making this interaction the only path for user feedback. Over time, healthcare organizations have taken these various IT products and, in trying to connect them, experienced difficulties. Today, everybody is getting serious about actual consistent use of these systems, so there is no tolerance for poor usability.
When you’re talking about this highly skilled workforce—physicians—the idea of distraction goes beyond simple job satisfaction and security. It comes down to patient safety. If I’m disoriented while trying to do the right thing, it’s not going to have the same outcome as an incorrect order at McDonald’s. Any number of errors could occur because of the inability of the system to accurately translate what I want to do for my patient versus what is done on the basis of using an EHR.
Data are beginning to appear that will help drive this push for better usability. The 2011 report from the Institute of Medicine regarding increased errors in the use of EHRs is controversial. However, the reality is that the people who have been strong advocates for the incorporation of IT in medicine are seeing that we’re past due to get it right when sharing information about usability translating to safety, quality and efficiency. We need to get going.
We need some sort of clearinghouse or Consumer Reports, if you will, for health IT products. Major EHR vendors are selling products that have significant problems and users need a forum in which they can discuss such issues. Many of these products have been around so long because the bulk of the medical profession has not been engaged in the discussion of usability and effective daily use. Vendors don’t demonstrate products to physicians because physicians generally don’t make purchasing decisions and write the checks. This conflict is a result of our maturation. This is a good problem to have because it means that no one is talking past one another. We are all interested in doing the right thing and moving on with meaningful use. It is, however, a problem that will not be easy to solve. The cost of reworking these systems to make them more usable is not minimal and will not be evenly distributed across all EHRs.
The medical profession needs to understand that EHRs and other health IT systems are here to stay, so engagement over the long haul is imperative. If not, a lack of physician use is going to be attributed to bad behavior and not taken seriously by anyone—least of all, the vendors.
We need more of a dialogue. If we don’t make progress on usability, the vision of health information exchange, true interoperability and the whole notion of effective incorporation of these tools into the practice of medicine will prove to be rhetoric rather than reality. With meaningful use Stage 2 emerging, this issue is not going to go away.