In this space, we talk a lot in the abstract about how physicians feel about EMR usability. Today, though, I wanted to share with you some great observations from a KevinMD.com piece by an angry anesthesiologist who lays out her own usability wishlist for EMRs and health IT generally.
In the piece, Dr. Shirie Leng fumes over the sheer work it takes for her to negotiate the systems she uses at her hospital. She notes that over the course of doing eight cases during a day, she’ll a) sign something electronically 32 times, b) type her user name and password into three different systems a total of 24 times and c) generate about 50 pages of paper given that the the computer record must be printed out twice.
To Dr. Leng, there’s ten steps institutions can take to eliminate much of the hassle and waste:
1. Eliminate user names and passwords: She suggests using biometric sign-in technology.
2. Eliminate the paper: Why print data that’s already entered into the system, she asks?
3. Make data systems compatible and 4. Make everyone statewide use the same system: Dr. Leng says it’s crazy that we don’t have interoperability within hospitals or between different institutions.
5. Don’t make her turn the page: “All the important information about a patient should be on the first page you open when you look at a patient,” she says. “I shouldn’t have to click six different tabs.”
6. Don’t make her repeat herself: If she does several cases the same way, with the same documentation each case, don’t make her re-enter it every single time.
7. Invest in voice-recognition software: During patient interviews, Dr. Leng notes, she wants to look at patients and talk, not hunt and peck at the keyboard or worse, spend hours later typing in data or clicking checkboxes.
8. Go completely wireless: Not an EMR point, but a good one nonetheless: why make doctors untangle cords and monitoring wires?
9. Hire a typist if you need one: Don’t turn nurses into data entry clerks, she argues. Right now they have massive amounts of data entry piled onto their plate.
10. Triple back-up the system: Paper doesn’t crash but computers do, she notes.
So there you have it, a list of EMR and health IT concerns straight from a practicing physician. I think all her points deserve attention.