There’s No “Easy” Button for Healthcare IT
A long-running television campaign for a national office supplies retailer features a big red button labeled “EASY”. If only it were so for physicians using hospital information systems.
The latest numbers from CMS (through February 2013) indicate 3,757 hospitals have collected Stage 1 Meaningful Use incentive dollars. That’s a significant percentage of all U.S. hospitals, and by extension an impressive number of physician users. But what has been physicians’ experience using this technology, in terms of its impact on their productivity and overall satisfaction? Survey data and anecdotal evidence suggest mixed results at best.
For example, in a recent CHIME Foundation survey of hospital CIOs, respondents most frequently identified poor physician usability as the primary obstacle to satisfaction with CPOE systems. KLAS Research just published a report about EMR system usability, which finds no major vendor has “nailed it”. And an article in Government Health IT this month reported “there were indications that as providers move into a second year of meaningful use, ‘the workflow becomes more routine, and they are performing at a slightly higher level than when they began… We see a slight increase as we move to a full year, but most is not statistically significant.’”
Only slightly higher performance? Not a statistically significant increase? This should be troubling to the healthcare industry. Surely no other industry would accept little improvement in worker performance after a year or more of hands-on experience with an automation solution. Nor would any other industry accept the net loss of productivity that physicians often report when using an electronic vs. a paper system for clinical workflows (think CPOE).
With Stage 2 and 3 adoption targets looming, the easy work is behind us. Widespread recognition that system usability is an ongoing and pervasive problem is an important first step to resolving the issue. But now we have to get serious. EMR-related applications must be designed to support physicians’ workflow, not re-invent it. Certainly fewer clicks and taps are a design imperative, as are personalized “favorites” for common orders and tools for streamlined “order set” building. Automated solutions must actually save physicians time, not merely “break even” with paper-based processes.
It can be done; in fact, it’s happening already. For instance, physicians at community hospitals where PatientKeeper CPOE has been deployed are, for the first time, actually happy to use the hospital’s software. Some are reacting (literally) with shouts of joy, which have to be seen to be believed.
There may be no “EASY” button, but hospital information systems surely can be a lot easier for physicians than they are today. They will have to be in order to achieve sustained Meaningful Use at the levels required for Stages 2 and 3.