More On EHR Usability: Let Doctors Decide

Here’s worthwhile some observations on how to drive improvements in EHR usability from Evan Steele, CEO of EMR, practice management and PACS systems vendor SRSSoft.  (Just for clarity, SRSSoft serves medical practices.)

While Mr. Steele’s comments may not be wildly original, I always like to see discussions of tricky issues like usability boiled down to a few key points, and he’s done a good job here. His arguments, with my commentary:

* Feedback from physicians and other providers should drive EMR usability improvements.

Of course — shouldn’t the software clinicians work every day with to improve health and save lives be adapted to fit the needs of those clinicians? You can’t offer complete freedom when you’re collecting structured data, but clinicians should be able to bend and stretch things as much as possible.

That of course, begs the question of what’s driving usability models right now, doesn’t it?  Certainly, EMR vendors care what clinicians think, but my guess is that the development roadmap has to come first far too often.

Here, let’s pretend I’ve inserted a lengthy rant as to how enterprise software companies in general just don’t connect well with their customers  – something that became painfully obvious to me when I worked for one several years ago. Suffice it to say that I doubt clinicians are as involved in vendors’ UI dev, much less feature set specs, as often as they should be.

* Usability measures should embrace not only primary care, but also specialists.

Again, this seems fairly obvious to me, but seemingly, not to federal officials, who, according to Steele, treated specialty needs as an “afterthought” when creating Meaningful Use standards.

In my opinion, it’s become fairly clear that specialty-facing systems are important, and that regulators should address such systems on their own terms. I’ve seen no sign that they’ve developed plans to do so as of yet, though. (Anyone know more than I do on this?)

* Usability shouldn’t be legislated.

For at least a couple of years, there’s been talk of the FDA’s stepping in and imposing usability rules on EMRs; observers say the rules would be akin to those they already do on medical devices and supporting software. (See more on this issue from medical device connectivity expert Tim Gee here.)

Steele, for his part, thinks such regulations would cause problems. Imposing governmental standards on EHR interface “will inevitably accommodate only a narrow range of users, leaving those with varying preferences and workflows without software to satisfy their usability requirements,” he argues.

I’d like to see Steele get his way on the first two suggestions. If EMR interfaces are driven by clinicians and take specialists into account, it’s far less likely that the government will feel obliged to impose itself upon the marketplace.

But if the industry doesn’t do a better job of partnering with clinicians, expect to see the FDA or other agencies step in.  Regulators may decide that if the industry can’t produce usable EMRs on its own, predictable, rulebound ones will do.