Why EMR Companies Don’t Care About Usability

Mon, 07/08/2013 - 9:29am
David Do, M.D.

I overheard nurses praising the pilot of a new technology with the promise of improving communication, safety, and saving on healthcare spending. The innovation: two-way texting. That’s one of the many indicators that hospitals are stuck the technological stone age.

Imagine how many eyes light up when you offer providers fewer logins, autopopulating forms, and uncluttered menus. There’s an assumption that technology, in the context of healthcare, has to be bad (sometimes attributable to security and privacy). Physicians in the hospital often complain about “technology” as a whole. Outside the hospital, people are constantly evaluating the metric of EMR adoption. In reality, there’s good and bad technology, and there are good and bad EMRs.

What we in healthcare need to realize is that internet companies over the past ten years have developed processes for developing adaptive, secure, and user-friendly technologies. We love our online banking, shopping, and emailing. Meanwhile in healthcare, everyone seems resigned to using poor, outdated technologies by established vendors that have lost the incentive to innovate.

We all know EMRs are painful to use. These systems are reminiscent of software from the 90s, with inconsistent menus, obscure placement of data, and overwhelming numbers of buttons. It’s not uncommon to traverse ten menus to order a routine laboratory test, or to miss a critical note or lab value hidden in an obscure screen. This is frequently compounded by so-called decision support, frequent pop-ups that are more likely to be irrelevant than genuinely useful. If the 16 hours of training required just to start using EPIC are any indication, these EMRs are not built around their users’ needs.

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