Not long ago, I wrote a piece slamming the lack of EMR usability standards out there today, arguing that the industry was pretty much going to stay in a rut until we got some. One of our readers, Prasad Patankar, posted a very thoughtful response which I felt deserved more exposure and discussion.
Here’s his ideas, in italics, with my comments interspersed:
* EMR systems should have a consistent hierarchy for navigation so
that it is easy for users to locate information.
This is hard to argue. Unfortunately, given the vendor turf wars going on out there, I think we’re going to be stuck with proprietary systems and proprietary hierarchies for some time to come. But what Prasad suggests here is just common sense, not that we can expect to see a lot of that on display.
* Error messages should be clear. They should explain why the error
occurred and explain what the users should do next. Definitely not
any programming language errors.
Again, I agree with Prasad here. This kind of consistency would do much to orient users. The problem is, these systems are still driven largely by developers, who best understand the nasty programming language error codes. Expecting them to make their EMR products speak plain English is a bit of a stretch, sadly.
* For screens that contain too much information, there should be an
option available for the users either to see the summary or a
detailed drill-down capability. Some EMR vendors have started
incorporating this functionality into their reporting modules.
Beautiful — a function vendors already understand. That’s enough to sell me on the notion that it can be more widely implemented, and soon. In this case, there’s no excuse for vendors to obfuscate; just go ahead and make the data easier to read already!
* Consistency should be followed in displaying allergies and current
medications in one single location. Users should not have to click
multiple windows to get to this. This also applies to past
encounters(progress notes) which have been migrated prior to
implementation of the new EMR system.
This is a very good idea. When Your Editor recently read up on research into errors made using EMRs, medication slip-ups were by far the most common event. (And the only event that created serious harm was administration of a drug to which the patient was allergic. Past notes might not be as urgent, but useful, definitely.
* It would also be interesting to see if EMR vendors could incorporate
the cultural context and meaning of a color in that context before
they use the entire color palette in their software.
This is an intruiging idea, though I can’t imagine the big enterprise vendors giving it much thought. Perhaps if Apple designed their interface… But that’s a tale for another day.