Improving the usability of electronic health record (EHR) systems is one facet of the AMA’s mission to make digital health technology an asset rather than a burden. The AMA has offered clear guidance to EHR vendors and some of them have taken the advice to heart.
Previous AMA research has highlighted how EHRs too often interfere with patient visits and called on vendors and software developers to make clinical care improvements their primary focus. The factors that have contributed to poor EHR usability were explored in a recent perspective essay in the Journal of the American Informatics Association written by AMA researchers.
To promote a better EHR user experience, the AMA developed eight EHR usability principles to help guide EHR developers on what to prioritize. The principles emphasize the practical applications physicians need to support their patients.
Two vendors—Westwood, Massachusetts-based Meditech and Athenahealth of Watertown, Massachusetts—have outlined how their companies successfully follow the AMA usability principles, as shown below.
Enhance physicians’ ability to provide high quality patient care. EHRs should fit seamlessly into a practice and not distract physicians from patients or compel time-consuming collection of information of questionable value.
Meditech says it has improved face time with the use of mobile devices rather having physicians tethered to their keyboard and mouse. Athenahealth cites how its designs reflect “situational awareness at the point of care” because they are based on lessons learned while watching physicians and staff interactions with patients.
Support team-based care. Systems should support staff productivity and distribute work appropriately across members of the care team. The Athenahealth products can track how well physicians are delegating documentation tasks to staff. The company also notes that it makes documentation easier by “making it obvious when required quality program data is missing.”
Promote care coordination. EHRs should automatically track referrals and consultations to enhance transitions of care and patient movements between care settings. Meditech notes that its products track referrals, consults, orders, lab results and other data that can be access across the continuum of care. Meanwhile, Athenahealth highlights that its care summaries “present the essential story of the patient.”
Offer product modularity and configurability. Physicians should be able to configure EHRs to best suit their workflow and patient population. Meditech notes that its products are designed to support industry standards and comply with government regulations for data and document exchange.
Reduce cognitive workload. EHRs should support medical decision-making with concise, context-sensitive and real-time data.
“Doctors shouldn’t be archaeologists,” a Meditech physician consultant said. Athenahealth notes that “most EHRs are set up to collect as much data as possible—in some ways, just because they can.” Instead of offering a “tidier haystack,” Athenahealth seeks to put the needle “right where the doctor needs it.”
Promote data liquidity. Useable interoperability and exchange of data are a prerequisite to improve care. Both vendors cite their membership in the CommonWell Health Alliance, which is a health-data-sharing network.
Facilitate digital and mobile patient engagement. With well-designed tools, patients can be useful sources of their own medical information. Meditech notes that it has built its EHR to facilitate digital and mobile patient engagement though a patient portal that works on tablets and mobile devices.
Expedite user input into product design and post-implementation feedback. User feedback, especially in address patient safety concerns, is essential to product improvement. Both vendors cite their robust clinician feedback programs with Meditech noting that it sees “every interaction with users as an opportunity to identify possible future improvements” through usability testing and customer feedback.
Other vendors also are working to improve EHR usability. For example, Cerner has collaborated with the AMA and MedStar Health’s National Center for Human Factors in Healthcare in the “Everybody Has Responsibilities” campaign. That includes a website with videos of health professionals experiencing the risks and challenges faced when EHRs can’t be used efficiently.
Physicians can participate in the AMA’s EHR Connect platform, which joins key stakeholders to collaborate around EHR development, usability, optimization and interoperability for improved end-user experiences. By joining EHR Connect, physicians can share their voice; learn from others’ expertise and experiences; and access news, events and resources.
Learn more about the AMA’s digital health leadership activities.