Thursday, March 06, 2014
The Answer To This Question Would Seem To Be Pretty Obvious. The EHR Needs To Be Optimised For Clinician Use!
This appeared a little while ago.
By Diana Manos, Senior Editor
The ultimate question comes down to: are EHRs made to help physicians or are physicians being made to work with their EHRs? That's the question asked yesterday in a HIMSS14 session aimed at getting rid of some of the frustrating bugs that can lead to discomfort, if not out-right catastrophe in medical care.
Imagine the unwelcome surprise a patient receives when they needed Tylenol at the hospital, the doctor ordered it electronically, and in walks a nurse with a Tylenol suppository.
This happens all the time, said Zach Hettinger, MD, director of Informatics Research for MedStar Health's National Center for Human Factors Engineering in Healthcare.
The reason is easy to explain, Hettinger said. This particular system’s electronic health record has 18 choices for Tylenol. The way it is designed sets up a hazard for doctors to accidently order the wrong one.
When it happens to Hettinger, a practicing physician, of course the nurse calls to verify. Then Hettinger replaces the order for one with oral tablets. But, this is just one more step to an already overloaded day, and an annoyance for both him and the nurse.
Raj Ratwani, a researcher at MedStar’s National Center for Human Factors in Healthcare, said these are the kinds of usability problems providers and health systems face every day. Ratwani and Hettinger were part of a panel at the HIMSS14 pre-conference workshop on patient safety on Sunday.
Doctors should not be “trained” by a system; the system should be “trained” initially by doctors’ needs, Hettinger said.
Location of the computer and other factors need to be taken into account. In emergency rooms, every time a physician is interrupted from entering information into an EHR, it increases the numbers of errors that the physician could make, and some of them could be “catastrophic,” Ratwani warned. That's why some hospitals provide laptops or computers on wheels to help the doctor move from the center of it all, closer to the patient, when entering data.
The answer to the question is a real no-brainer. To me this applies both at the development phase as well as the implementation phase of the introduction of EHR systems and the important thing to understand is that user acceptance can be critical to the success or failure of a product or implementation.
At least part of the reason we have seen such limited success in the PCEHR program was related to the failure to actually figure out in advance who the PCEHR was for and then consult those users properly. Hence the mess we now see!
Posted by Dr David More MB PhD FACHI at Thursday, March 06, 2014