Though EMR vendors might argue the point, I keep hearing the same complaints from the field — that virtually none of them offer an intuitive user interface.

Readers of this blog are well aware of this issue, I’m sure, but I’d argue that it’s still worth discussing. After all, few if any EMR firms seem to have solved the problem. (If you know of an EMR you consider intuitive to use, please let me know and I’ll discuss it in a future article.)

Given the incredible problems clumsy UIs can create, I’m surprised pundits and consultants don’t speak out on the subject more often. My journalistic colleagues turn out story after story about wayward doctors who won’t use their institution’s EMR, but few dig into what’s wrong with the EMRs themselves.

Far too many EMR front-ends feel like jury-rigged database interfaces, rather than systems designed to support clinician workflow.  If I had to get my work done using counterintuitive forms, menus and checklists, I think I might leave journalism!

Unfortunately, the decision-makers who buy big EMR systems — you know, the ones who spend hundreds of millions over several years — don’t seem to be very concerned about this issue.  I assume it’s because they’re more worried about systems integration than user satisfaction, and hope they can force kludgy interfaces down clinicians’ throats. Under these circumstances, vendors don’t have a lot of incentive to change.

So, is there a way to change this dynamic? A couple of interesting, though unlikely, possibilities come to mind:

* I may have said this before, but isn’t it about time someone got Apple to design an EMR interface? I know the company has some serious detractors, but even if you don’t buy into the Apple legend  it hard to argue that it’s created some of the most usable interfaces on earth.

* Why not to develop a standard for measuring EMR usability, one which is publicly shared and built by consensus? I’m not saying it would be easy to develop such measures — in fact, I’m sure it would be very complicated — but if we could establish a few user experience benchmarks, it would be very helpful.

The bottom line, though, is that vendors do what the market demands.  Until providers dig their heels in and refuse to buy clumsily-designed systems, nothing’s really going to change.  Maybe CIOs will get more demanding when users stage a revolt and refuse to touch their painfully awkward EMR?