Electronic Health Records and Patient-Centric Design

CIO’s story Why Electronic Health Records aren’t more usable offers an interesting perspective on the current (improved?) state of affairs in medical care records. From the article:

The American Medical Association in 2014 issued an eight-point framework for improving EHR usability. According to this framework, EHRs should:

  • enhance physicians’ ability to provide high-quality patient care
  • support team-based care
  • promote care coordination
  • offer product modularity and configurability
  • reduce cognitive workload
  • promote data liquidity
  • facilitate digital and mobile patient engagement
  • expedite user input into product design and post-implementation feedback.

Nevertheless, it does not appear that EHR vendors are placing more emphasis on UCD. The Office of the National Coordinator for Health IT requires developers to perform usability tests as part of a certification process that makes their EHRs eligible for the government’s EHR incentive program. Yet a recent study found that, of 41 EHR vendors that released public reports, fewer than half used an industry-standard UCD process. Only nine developers tested their products with at least 15 participants who had clinical backgrounds, such as physicians.

Note that this situation is not due to a lack of user-centric efforts to make medical records more useful. Indeed there are several efforts underway, including HealthAuth, Kantara’s Healthcare ID Assurance Working Group, Patient Privacy Rights, HEART working efforts with OAuth and UMA, and more. As the article noted, there are regulatory complications as well as crazy-complicated workflow requirements imposed by the software designers/vendors. We need a shift in focus here.