There’s no question health information techs (HITs), especially Electronic Health Record (EHR) systems, can play a critical role in transforming the entire healthcare industry. Unfortunately, most EHRs are not only badly designed, but they also suffer from serious usability issues and usually integrate poorly with healthcare workflow.
While there’s widespread adoption of EHR systems across the healthcare spectrum, there exist huge gaps between the current state of Electronic Health Records and their optimal potential and usefulness.
Most EHRs, which are the most widely used digital platforms for healthcare, are so poorly designed that doctors are forced to hack the system to make it work. They have little or no choice but to resort to using verbal comments, handwritten notes, and other quirky ways just to convey patient information, something that a recent study says is putting patient data at risk.
According to this eye-opening study recently published in PLOS, bad EHR usability is not only posing a threat to health care quality but also increases the risk of data security breaches in an industry that’s already grappling with rising cases of cybercrime and technology security issues. When doctors and other healthcare providers work around the EHR system, the chances are good that some crucial patient information will fall through the cracks, causing lack of sync between clinical care teams.
As if that’s not bad enough, providers usually bear the biggest brunt of EHR usability problems. In fact, according to Digital Authority Partners, bad EHR user experiences is the third most common cause of physician burnout, an issue that’s currently described as a dire public health crisis.
“As physicians, we have seen how frustrating computer interfaces have crowded out engagement with patients, undermining patient encounters for both physicians and patients. We felt how long work days become still longer as physicians struggle to keep up with a soaring burden of administrative tasks,” states the team that studied physician burnout and led by Ashish K. Jha, MD, MPH at the Department of Health Policy and Management, Harvard T.H. Chan School of Public Health.
In this study, the researchers looked at how providers at a well-known teaching healthcare facility used an Epic EHR system. They focused the scope of study on the use of the EHR system during doctor’s morning rounds. Not just that, but they also surveyed doctors about how electronic health record system support their clinical workflow, as well as conduct thorough interviews with doctors and a number of other system end users.
What they discovered is that there’s a large gap in how providers use the EHR system. In specific, they found that doctors mostly used the system prior to going into a patient’s room in the morning, but rarely when in the room.
What’s even more interesting is that approximately 50 percent of interns, resident doctors, clinicians, and doctor assistants used the system once they have left the patient’s room. The other half extensively used workarounds, complaining that the EHR system does not facilitate efficiency and communication.
In their defense, most clinicians interviewed said that EHR systems have proven to be less useful than handwritten notes during their morning rounds. They further said that handwriting the notes helps them process the patient data faster and remember it better. The trouble, however, is that handwritten notes and verbally communicated patient information will likely not make it into the EHR system. This means one thing: inefficiency and communication breakdown between clinical care teams.
With that being said, a poor EHR system hurts patient care and quality in a two-prong way:
(1) It takes time away from clinicians who spend a couple of hours updating the otherwise hard-to-use EHR system. In other words, poorly designed EHRs distract doctors from delivering optimal care quality. This also means less time for patient contact.
(2) It forces doctors to adopt workarounds that will directly or indirectly affect patient care. Even worse, this can lead to increased data security breaches.
No matter how you look at it, bad EHR user experiences are always hurting the patient and the clinicians alike. It’s a lose-lose situation. So, what are the possible solutions to bad EHR usability to reduce the risk of data security breaches?
It’s clear that physician burnout translates into lower quality care and increased risk to patient data security. But then again, everyone in the healthcare industry knows that EHR systems are here to stay and that they offer immense benefits, including ready access to patient data. So, the only way forward is to spruce up their usability, efficiency, and integrate them well with clinical workflow.
Accordingly, the study recommends a set of three solutions to improve EHR user experiences:
EHR Design Overhaul: Since the root of the problem lies in the design of the electronic health record systems, it’s crucial for health tech companies to go back to the drawing board. At the minimum, they should consider significant interface improvements and design changes. After all, user-friendly health apps and websites are easy to use, especially in the patient’s’ room in real time. More importantly, EHR systems should incorporate methods of visualizing data to keep information overload at bay.
Mobile/ App Integration: EHR systems should include well-designed, visually-heavy, and easy to use mobile apps. These apps should make it easy for clinicians to access the system on the go. In addition, they should have supplementary health IT tools that will aid clinical workflow. For instance, apps with handwriting recognition tech could help doctors input patient data into the system without any hassle.
Ongoing Training: There should be training programs in place to help physicians and other care team members to learn how to better integrate EHR into their daily workflow. They should also help encourage EHR use as a means of sharing patient information between clinicians/ care team members and enhancing communication.
On top of that, the patient’s rooms should be redesigned and adjusted to better integrate with EHRs. For example, whiteboards can be installed so that EHR data can be projected and accessed in real time in the room.