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The Challenge of Creating a Good EMR User Interface

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I recently saw a newsletter done by User Centric that had a couple interesting pieces.

First, Dr. Wendy Yee writes, “Most HCPs will bluntly tell you that they did not go through medical training to become data entry clerks. They also are highly sensitive to time requirements because their days can be brutally compressed.” Sounds a lot like my post EHR Software Makes Doctors Secretaries.

Dr. Yee also provides an interesting list of multiple items that are simultaneously going through a doctor’s mind while using an EHR:

  • There must be a way to make order entry faster…
  • What was the procedure code for that variation of a genetic test?
  • Let’s see, should I order Test ABC or Test DEF (or both)?
  • I need to check for Jane Doe’s lab results from yesterday.
  • Why isn’t that med listed under antivirals?
  • What does that obscure lab reading mean?
  • Has the patient’s problem list changed in the last day or so?
  • Why do I have to enter patient notes *this* way when the EHR at the teaching hospital has me enter it the other way?
  • Are there additional contraindications?
  • When was the patient’s last MRI?
  • I’m running behind, but I still need to enter this script.

Is it any wonder that it’s not a simple task to make an EHR that a doctor will consider usable? Not impossible, but certainly a challenge.

User Centric will be at HiMSS, Chicago! Booth #3382 They’ll be demonstrating how eye tracking can be utilized to uncover opportunities to improve user interfaces. No, I don’t have any financial connection with them, but eye tracking is really cool technology. Plus, I’m happy to support anyone that I think can make a difference when it comes to making EMR software more usable.

April 1, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

CCHIT and Open Source (FOSS) Meet at HIMSS

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I’d been meaning to post this for a while, because I hope that it will be well attended. CCHIT and various open source EMR groups, advocates and friends will be meeting with CCHIT during HIMSS. I first read about this from Neil Versel where he said this:

Healthcare FOSS guru Fred Trotter and Linux Medical News editor Ignacio Valdes, M.D., are leading the event, Monday, April 6, at 2 p.m. in Room 10d at the Hyatt Regency McCormick Place at 22nd Street and South King Drive in Chicago. Trotter called the encounter “like offering to meet with the Rebel Alliance at the annual Death Star conference,”, but I imagine they intend for things to be civil.

I love the Death Star reference. This should be a pretty interesting meeting. I was talking to someone today who suggested that they were going to come to some sort of consensus at that meeting. I suggested that they probably wouldn’t come to a consensus, but at most agree to disagree. However, I’m a strong advocate for communication and understanding between parties. So this is a good thing.

The best part for those who can’t attend HIMSS is that they’re planning on doing a webcast of the event. Here’s the details:

Date: Monday, April 6, 2009

Room 10d, Hyatt McCormick Conference Center, Chicago

Session #1 1:00 – 2:00 PM CDT

Interoperability 09 and Beyond: a look at CCHIT’s roadmap for the future

Session #2 2:00 – 3:00 PM CDT

Open Source Forum: a dialogue on certification for open source EHRs

Here is the link to register for the webinar:

https://www1.gotomeeting.com/register/429901059

After registering you will receive a confirmation email containing
information about joining the webinar. We will also be recording
these sessions, and plan to make the media files available on the web
for later downloads.

There’s actually 2 sessions and I’m really interested to see how it goes. I wish I could be present, but I’ll definitely be at the webinar and posting my thoughts on twitter. I do wish that CCHIT would add a ustream video feed of it as well.

I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

ONC Head Blumenthal Says Certified EHR Not Good Enough

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John over at Chilmark Research has a really good find on his blog. He quotes the new head of ONC, David Blumenthal, from an article in the New England Journal of Medicine (NEJM) where Blumenthal talks about the certified EHR requirement in the HITECH act. Here’s the quote:

ONCHIT currently contracts with a private organization, the Certification Commission for Health Information Technology, to certify EHRs as having the basic capabilities the federal government believes they need. But many certified EHRs are neither user-friendly nor designed to meet HITECH’s ambitious goal of improving quality and efficiency in the health care system. Tightening the certification process is a critical early challenge for ONCHIT.

I find it really interesting how two people can take the same quote different directions. Chilmark Research gives a nice little rant about how you can’t certify usability, quality and efficiency in an EHR. I agree with him on most points and I definitely agree that the market is much better at these three items than some government certification body.

However, I don’t feel like this was what Blumenthal meant in the above quote. I don’t think Blumenthal was trying to say that the certification would need to certify user-friendly, quality and efficient EHR software. Instead, I see the above quote meaning that the current CCHIT certification isn’t good enough, because it has certified a bunch of unusable EHR (a topic we’ve talked about many times before). Sounds to me that Blumenthal is making a case for why the government shouldn’t use the CCHIT certification. At least not in its current form. Essentially Blumenthal is saying that CCHIT isn’t good enough to meet the goals of HITECH.

This seems like a ray of hope for myself and others who think that selecting CCHIT certification as the certified EHR requirement of the HITECH act is the worst decision the government could make. Albeit still just a ray.

What Blumenthal means about “tightening the certification process” is up for debate. He could mean something like what John from Chilmark research describes. Basically some convoluted method of measuring usability, quality and efficiency of an EHR system. Or it could mean that the certification process will need to be tightened so that unneeded requirements are removed and it gets cut down to what will help an EHR achieve the ambitious goals of the HITECH act.

Of course, in the end the certified EHR criteria will probably land somewhere in between. However, this quote did give me some hope that Blumenthal realizes the impact that it will have on EHR adoption if many of the currently unusable certified EHR gain wide adoption thanks to the $18 billion in EHR stimulus money.

I do think John from Chilmark Research does make a nice conclusion to his post:

Suggesting that we tighten the certification process is heading in the wrong direction. Instead, we need to actually relax the certification process to encourage innovation in the HIT market allowing developers to create solutions that will truly provide value to their users while concurrently meeting the broader objectives of delivering better care and better outcomes. Creating light certification criteria and focusing more on what outcomes we wish to see occur as a result of broad HIT adoption is where Blumenthal and his staff need to focus their energies.

I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.