Friday, April 29, 2011

Now Here Is One Of the Huge Sleeper Issues in Health IT!

The following report appeared a few days ago

Health IT work group considers EHR usability testing

By Joseph Conn

Posted: April 22, 2011 - 12:00 pm ET

At a meeting in Washington on Thursday, a work group of the federally chartered Health Information Technology Policy Committee tackled the question of whether and how it's possible to test the usability of electronic health-record systems—and opinions on the viability of such testing ranged from outright skepticism to absolute confidence.

The committee's adoption and certification work group heard testimony from an array of EHR experts, including providers, developers, testers and market watchers.

Dr. Christine Sinsky, an internist at Medical Associates Clinic in Dubuque, Iowa, said she has worked with an EHR system as both a clinician and a technical adviser since 2003. She described a litany of usability problems she has experienced personally or that have been reported to her. These included "death by PDF" when 50 scanned documents were stuffed into a patient's electronic record and needing 10 minutes for one EHR system to place an order for a mammogram.

Work-group member Carl Dvorak, executive vice president of Epic Systems Corp., Verona, Wis., was one of several vendors to testify. Dvorak said he hoped that regional extension centers, established by the federal government under the American Recovery and Reinvestment Act of 2009, would provide feedback on usability issues. Although vendors don't fear usability measurement, he asserted, "I definitely think they are afraid of measurement by someone with a bias."

Most important in the construction of any mechanism designed to measure EHR systems' usability would be keeping "the voice of the physician front and center," he said.

More here:

As background information the US Agency for Healthcare Research has done some very useful and succinct research.

This can be downloaded from here:

There is more coverage here on the same area:

NIST, ONC plan measures, testing to improve health IT usability

April 25, 2011 | Mary Mosquera

GAITHERSBURG, MD – Healthcare providers may soon have guides that describe the usability of electronic health records – designed to make the steps to adopt and use health IT clear and transparent and, in the process, improve patient safety.

Among the efforts, the National Institute for Standards and Technology (NIST) is developing a set of procedures that are objective and repeatable for evaluating, testing and validating the usability of electronic health records and other health IT systems, said Lana Lowry, NIST health IT usability project lead.

NIST plans to present the specifications at a workshop June 7, she said at an informational hearing sponsored by a panel of the advisory Health IT Policy Committee.

With meaningful use, providers will expect more functionality and robust performance from their EHRs. But providers and health IT researchers say there is uneven usefulness, ease of usability and user satisfaction among EHRs

As a result, the ONC will develop guidelines to measure an EHR's usability in coordination with public and private organizations and NIST, said National Coordinator Farzad Mostashari, MD.

“All too often we hear from providers that they look forward to the day when the technology works for them instead of them working for the technology,” he said at the meeting April 21.

Usability has implications for patient safety, adoption, and effective health IT implementation and for hospital and physician productivity.

More here:

A quick Google search for EHR and usability will also find lots more!

This is a hot topic that we have to progressively improve on how we perform over time. I have to say I am not sure it would be easy to test for usability but, rather like pornography, I am pretty sure I can recognise it when I see it!

In the report one fascinating point is made. They point out vendors see usability and key to their competitive advantage and so really don’t share their views and techniques.

That it is seen as key is a good thing - that people are keeping secrets is sad but understandable!

The PCEHR as presently planned has not even considered the issue so far as I can tell. Most of what they seem to be proposing is ‘anti’ rather than ‘pro’ usability as far as I anyone knows.


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