The other day I was at a conference where several EMR industry insiders presented on user interface issues. I’ll confess, I was expecting the usual defensiveness — “our user interface is just fine, it’s just that our users don’t understand it” — but instead heard a lot of earnest discussion about the problems with today’s EMR UIs. The problem is, none of them seemed have any clearly-defined ideas on how those problems will be addressed.
Speakers at the conference, who included vendor reps, clinicians, academics and more, did seem to agree that few EMRs had achieved satisfactory usability. More than one cited research suggesting that many EMR interfaces just don’t cut it.
If there could be said to be any consensus, it was that usability standards were at best a slippery issue and at worst, might force development in the wrong direction by measuring the wrong thing. One speaker noted that even if clinicians were satisfied with a system’s UI, this might not be the best way to study its value, as it doesn’t mean that the system is particularly efficient.
But that could be a bit of a cop-out. According to a HIMSS paper from 2009, there are several methods which could emerge as front-running approaches to measuring usability and efficiency (which, it seems, are too often addressed separately).
Interestingly, the HIMSS authors said that two completely unrelated safety programs might provide some insight into improving developing EMR usability standards:
* The National Highway Traffic Safety Administration Child Safety Seat Usability Rating Program
According to HIMSS, this program offers several lessons, including that the NHTSA spent two years to develop the program, that it collected data to see how well its ratings were working, and that officials have been flexible enough to change their standards as the market changes.
* FDA and Human Factors Regulation and Guidelines for Device Manufacturers
As some of you may know, the FDA requires device manufacturers to follow Human Factors regs. HIMSS researchers argued that a few aspects of this program can be applied to directly to setting EMR usability standards, including the requirement that the manufacturer be educated in Human Factors, that manufacturers should adhere to standards set by other standards bodies as well as their own, and that manufacturers must be able to prove Human Factors compliance at any stage of the inspection process.
Folks, I don’t know if the anti-standards talk I heard at the conference was just a bunch of posturing, or whether developing usability standards is a great idea, but this is certainly a hot issue. Where do you stand? Can the EMR industry benefit from an externally- or even internally-developed set of usability standards, or are there better ways to spend development time?