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EHR DeinstallIt will come as no surprise to physicians that many EHRs are hard to use. In fact, the Rand Corporation conducted a studythat found EHRs worsen physician satisfaction. That study (and other factors) prompted the American Medical Association (AMA) to create a framework with eight ways to improve usability.
Here are the priorities as the AMA sees them:

  • Enhance physicians’ ability to provide high-quality patient care
  • Support team-based care
  • Promote care coordination
  • Offer product modularity and configurability
  • Reduce cognitive workload
  • Promote data liquidity
  • Facilitate digital and mobile patient engagement
  • Expedite user input into product design and post-implementation feedback

Dr. Steven Stack, chair of AMA’s Advisory Committee on Physician EHR Usability and president-elect of the association said in a September webinar announcing the framework that the design and implementation of EHRs today don’t align with the “cognitive and workflow” requirements of physicians across specialties and practice settings.
Interestingly, AMA said it recognizes that not all usability issues are the result of poor software design. Some are due to sub-optimal implementation stemming from inadequate training, liability concerns, or heavy-handed risk management, said the authors of the white paper on the new framework.
AMA also listed the key challenges physicians face with EHRs, many of which will sound familiar to our physician readers.

  • Interference with the patient visit
  • Lack of system-design support for team-based care
  • Issues with care coordination due to lack of interoperability
  • Increased cognitive workload for physicians
  • Lack of data liquidity
  • High switching costs
  • Lack of product modularity to support unique physician practices and population needs
  • Insufficient support for incorporating end-user input into product design and post-implementation feedback for product improvement

The AMA says it plans to use its framework to work with vendors, advocate for effective health IT policy, partner with researchers, and educate physicians so they can lead in the development and use of future EHRs that can improve patient care.
The framework white paper is only 12 pages and is well done. It can serve as a guide to those looking for the most advanced, usable EHRs right now and a glimpse at where these systems are, hopefully, headed in the future.
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Last Updated on October 24, 2014