Friday, November 22, 2013

This Is Really An Interesting Article On E-Health Software.

This appeared a little while ago

Why Doctors Hate EHR Software

Have meaningful use incentives merely propelled sales for a lot of lousy software?

Maybe this will be a "no duh" observation for those who work in healthcare or health IT, but a lot of doctors really hate the electronic health records (EHR) software they're compelled to use.
As an InformationWeek staffer recently assigned to this beat after only occasionally covering health IT in the past, I was surprised how unanimously and passionately dissatisfied most doctors are with the usability of this software, which they see as draining rather than enhancing their productivity. I'm sure there are exceptions where doctors are more enthusiastic about technology, the software they are using is higher quality, or a little of both. But if you open the door to a conversation about how horrible medical records software is, you'll get an earful.
Here's what I'm basing this on. Having spent the past few months writing about massive open online courses (MOOCs) for the education beat, I was happy to discover a Coursera course on Health Informatics in the Cloud starting at just about the time that I needed to come up to speed on my new beat. I'm happy to say the instructor, Georgia Tech's Mark L. Braunstein, MD, will be contributing to InformationWeek as a columnist, so watch for that. Braunstein has spent most of his career in healthcare IT, so I think it's fair to say he's a true believer in the potential and the necessity of digitizing medical information. However, when I turned to the course discussion forums I found a message thread titled "Health IT Doesn't Fix Problems -- Good Health IT Does."
One of my classmates was a pediatrician named Dave Denton, and the point of his discussion was that he hadn't seen a heck of a lot of good health IT.
"I use several EHRs in my clinic and hospital," wrote Denton, who practices in Portneuf, Idaho. "None of them allow transmission of data between systems. They all are encumbered by poor graphic user interfaces that make it hard to see patient data in a way that makes sense and helps patient care. It is actually much harder to take care of sick patients in the ICU with our new hospital system. They also tend to hide the pertinent by scattering it through the program and displaying all types of ancillary data, time stamps, and formatted notes that are inserted to ensure appropriate coding, but get in the way of seeing what is important. I have made several errors by failing to find the correct information in the chart because it was buried in the note. Finding what is important has become a treasure hunt."
In a follow-up post on dysfunctional workflow imposed by the software, he added, "I am not one of the physicians striving to resist change and implementation of EHR. There are so many valuable things this technology can bring to medicine. I am the chairman of our information systems committee in our hospital striving to make things work, but frustrated by the poor quality of products that have been forced into the marked by unrealistic timelines."
There are two points to be made in raising this article.
First to highlight the course mentioned. I hope it will be run on a regular basis so I am sure many in Australia would be interested in participating.
Second it to make the obvious point that there is a lot of unhappiness with at least some EHR software. It seems strange this issue has not been sorted long since. I wonder what a survey of Australian Users would reveal? I need to run a poll on the issue on Australian EHR users.

1 comment:

Grahame Grieve said...

"displaying all types of ancillary data, time stamps, and formatted notes that are inserted to ensure appropriate coding" - well, the interesting challenge is that in Australian practice, a lot of them have been inserted for clinical safety reasons. Finding the balance - displaying the right amount of information - is impossible. Too much is not enough. Doctors do tend to hide behind the vendors on this, and not take responsibility for the fact 100 little requests for extra information "just in case" adds up to a 1 big mess. And vendors are trapped - more configurability = more problems, often safety problems in a different place, because it's really really hard to get our configuration aligned throughout the product.