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Building Usable EMRs: What About The Patient?

I think most of us reading HealthcareScene.com blogs like this one would agree that for EMRs to become more usable, the process of developing them will have to change.  Specifically, everyone seems to agree that if vendors and physicians don’t work together on usability, we’ll end up with with system after system that nobody wants.

But what about patients? Do they have a role in making sure EMRs are usable?  According to Jon Mertz, the answer is a definite yes.  As Mertz sees it, it’s not good enough for vendors and physicians to talk shop to one another — patients will have to be part of the conversation.  I think he makes a lot of sense.

Talking with EMR vendors is a good way for physicians to get more of what they want, but it’s not enough, Mertz argues, I think quite persuasively. It’s also important for physicians to ask patients want to see in an EMR, especially so given that patients will eventually have access to all of that information. “Patients add an essential perspective to how an [EMR] should be used,” Mertz writes. “It is a system to serve them and their care.”

Vendors should also be talking to patients as well as physicians, Mertz suggests. “Even though physicians, clinicians, and administrative personnel are the primary users of an EHR, their solutions benefit patients, too. Information in an EHR will be viewed and carried forward by patients, so they can provide a valuable perspective on usability.”

The final step in this cycle is to develop a patient base which actively uses EMR data and is quite willing to offer feedback on how the process is working. Specifically, they need to be capable of letting hospitals, physicians and other providers know how their access to data is working, especially if the form they’re getting in doesn’t serve their needs.

I really appreciated Mertz’s take on getting patients involved in the EMR usability process. It’s a point that doesn’t get made often enough — and will definitely need to be talked up more in the future. After all, without patients feeling comfortable with their data, the ultimate goals of Meaningful Use aren’t attainable.

November 12, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Doctor Says His EMR Offers Too Much Information

Looked at one way, the more data a doctor has, the better. After all, doctors are trained to sift effortlessly through thousands of data points and head inerringly for ones that matter most. And if that’s true, well, EMRs should be the greatest thing ever to happen to medicine.

Well…not really, according to Dr. Westby G. Fisher, who feels that floods of EMR data are actually causing big problems.

There’s so much data that we risk doctors becoming lost in it. It is entirely possible that we are in danger of not being able to find our most important clinical signals amongst the noise and clutter of all the data.

It’s not just that EMRs are set up to deliver excess information to doctors, Dr. Fisher says. It’s also that EMRs have to be the Swiss Army Knife of medicine, offering something unique for nurses, administrators, geeks, the government, legal system and more. What that means is data, data and more data, he notes.

In his view, the programmers who are rolling out EMRs and implementing Meaningful Use requirements may be brilliant, but they’re nearly clueless when it comes to understanding how doctors actually interact with patients. What happens he notes in an inarguable aside, is that as programmers respond to requirements, they pile on all kinds of junk which ruins the physicians’ user experience: “buttons, flags, optios, icons, colors, warning alerts and (if we’re lucky) text.”

What about having so-called “scribes” enter the data, logically and simply, so doctors can just review, study and diagnose?  Not much help, as all that does is move doctors a small step above being data entry clerks, Dr. Fisher says: “With such a model, aren’t we just changing our doctors from data entry to quality assurance personnel?”

Folks, some of these are arguments you’ve heard before, but I still think Dr. Fisher makes some really important points. If you too wonder whether EMRs — in their current form at least — are bad for the medical  profession, check his piece out. It’s worth a read.

March 28, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.