How to improve the usability of clinical records systems

“It is incredibly disruptive for physicians and nurses to make use of a new electronic health record. The current generation of electronic health records are not very usable. They are not well designed to increase our efficiency and to make our work easier—but rather, they slow us down.”
—Steven J. Stack, MD, president of the American Medical Association, in a May 2016 article in The Boston Globe.

Technology holds the key to improved patient outcomes, reduced costs and the success of the shift to a value-based payment environment. Unfortunately, the journey has become painful for many clinicians as they grapple with new electronic health records systems.

HDM-033116-Docs.pngThe latest example comes from doctors and nurses at Boston-based Partners HealthCare—they expressed dismay with the implementation of a EHR program from Epic, as reported by The Boston Globe. The complaints are familiar ones—too many keystrokes, too much focus on the computer and too much trouble getting the information they need to treat patients.

It doesn’t have to be that way. There are a number of things that can be done to make life much simpler for harried clinicians as they adapt to new, complex systems. Here are seven ways to enhance EHR system usability.

Focus on click reduction. The key to acceptance and usability is to reduce frustrating additional steps. Deloitte proposes that within two clicks of the login screen, clinicians should be able to access 80 to 90 percent of their job function. Vendors and organizations should do an in-depth analysis of clicks and screens to identify extraneous steps in the process.

Set up personalized desktops. Another way to streamline the click process is to eliminate multiple logins. Software can create and personalize a consolidated desktop that is “always on.” With a single tap of a badge, fingerprint or phone, clinicians can be logged into every required application and the EHR. They are also able to carry that active session with them by tapping in and out of various workstations. User awareness provides clinicians with the most pertinent patient records without the need to hunt and peck through census data or scanning each open chart.

Utilize speech recognition. Many organizations are turning to speech recognition software to minimize manual data entry. Speech recognition is rated one of the most rapidly growing applications, and a recent KLAS report showed nine of 10 hospitals plan to expand the use of this software. Coupling speech recognition and situational awareness software can dramatically reduce key clacking by eliminating time-consuming login and logout processes for every location change. This enables clinicians to focus on treating the patient instead of treating the computer.

Support team-based care. Tying up physicians with laborious data entry tasks is a familiar complaint from users. The American Medical Association (AMA) recommends implementing software that empowers other team members to complete more routine data entry. This maximizes productivity for everyone and enables physicians to spend more time interacting with patients.

Customize for usability. A major source of clinician frustration is being forced to deal with a “one size fits all” system configuration. Every organization has its own unique workflow, and the software should be developed in modular fashion to enable configuring the system to match. The AMA suggests developing specialized applications to help achieve the appropriate level of customization.

Provide contextual interoperability. Interoperability—enabling disparate systems to share data—is also about presenting EHR information in ways that both enhance an individual clinician’s clinical computing experience, as well as improve the overall quality of a patient’s healthcare. Using real-time bidirectional interaction, situational awareness software presents the clinician with a coordinated view of data from the EHR and other specialty applications based on the awareness of the user, location, patient and device.

Incorporate user feedback. One of the AMA’s key recommendations is for vendors to provide the ability for users in the field to provide context-sensitive feedback. This input should then be used to improve system performance and safety. Incorporating constructive suggestions will go a long way to enhance EHRs and encouraging more widespread use by clinicians.

With demands for information-sharing and improved patient outcomes continuing to grow, the need for effective and user-friendly technology has become urgent. There will always be struggles with new system implementations, but the systems are not the problem—they are part of the solution. The key is simplifying the use of these large EHRs. In the end, that’s the prescription that will relieve clinician pain.