EHR performance standards needed to ensure usability, safety

The design, development and implementation of electronic health records must be improved to ensure the usability of EHRs for clinicians and safety for patients.

That’s the conclusion of a new EHR usability and safety analysis funded by the American Medical Association and led by researchers at MedStar Health’s National Center for Human Factors in Healthcare.

“While there are many benefits to using EHRs, there are also usability and safety challenges that can lead to patient harm,” said Raj Ratwani, lead author of the study and director of the MedStar Human Factors Center.

Also See: EHR usability issues linked to patient harm events

Ratwani and his co-authors focused their study—published earlier this month in the Journal of the American Medical Informatics Association—on emergency medicine physicians using EHRs to perform certain common tasks, such placing orders for medical imaging, lab tests and medications. In particular, they included EHRs from the two largest vendors—Epic and Cerner—across four health systems, with two sites per vendor.

“There was wide variability in task completion time, clicks and error rates,” according to the study’s authors. “The variability in time, clicks and error rates highlights the need for improved implementation optimization.”

In addition, the researchers contend that their results “suggest that basic performance standards for all implemented EHRs should be considered in order to ensure usable and safe systems” and that health IT vendors and providers “should work together to ensure that usable and safe products are implemented and used.”

“Our findings reaffirm the importance of considering patient care and physician input in the development and implementation of EHRs,” said Michael Hodgkins, MD, co-author of the study and AMA’s chief medical information officer.

“There are multiple variables impacting the end user experience that contribute to physician burnout, a diminished patient-physician relationship and unrealized cost savings,” added Hodgkins. “While design can be an important factor, so too can implementation choices made onsite. Increased collaboration between vendors, information technology purchasers and physicians is needed to optimize experiences and address current needs.”