The following was submitted by Rizwan Kheraj, Industrial Technology Advisor, National Research Council - IRAP Pacific.
The usability of software systems is a key acceptance criterion to adoption of new technologies. Health Information Technologies are not any different in this regard.Having been in the software usability field for several decades I am always amazed how even today software systems are developed for other software systems and not for human beings (Apple versus SAP?).
This recent article (link below) talks about the importance of designed EMR systems following the logical processes / workflow and steps a doctor would go through to collect information and make decisions about the patient. Sometimes Doctors probably wish there was a big red button on the screen called DWIM ("Do What I Mean"). In the age when our tolerance for non-usable software is extremely low given our experience with highly usable software systems, ATMs, etc we should expect 21st century software to meet the bar of highly usable systems.http://www.canhealth.com/tfdnews0076.html
A recent report by the AHRQ (Agency for Healthcare Research & Quality) that provides a snap shot of electronic health record vendor usability processes and practices (link below) concluded that current best practices and standards of design, testing, and monitoring electronic health record products for usability are varied and not well disseminated. Given the current trend towards the adoption and meaningful use of health IT and the role usability can play in realizing intended benefits, a change from the current modus operandi is required. There is, however, a raging agreement that these systems need to be designed for humans to use - not other computers.http://healthit.ahrq.gov/portal/server.pt/community/ahrq_national_resource_center_for_health_it/650
However, Healthcare cannot wait for systems to become "usable" in time for reform to occur. In the US the government has adopted regulations that will compel (http://edocket.access.gpo.gov/2010/pdf/2010-17207.pdf) and generously pay American physicians ($27B over ten years in incentive payments to physicians - approximately $63,000 per physician) to make "meaningful use" of electronic health records. In Canada, the financial are not as lucrative and no doctor is under obligation to actually use these systems even if they use government money to purchase the technology. The article below is an interesting one that contrasts the two North American siblings approaches.http://www.cmaj.ca/earlyreleases/8sept10_united-states-to-compel-physicians-to-make-meaningful-use-of-electronic-health-records.dtl
Is your EMR usable? Do you end your clinical day saying, "I love working with my EMR system?", or "I hate this EMR, it does nothing to help me during the day other than create additional work?"
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