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Improving EHR Usability Through the Cloud

by Stephanie Zaremba, Director of Government and Regulatory Affairs

A recent post on The Health Care Blog caught my eye this week with an initial statement that health IT is a tool that, just like any tool, can produce excellent results when used properly —but can also lead to harm if used incorrectly.

Whether we’re talking about  a car, a piece of machinery, a stethoscope, or an EHR, correct use of a tool comes down to usability and training. It’s great to see a medical informatics thought leader like blog author Dr. William Hersh making this point.

Dr. Hersh and his team at the Oregon Health & Science University medical center just received a grant from the federal government to continue their electronic health record simulation research, which Dr. Hersh describes as “novel” in the health IT world. I agree that this research is important. Examining an EHR’s use in a simulation environment allows you to ascertain whether the right information is presented to the right person in the clinical workflow at the right time, and in the right way, so that the user interface is facilitating—not hindering—the delivery of quality health care.

However, the simulation approach is not exactly novel—we’ve been doing it for a couple of years at athenahealth. And while I agree that simulation research could provide “insights to improving the use of HIT in the clinical setting,” the true value of such research can only be realized through the cloud and cloud-based services. Why?

Here is what athenahealth sees playing out in the market, and why we think there is a better way:

  1. The federal government is pumping millions of dollars into the health IT industry through the Meaningful Use program. This is encouraging thousands of hospitals and health care providers to implement software-based EHRs.
  2. After spending hundreds of thousands (if not millions) of dollars and many, many months implementing massive software-based EHR systems, health care providers across the country are pulling their hair out in frustration as they try to climb the steep learning curve on a new IT system and transition their paper-based workflows into an electronic world.
  3. As the cries of frustrated physicians and nurses grow louder, there is a focus on the poor usability of EHRs, particularly with some EHRs that are based on decades-old code and come with hefty price tags for updates that might fix that poor usability.
  4. The federal government is recognizing that the Meaningful Use program is funding the continued existence of EHRs that do not, and technically cannot, respond quickly to the market’s demand for more usable products. As a result, the government is now funding a variety of usability research to help spur improved usability in EHRs. However, even if all of that research produces amazing findings with respect to usability, implementing those findings across the thousands of health care providers on software-based EHRs will take years. And the frustration and hair tearing will continue until then.

What is the better way?

The better way is measuring and studying usability across an entire client base that’s using the same instance of cloud-based software.

The better way is a vendor that proactively and continually strives to improve user interfaces.

The better way is immediately placing findings from usability studies into planning and development cycles.

The better way is implementing improvements across an entire client base as quickly as possible—not through years of piecemeal updates one client at a time.

The better way to continually improving usability is in the cloud.

At athenahealth, we’re already there.

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